Lexapro and tylenol (Is it safe to use these two together?)

In this blog, we are going to talk about the concomitant use of lexapro and tylenol. Lexapro is an antidepressant, whereas tylenol is a pain killer, most commonly known as Paracetamol. 

Analgesics are often considered dangerous to use with antidepressants. This blog will cover if it’s okay to take tylenol with lexapro and how much is too much. 

Can you take lexapro and tylenol together? 

Yes, you can take lexapro and tylenol together. In fact, tylenol is considered the safest painkiller to use when you’re being treated with lexapro. 

It is important to mention here that the safety of concomitant use of antidepressants and painkillers is variable, no matter how safe the analgesic is.

The effects of drugs on the body depend on various factors. If we only talk about lexapro, it has variable effects on people. 

Some people tolerate it pretty easily and take much less time to adjust to it, as compared to other people who could take up to 2 months to adjust to lexapro. Such people also suffer from side effects which last for more than a month. 

Then there are some people who can’t even tolerate lexapro in the first place and start showing signs of allergic reactions, including redness of skin, rash, itching, burning sensation, blisters, chest tightening, difficulty in breathing etc.

Similarly, the body’s reaction to the combined use of meds can also vary from person to person. It is extremely hard to predict the possible interactions between medicines. 

Researchers are studying the effects and safety of tylenol with the use of lexapro and other selective serotonin reuptake inhibitors (SSRIs). However, one study suggests that you can never be sure about the safety of one drug when used in combination with the other. 

It is a difficult task to consider any painkiller safe with the use of antidepressant. Another study researched on the concomitant use of tylenol and SSRIs and observed the increased mortality rate over prolonged use. 

Make sure you don’t take too much for it. As long as you stay to lower doses, things will be just fine for you. Some people have a troubled mindset and they think that if they double the dose of the drug, they’ll achieve twice the therapeutic response. 

That’s not true. Meds are not something to fool around with. No person takes them in a healthy state, so obviously it is not something that should be a part of your normal life. Higher doses will not give twice the beneficial effect, but cause twice the side effects, for sure. 

Tylenol, most commonly known as paracetamol, is considered pretty safe, but even this drug can make a negative impact on your liver if consumed in higher doses. 

Side by side comparison of side effects 

Tylenol	Lexapro
Gastrointestinal side effects, including nausea, vomiting or diarrhoea. Abdominal pain Skin rashGrey-brown stoolItching Dark colored urineHeadache Dizziness Allergic reactions, including breathlessness, blistered skin, hoarseness, tightness of chest etc.	Loss of appetite Constipation or diarrhoeaSexual issuesDifficulty in falling asleepVertigo Decreased salivation or dry mouthSweatingAnxiety NauseaShakingWeaknessSleepiness and fatigueWeight gain

These drugs can cause serious side effects as well. Tylenol, when used in higher amounts, can cause liver damage which might disturb the levels of liver enzymes and cause jaundice associated with yellow eyes, skin and urine, abdominal pain, fever, pale stools etc. 

Lexapro, on the other hand, can also produce serious side effects, which include:

• Angle-closure glaucoma causes symptoms like eye pain, vision changes, or swelling or redness in your eyes.
• It could cause low sodium levels which can result in psychological symptoms like confusion, agitation, inability to understand surroundings, memory loss etc.
• It can cause elongation of QT interval, causing increased heartbeat or arrhythmia
• Teeth grinding
• It may also put you at an increased risk for dangerous bleeding, especially when taken with medications such as nonsteroidal anti-inflammatories (NSAIDs), warfarin (an anticoagulant medication), or other anticoagulants. 

Ensure the proper use of medications

It is extremely important to ensure that you’re using your meds exactly as you should. Ask your doctor if lexapro is the right choice of antidepressant for you. Stick to your doctor’s recommended dose. Do not take more or less than that. 

It’s always beneficial to be on the safer side. Ask your doctor before taking tylenol and lexapro together if you’re pregnant, trying to conceive or if you’re a breastfeeding mother. Make sure you don’t use lexapro with the following medications:

• Monoaminoxidase inhibitors (MAOIs). The combination use can increase the risk of serotonin syndrome. 
• Non-steroidal anti-inflammatory drugs (NSAIDS). The combination use can increase the risk of bleeding. 
• Pimozide. The concomitant use can increase the plasma concentration(availability of a drug in the blood) of pimozide to much higher levels. It can result in life-threatening arrhythmia.
• Controlled substances, including all narcotic 
• Analgesics. The concomitant use can cause severe psychological side effects. 
• Mood stabilisers 

Lexapro usually does not interact with foods and drinks, except alcohol. Alcohol can dull down your brain and exacerbate your depression symptoms. 

You might suffer from suicidal thoughts. Alcohol and lexapro together can make this effect much more pronounced and could become life threatening. 

Make sure you avoid taking too much lexapro. Overdose can seriously harm you and make you go through symptoms of serotonin syndrome. It is a condition that occurs when the amounts of serotonin get dangerously high. 

The excess serotonergic activity can make you behave abnormally and include other symptoms like:

• Fever with chills. 
• Excessive sweating 
• Restlessness and fatigue
• Headache, which often feels like your head is pounding
• Changes in blood pressure and/or temperature
• Nausea
• Vomiting
• Diarrhoea
• Bradycardia
• Tremors
• Muscle twitching and muscle pain
• Shivering and goosebumps

To avoid overdose, take your medication only once per day. If you’re not sure whether you have taken your lexapro or not and it’s way past the usual time at which you take your med, just let it go and look forward to taking the next dose on time. 

