Can I take Dextromethorphan cough medicines and Sertraline together?

You should speak to your doctor or pharmacist before taking dextromethorphan cough medicine and sertraline together. Combining them can increase the risk of serotonin syndrome.

Why this happens

Sertraline is an SSRI antidepressant that increases serotonin levels. Dextromethorphan cough medicines also slightly increases serotonin. When combined, they can raise serotonin to unsafe levels.

Both medicines can also have a calming effect on the central nervous system, which may lead to increased sleepiness.

How to know if you're having a drug interaction

You may be experiencing an interaction between dextromethorphan and sertraline if you:

• Feel agitated, restless, or confused.

• Have a rapid heartbeat or high blood pressure.

• Are sweating heavily, are shivering, or have a fever.

• Have muscle twitches, stiffness, or a tremor.

• Feel dizzy or drowsy.

• Have a high temperature (fever).

What you should do

If you develop any of the above symptoms, you should:

• Stop taking dextromethorphan and seek urgent medical advice.

• Do not take any further doses of dextromethorphan until you have spoken to a healthcare professional.

• Tell the healthcare professional that you are taking sertraline. They may suggest a different type of cough medicine that does not contain dextromethorphan (such as a simple linctus or a medicine containing only guaifenesin).

Important precautions

Depression and anxiety disorders

You may experience an increase in suicidal thoughts or the urge to self-harm when first starting sertraline or changing the dose. This is more common in young adults under 25. Contact your doctor or go to hospital immediately if you notice any changes in your mood or behaviour.

Bipolar disorder or history of mania

Sertraline can trigger a manic episode (extreme high mood and overactivity) in people with undiagnosed bipolar disorder.

Bleeding disorders or use of blood thinners

Sertraline can increase your risk of serious bleeding, especially if you are also taking aspirin, ibuprofen, or blood-thinning medications like warfarin.

Serotonin syndrome

Check with a pharmacist before using cough suppressants with sertraline, as the combination can cause a life-threatening reaction called serotonin syndrome.

Food and drink warnings

Alcohol

You should avoid drinking alcohol while taking these medicines. Both sertraline and dextromethorphan can cause drowsiness and dizziness; alcohol will significantly increase these effects, making you feel more sleepy and less alert.

Grapefruit juice

Avoid consuming large amounts of grapefruit juice. Grapefruit can increase the levels of sertraline in your blood, which may increase the risk of side effects.

Caffeine (Coffee, Tea, Energy Drinks)

Sertraline can sometimes cause nervousness or tremors. Consuming high amounts of caffeine may worsen these side effects or increase feelings of anxiety. It is advisable to monitor your caffeine intake.

Using other medicines

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.