What drugs interact with Lexapro and Prozac?

Lexapro

All SSRIs, including Lexapro, should not be combined with drugs in the monoamine oxidase inhibitor (MAOI) class of antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl), and procarbazine (Matulane) or other drugs that inhibit monoamine oxidase such as linezolid (Zyvox) and intravenous methylene blue. Such combinations may lead to confusion, high blood pressure, high fevers, tremor or muscle rigidity, and increased activity. At least 14 days should elapse after discontinuing Lexapro before starting an MAOI. Conversely, at least 14 days should elapse after discontinuing an MAOI before starting Lexapro.

Similar reactions occur when SSRIs are combined with other drugs that increase serotonin in the brain, for example tryptophan, St. John’s wort, meperidine (Demerol), lithium (Lithobid, Eskalith), triptans (for example, sumatriptan [Imitrex, Alsuma]), and tramadol (Ultram)

Use of selective serotonin reuptake inhibitors may increase the risk of gastrointestinal bleeding in patients taking warfarin (Jantoven, Coumadin), aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and other drugs that cause bleeding.

Prozac

Taking Prozac with other drugs that make you sleepy or slow your breathing can cause dangerous side effects or death. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxant, or medicine for anxiety, depression, or seizures.

Many drugs can interact with Prozac. Tell your doctor about all your current medicines and any you start or stop using, especially:

Taking monoamine oxidase inhibitors (MAOIs) with Prozac may cause a serious (possibly fatal) drug interaction. Avoid taking MAOIs (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) during treatment with Prozac. Most MAOIs should also not be taken for 2 weeks before and at least 5 weeks after treatment with Prozac. Ask your doctor when to start or stop taking this medication.

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including other SSRIs such as citalopram/paroxetine, SNRIs such as duloxetine/venlafaxine), tryptophan, among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Many drugs besides Prozac may affect the heart rhythm (QT prolongation), including pimozide and thioridazine, among others. Aspirin can increase the risk of bleeding when used with Prozac. However, if your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually at dosages of 81 to 325 milligrams a day), you should continue taking it unless your doctor instructs you otherwise.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness including alcohol, antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and narcotic pain relievers (such as codeine).

Check the labels on all your medicines (such as allergy or cough-and-cold products), because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Are Lexapro and Prozac safe to use while pregnant or breastfeeding?

Lexapro

The safety of Lexapro during pregnancy and breastfeeding has not been established. Therefore, Lexapro should not be used during pregnancy unless, in the opinion of the doctor, the expected benefits to the patient outweigh unknown hazards to the fetus.

Lexapro is excreted in human milk. Lexapro should not be given to nursing mothers unless, in the opinion of the doctor, the expected benefits to the patient outweigh the possible hazards to the child.

Prozac

Prozac should only be used during pregnancy if the potential benefit justifies the potential risks to the fetus

Prozac is excreted in breast milk. Therefore, use of Prozac while nursing is not recommended.