If you have missed a dose, take it as soon as you remember, but if a lot of time has passed and your next dose is near, do not take it. It’s better to skip the missed dose and take the next one.

When to call your doctor 

Reach out to your healthcare provider, if you:

• Experience unbearable pain in your stomach after taking tylenol and lexapro together. 
• Feel agitation, excessive sweating, hyperventilation, skin redness, itching, burning sensation or any other sign of allergic reaction
• Have taken too much lexapro or tylenol 
• Get confused or nervous
• Notice your eyes and skin being pale or dark yellow urine
• Feel suicidal
• Find it difficult to have an erection (for males) 
• Can not sleep multiple nights in a row

Make sure you monitor your side effects and inform your healthcare provider before your side effects become worse. 

Conclusion

In this blog, we have discussed the possible interactions between tylenol and lexapro. Tylenol is a painkiller, which is also known as paracetamol. It is considered the safest painkiller, especially when compared to NSAIDs. 

Lexapro, on the other hand, is an antidepressant which belongs to the class of selective serotonin reuptake inhibitors (SSRIs). These meds have to be taken daily for several months for sufficient therapeutic response. 

During this time period, it is safe to use tylenol as a painkiller or antipyretic, but make sure you don’t take too much. High doses are more capable of producing side effects and interacting with other medications.

Make sure you ask your doctor what kinds of medications you can take while taking lexapro, including over-the-counter drugs. Proper use of drugs can help you prevent unwanted effects. 

FAQs: Lexapro and tylenol

What pain reliever can I take with Lexapro?

You can take paracetamol with lexapro. Make sure you don’t take too much. 

Can I take Tylenol while on antidepressants?

Yes, you can take tylenol, but it’s better to take it if absolutely necessary. It’s better to avoid analgesics while being on antidepressants. Few studies suggest that higher doses of tylenol with antidepressants can cause serious damage. 

What can you not mix with Lexapro?

Do not mix following medications with lexapro:

• Monoaminoxidase inhibitors (MAOIs). The combination use can increase the risk of serotonin syndrome. 
• Non-steroidal anti-inflammatory drugs (NSAIDS). The combination use can increase the risk of bleeding. 
• Pimozide. The concomitant use can increase the plasma concentration(availability of a drug in the blood) of pimozide to much higher levels. It can result in life-threatening arrhythmia.
• Controlled substances, including all narcotic 
• Analgesics. The concomitant use can cause severe psychological side effects. 
• Mood stabilisers 
• Alcohol 

Should I take 10mg or 20mg of Lexapro?

The recommended dose of lexapro is 10mg, once a day. Your healthcare professional suggests an appropriate dose for you, based on your symptoms and tolerability. Do not start, switch or stop antidepressants without your doctor’s approval. 

Is it better to take Lexapro in the morning or at night?

It depends on what kinds of side effects you’re going through. 

• If it causes insomnia, morning is preferred.
• If it causes drowsiness, night time is preferred.
• If it causes nausea, night time is preferred.
• If it causes urinary problems, morning is preferred.
• If it causes loss of libido, morning is preferred.
• If it causes loss of appetite, bedtime is preferred. 

What happens if you take ibuprofen with Lexapro?

Ibuprofen is a non-steroidal anti-inflammatory drug. It is contraindicated to use with SSRIs, including lexapro, and if it is extremely important to use, these meds should be used with caution as they can increase the risk of bleeding. 

These meds can also cause disturbing gastrointestinal side effects including abdominal pain, internal GIT bleeding, nausea, vomiting and diarrhoea. 

References 

• Ole Köhler et al. Brain Behav. (2015) – Inflammation and depression: combined use of selective serotonin reuptake inhibitors and NSAIDs or paracetamol and psychiatric outcomes https://pubmed.ncbi.nlm.nih.gov/26357585/ 
• Caution: Popular painkillers may interfere with antidepressants, from the Harvard Mental Health Letter https://www.health.harvard.edu/press_releases/caution-popular-painkillers-may-interfere-with-antidepressants
• Should I avoid certain foods while taking ESCITALOPRAM OXALATE? https://www.webmd.com/drugs/2/drug-63989/escitalopram-oxalate-oral/details/list-interaction-food
• William M. Lee, MD (2017) – Public Health: Acetaminophen (APAP) Hepatotoxicity—Isn’t It Time for APAP to Go Away? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5696016/#__ffn_sectitle
• Gerriets V, Anderson J, Nappe (2021) Acetaminophen https://www.ncbi.nlm.nih.gov/books/NBK482369/#_NBK482369_pubdet_ 
• Escitalopram (Oral Route) https://www.mayoclinic.org/drugs-supplements/escitalopram-oral-route/proper-use/drg-20063707?p=1
• Connie Sanchez, Elin H. Reines and Stuart A. Montgomery (2014) – A comparative review of escitalopram, paroxetine, and sertraline: are they all alike? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047306/ 
• Andrea Cipriani, Claudio Santilli, Toshi A Furukawa,  Alessandra Signoretti, Atsuo Nakagawa (2009) -Escitalopram versus other antidepressive agents for depression https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164382/#:~:text=The%20most%20commonly%20observed%20adverse,sweating%2C%20fatigue%2C%20and%20somnolence.