WebMD Ask the Pharmacist

Drug Interaction and Safety: Ask the Pharmacist

Macary Marciniak, PharmD, BCPS, answers your additional questions about drug interaction and safety.

Question:

Can I take sotalol 80 mg and doxycycline 100 mg at the same time? Are there any adverse reactions?

Answer:

There are no interactions between sotalol, a heart medication, and doxycycline, an antibiotic. Common side effects when taking sotalol are a slow heart rate, dizziness, lightheadedness, or fatigue. Common side effects when taking doxycycline include diarrhea and nausea. Very rarely, people may have an allergic reaction to doxycycline (or any antibiotic), so if you notice a rash or have difficulty breathing, let a health care professional know right away.

Also, it is very important to take the full course of the doxycycline to completely clear the infection and prevent antibiotic resistance (a situation where the antibiotic is not as effective as it should be for the infection).

Question:

I take a blood thinner (Coumadin) and metoprolol. Is it OK for me to take Benadryl or Theraflu?

Answer:

There should not be any concerns with taking Coumadin, metoprolol, or Benadryl. Theraflu is a nonprescription product for cough and cold, and it comes in a number of different versions. If Theraflu contains a pain reliever, it would most often be acetaminophen, which would be fine to take with Coumadin.

Be sure to read the label of any nonprescription product that you may buy. If the product contains aspirin, ibuprofen, or naproxen as the pain reliever/fever reducer, then check with a health care professional first. It is typically recommended that individuals taking Coumadin not take aspirin, ibuprofen, or naproxen to avoid a risk of bleeding. Also, Theraflu may contain an antihistamine, and Benadryl is also an antihistamine, so it would not be wise to take both of these products together.

Question:

I saw on the package of my birth control that it needs to be stored at 67-72 F, but I keep my house much colder than that. Is it ineffective now -- or less effective?

Answer:

Most medications need to be stored at room temperature, a temperature close to the range of 67-72 F. The medication should not be placed in the refrigerator or freezer. Although your house may be kept colder than 67 F, it is likely not at the same temperature as a refrigerator, which is often around 37-41 F. If stored at room temperature, your birth control should be effective.

If you have any questions, feel free to consult the manufacturer of your birth control product, who may have specific data about your product and the temperature that you keep your house.

Question:

Can you take Mucinex for cough and acetaminophen or ibuprofen for fevers? Or will that be overdosing?

Answer:

Mucinex is a nonprescription cough product and comes in a number of different versions. Currently, none of the available versions include a pain reliever/fever reducer such as acetaminophen or ibuprofen. So you would not be overdosing by taking both Mucinex plus acetaminophen or ibuprofen.

Question:

I'm taking amoxicillin 500 mg 3 times a day for an infection in my gums. I’m starting to get a cold. Can I take NyQuil with this drug?

Answer:

NyQuil is a nonprescription cough and cold product and comes in a number of different versions. There should not be any interactions between any of the NyQuil products and the amoxicillin. However, some NyQuil products may interact with other medical conditions, prescription medications, or nonprescription medications you may be using.

Question:

Can OxyContin and Flexeril be taken together?

Answer:

OxyContin is a prescription pain reliever and Flexeril is a prescription muscle relaxant. Both products work differently and may be used in combination to treat muscle pain. When taking these medications together, you may notice more dizziness or drowsiness.

Question:

Are there any interactions with metoprolol and Prevacid?

Answer:

There are no interactions between metoprolol and Prevacid.

Question:

Can I take Dramamine and Zantac at the same time?

Answer:

There are no interactions between Dramamine and Zantac.

Question:

Can Vicodin be taken with methotrexate and prednisone?

Answer:

There are no interactions between Vicodin, methotrexate, and prednisone.

Question:

Can I take diphenhydramine and guaifenesin at the same time? Will it help get rid of mucus in the ears and head faster than just one?

Answer:

Diphenhydramine is an antihistamine, and helps to relieve symptoms like allergies or a runny nose. Guaifenesin is a cough expectorant and can help to clear mucus in your head and chest. Probably, the best choice for the symptoms you describe is the guaifenesin alone. While you can take both products together, this will not get rid of the mucus any faster.

Drinking water will help to clear out mucus. You should always take the guaifenesin with lots of water. If you take diphenhydramine in addition, that may also make you thirsty.

Question:

I am taking Zoloft, and I am taking Claritin D. What could happen?

Answer:

There are no interactions between Zoloft and Claritin D.

Question:

Can you take NyQuil Cold & Flu over-the-counter medicine while taking prescribed Tamiflu?

Answer:

There are no interactions between NyQuil and Tamiflu.

Question:

Is it OK to take Lexapro and Seroquel?

Answer:

Lexapro and Seroquel are prescription medications often used to treat mood disorders. Taking these two medications together may increase the chance of a life-threatening heart arrhythmia. You should talk with your health care provider to ensure that he/she is comfortable with you taking both of these medications together.

Question:

Can you take Viagra while taking warfarin?

Answer:

There are no interactions between Viagra and warfarin.

Question:

Is it OK to take guaifenesin when you are taking Singulair?

Answer:

There are no interactions between guaifenesin and Singulair.

Question:

Can you take Nexium and Zyrtec together?

