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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by eric24 on October 6, 2003, at 20:23:08
I've got a really bad cold or something. I don't even have the sniffles, or a sore throat. I just cannot stop coughing, and I've got a fever and dizzyness. I hate this. The cough drops aren't cutting it.
Can I use cough syrups with an MAOI? I think I read somewhere that you can't. I'm going to a GP on Friday, but somehow I think he is not going to know the answer to this question. Thanks for the help guys,
Eric
Posted by Caleb462 on October 6, 2003, at 21:34:02
In reply to Robitussen and Parnate a no-no?, posted by eric24 on October 6, 2003, at 20:23:08
> I've got a really bad cold or something. I don't even have the sniffles, or a sore throat. I just cannot stop coughing, and I've got a fever and dizzyness. I hate this. The cough drops aren't cutting it.
>
> Can I use cough syrups with an MAOI? I think I read somewhere that you can't. I'm going to a GP on Friday, but somehow I think he is not going to know the answer to this question. Thanks for the help guys,
>
> EricNo, you should not use a cough syrup with an MAOI. Most cough remedies contain DXM, which in combination with an MAOI, can cause serotonin syndrome. Menthol cough drops are fine to use, but they don't work too well for a serious cough.
You could see about getting a small prescription for codeine from your GP, which is fine to take with Parnate, and works better than DXM anyway.
Posted by Ame Sans Vie on October 8, 2003, at 21:12:24
In reply to Robitussen and Parnate a no-no?, posted by eric24 on October 6, 2003, at 20:23:08
Caleb's got it -- avoid the DXM at all costs. And yes, you most likely should see a doctor about an opioid-based syrup (or other formulation -- doesn't have to be a syrup) if the cough is non-productive (most people want to go right for the syrups, but the truth is they don't "coat" your throat and exert any more an effect than pills, lozenges... even suppositories). That being said, a lot of prescription drug references like to try to scare you away from all opioids if you're taking an MAOI, which is ridiculous. Meperidine/pethidine, buprenorphine, and tramadol should always be avoided, but I can't think of one good reason to fear any of the other opioid based analgesics/antidiarrheals/anaesthetics/cough-suppressants while taking an MAOI. I found the Tussionex Pennkinetic cough suspension to be just great for a hacking cough I had while on Nardil a while back, as well as another pretty nasty one I caught a few months ago that DXM alone just didn't take care of. It's a combination of hydrocodone (the active narcotic in Vicodin/Vicoprofen/Norco/Zydone/Lorcet/Lortab/etc.) and chlorpheniramine maleate (a common antihistamine. Some say that MAOIs are contraindicated with antihistamines, but I have yet to see any literature that indicates this nor any first-, second-, or even third-hand stories about close-encounters with MAO inhibition plus antihistamine. I think a lot of people think "pseudoephedrine", which is a decongestant contained in a lot of antihistamines (Actifed, for example) which can be dangerous taken with MAOIs.
Only one thing I have to disagree with is codeine being more potent than DXM... as far as I can remember, DXM and codeine are equipotent cough suppressants. Though I'll concede that codeine can be a little more fun (if ya don't forget the diphenhydramine cream, and lots of it, lol).
Posted by Jane Austen on October 9, 2003, at 4:33:19
In reply to Re: Robitussen and Parnate a no-no? » eric24, posted by Ame Sans Vie on October 8, 2003, at 21:12:24
I agree that codeine is great for suppressing coughs, fevers and runny noses. And used short-term of course. I don't think pseudoephedrine works anywhere near as well as codeine. I have tried both, seperately and pseudoephedrine barely touched my cold/flu symptoms and made me nutty and wound up as well.
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