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lallieth

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Is it a safe to take most OTC meds for cold,or are there interactions that I should be aware of...I also take ativan now and again and want to be sure that any cold medication doesnt cause an adverse reaction
 

David Baxter

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Re: SSRI"S & Cold Medications

Steve (TSOW) may have something to add here, but it shouldn't be a problem, as far as I know. If one of your medications makes you drowsy and you also have that reaction to cold medicines, the combination may make you more drowsy.

I usually advise trying new combinations on a weekend at a time you don't have to drive anywhere.
 

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re: SSRI's & Cold Medications

Is it a safe to take most OTC meds for cold,or are there interactions

The short answer is, it depends. The determining factor is the metabolic pathway of the medication in question.

Some components of cough and cold (OTC) preparations use the same metabolic pathway as some medications.

What's important to understand is that not all medications within a given class of meds use that pathway ( specifically the cytochrome P450 pathway ). So one cannot generalize that all SSRI's can or cannot be used safely with cough and cold preparations.

The same interaction can occur with other prescription medications, interacting with each other or other over the counter preparations.

Please read through the "Sticky" postings in the Medications Interactions Section of the Forum for a good understanding of drug/drug interactions, the Cytochrome P450 issue and some good online interaction checkers which will report on any potential interactions.

Ativan (lorazepam) does not use the Cytochrome P450 metabolic pathway and can safely be taken with appropriately prescribed medication without this concern.

I usually advise trying new combinations on a weekend at a time you don't have to drive anywhere.

Good advice, and if one stays at home during that weekend the same caution would apply to operating dangerous machinery.
 

lallieth

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re: SSRI's & Cold Medications

Ok thanks,but am I right to assume that any liquid medication that contains alcohol will of course interact with the ativan,increasing drowsiness etc..
 

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re: SSRI's & Cold Medications

am I right to assume that any liquid medication that contains alcohol will of course interact with the ativan,increasing drowsiness etc

Yes, benzodiazepines [DEF]potentiate[/DEF] alcohol, thereby increasing the effects of the alcohol beyond what they would be if the same amount of alcohol were taken alone.
 

lallieth

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re: SSRI's & Cold Medications

I had a talk with my pharmacist today and he assured me that most medications can be taken during a cold,if only for a short time,he advised against long term use,and told me to gauge my reaction to a certain cold remedy that contained alcohol or pseudoephedrine.
 

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re: SSRI's & Cold Medications

my pharmacist today and he assured me that most medications can be taken during a cold

I would respectfully vigorously disagree. I find the response to be overly simplistic and cavalier on behalf of your pharmacist, assuming you were in fact speaking with a licenses pharmacist and not a pharmacy lab technician.

There are important and potentially serious drug /drug interactions with each of the ingredients of a cough and cold preparation and many prescription medications.

In order to satisfy your curiosity, use one of the interaction checkers we have listed HERE

We have talked about the cytochrome P 450 issue in the past and is an issue that cannot be disregarded when using over the counter preparations with prescription medications.

I won't characterize the response from your pharmacy on this question, but for your own intellectual satisfaction and your "continuing medical education" would encourage you to read through all the "Sticky" postings in our Medication Interactions Section.

There you will get a comprehensive yet scientific explanation of the cytochrome P450 liver enzyme and how it is responsible for drug / drug interactions.

Bottom line: if you take an OTC or Rx preparation which uses the same metabolic pathway as an important Rx medication you are currently taking, one of two potential clinical results can occur:

1) the medication you are taking loses its clinical effectiveness
2) the blood levels of the medication you are taking are increased, because the metabolites are not being cleared. Result: unexpected adverse effects and in some cases concerns about toxicity.
 

David Baxter

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re: SSRI's & Cold Medications

In defense of the pharmacist, Steve, I would note that s/he did recommend against long-term use and caution for OTC medications containing alcohol or pseudoephedrine.
 

braveheart

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re: SSRI's & Cold Medications

From my understanding from what I've read, I cannot take cold and flu remedies [in the UK = daynurse etc] with mirtazapine - a NASSA.
Instead I take ibuprofen.
 

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re: SSRI's & Cold Medications

I would note that s/he did recommend against long-term use and caution for OTC medications containing alcohol or pseudoephedrine

Perhaps I went into a fire, aim, ready mode. :eek:

I cannot take cold and flu remedies [in the UK = daynurse etc] with mirtazapine

Braveheart,

What is the interaction reported to be in this case?
 

braveheart

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re: SSRI's & Cold Medications

I think it's because of the ant-histamine effect? I forget where I read it now..
 

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re: SSRI's & Cold Medications

medicinenet.com mirtazapine article

I think it's because of the ant-histamine effect?

You are quite right, that because this medication acts in the same way as some anti-histamines, the use of anti-histamines such as Benadryl, Atarax and Vistaril should not be used while taking mirtazapine.

You may be interested in the medicine-net article to which I included a link for more information about Remeron ( mirtazapine ).
 

Emily

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re: SSRI's & Cold Medications

I know this thread is old, but I am trying to find out if I can take ephedrine while I am on an SSRI (Cipralex or Lexapro in USA). There are cautions against mixing ephedrine and other antidepressants (MAOIs, barbituates, tricyclics) and things like St Johns' Wort because of the risk of SS, and here you say to be careful with pseudoephedrine but I want to know the specific risks of mixing the two. If someone could fill the gap for me I would appreciate it.
 

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re: SSRI's & Cold Medications

Emily,

If your concern is with Escitalopram and cold medications, then the concern would be with preparations containing the cough suppressant dextromethorphan, for the reasons you stated.
 

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