Answer:

There are no interactions between Nexium and Zyrtec.

Question:

Can I take Alka-Seltzer Plus Night Cold Formula if I am on methotrexate and Humira?

Answer:

There are multiple versions of Alka-Seltzer products on the market. Some of these versions do contain aspirin. Aspirin may increase the risk of bleeding for someone taking methotrexate. The short-term use of a product like Alka-Seltzer may not be a problem, but there may be alternative medications for your cough and cold symptoms that may be just as effective, but safer for the medications that you are taking.

Question:

I am prescribed Adderall and methadone. Is this OK?

Answer:

Adderall is a prescription medication used to treat attention deficit disorder, and methadone is a prescription medication used to treat pain. It is possible that taking these medications together may cause someone to feel a little more drowsy or sedated. I would watch out for that, but it should be fine to take both of these medications together.

Question:

Can I take a Celebrex and ibuprofen together?

Answer:

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) and Celebrex is a specific type of NSAID called a Cox-2 inhibitor. A person would be on one of these medications, but not both at the same time. Celebrex would be preferred for someone who has had an ulcer or may be at risk of developing an ulcer.

Question:

Can you drink a non-alcoholic beer if you are taking a narcotic-like drug for arthritis pain?

Answer:

Non-alcoholic beers contain small amounts of alcohol. Individuals taking narcotic-like drugs for pain should avoid drinking alcohol. A non-alcoholic beer would be preferred to an alcoholic beer, but recognize that there is still some alcohol present. Drinking alcohol with narcotic-like medications can increase the risk of drowsiness.

Question:

Is it safe to take lorazepam and fluoxetine for anxiety and depression?

Answer:

Lorazepam and fluoxetine may be used in combination to treat anxiety and depression. To determine if both of these medications are truly safe, it would be helpful to know the other medical conditions or medications that a person is taking. In this way, we can ensure that these are the best choices to treat these symptoms or if there may be any interactions with other conditions or medications someone is taking.

Question:

If I have been taking levothyroxine 75 mcg and the pharmacy gave me Levothroid 75 mcg. Are these two drugs the same thing, like they told me? Could the change cause severe joint pain as a side effect?

Answer:

Levothroid is a brand-name medication and levothyroxine is the generic counterpart. Thyroid medications need to be monitored very closely. If changes are made to your thyroid medication, then you should have laboratory monitoring conducted to be sure your thyroid levels are appropriate. This monitoring should occur if you change brands or switch from brand to generic.

Typically, your health care provider would monitor your thyroid (TSH) levels within 6 weeks of the change. If medications are being changed, you should monitor for any new signs or symptoms. Joint pain, however, is not a common side effect of Levothroid or levothyroxine.

Question:

Can I take Benadryl and Sudafed together?

Answer:

Benadryl is an antihistamine and Sudafed is a decongestant. Both medications can be used together to treat symptoms of the common cold or allergy.

Question:

Can you take naproxen with ibuprofen?

Answer:

Naproxen and ibuprofen are both nonsteroidal anti-inflammatory drugs (NSAIDs). A person would be on one of these medications, but not both at the same time.

Question:

Can I take Coumadin and prednisone?

Answer:

A person taking both Coumadin and prednisone may be at increased risk for bleeding. You should ensure that all your health care providers, particularly those monitoring your Coumadin, are aware that you are on both of these medications. If the prednisone is necessary, your health care provider(s) may monitor your Coumadin and INR levels more frequently. Your INR level may change 3 to 10 days after starting the prednisone.

You should also look out for signs of increased bleeding, such as unusual bruising or blood in your urine or stool. If you notice any of these signs, please contact your health care provider(s) immediately.

Question:

I have been taking Zoloft now for 3 months. The doctor has just increased the dose to 200 mg each day. The doctor has also prescribed Remeron 30 mg. Is taking both together safe?

Answer:

Zoloft and Remeron may be used to treat mood disorders. When taking both products together, there is a chance that levels of serotonin may be increased in your body. Your health care provider(s) may want to monitor you for signs of increased levels, such as agitation, diarrhea, fever, or tremor.

Question:

Can I take Mucinex DM with a Z-Pak?

Answer:

Mucinex DM is a nonprescription product that contains guaifenesin, an expectorant, and dextromethorphan, a cough suppressant. A Z-Pak is a prescription antibiotic used to treat infections. There are no interactions between Mucinex DM and a Z-Pak.

Question:

I am currently on the Depo-Provera shot. I was recently placed on naproxen to reduce swelling in my knee. Do these two drugs interact with each other?

Answer:

There are no interactions between Depo-Provera and naproxen.

Question:

I am currently taking Zonegran for seizures. Is OK to take a medicine called clarithromycin for a sinus infection?

Answer:

It is possible that clarithromycin may decrease the metabolism of the Zonegran, leading to increased concentrations of the Zonegran in your body. You may want to talk with your health care provider(s) to ensure that they are comfortable with you taking these medications together. Clarithromycin might be the best treatment for short-term treatment of your sinus infection. But there may be other antibiotics that would be safer alternatives -- and just as effective for your sinus infection.

Question:

Can you take an antacid for indigestion and heartburn with Plavix?

Answer:

You should not have any problems taking an antacid for indigestion or heartburn along with Plavix.

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