Mucinex (guaifenesin) interactions to avoid

In this article:

• Mucinex drug interactions
• How to minimize Mucinex interactions
• When to talk to a doctor

In this article

• Mucinex drug interactions
• How to minimize Mucinex interactions
• When to talk to a doctor

Mucinex is the brand name for guaifenesin, which is a cough expectorant that works by loosening mucus in your chest so it can more easily be cleared or coughed out. Mucinex is also the brand name of a family of medications that treat cold symptoms, coughs, the flu, and allergy symptoms.

In addition to Mucinex products containing only guaifenesin, some of the most commonly used Mucinex combination products include Mucinex D and Mucinex DM. Mucinex D is an expectorant and nasal decongestant that combines guaifenesin and pseudoephedrine. Mucinex DM combines guaifenesin with dextromethorphan, a cough suppressant.

Mucinex products containing only guaifenesin do not have any known drug or other interactions, but combination Mucinex products—including Mucinex D and Mucinex DM—may interact poorly with certain medications or substances. If you are taking any Mucinex product, you should read labels carefully so that you understand what the product contains and so that you can be aware of any potential interactions.

Mucinex drug interactions

When taken as guaifenesin alone, Mucinex has a relatively low risk of any concerning interactions with other drugs, says John Abroon, MD, a board-certified internist and primary care physician in New York City. “The challenge comes from multi-symptom products where it’s paired with dextromethorphan or pseudoephedrine,” he says. 

Here’s what to know about some of these combination Mucinex interactions. 

Mucinex type	Drug class or group name	Example drug names	Interactions/side effects
Mucinex D (guaifenesin and pseudoephedrine)	Monoamine oxidase inhibitors (MAOI)	Marplan (Isocarboxazid) Emsam (Selegiline) Nardil (Phenelzine) Parnate (Tranylcypromine)	Elevated heart rate and blood pressure
Mucinex DM (guaifenesin and dextromethorphan)	Monoamine oxidase inhibitors (MAOI)	Marplan (Isocarboxazid) Emsam (Selegiline)  Nardil (Phenelzine) Parnate (Tranylcypromine)	Serotonin syndrome
Mucinex DM (guaifenesin and dextromethorphan)	Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs)	Zoloft (sertraline) Prozac (fluoxetine) Cymbalta (duloxetine) Effexor (venlafaxine) Anafranil (clomipramine)	Serotonin syndrome
Mucinex DM (guaifenesin and dextromethorphan)	Respiratory suppressants like benzodiazepines and opioids	Xanax (alprazolam) Klonopin (clonazepam) Vicodin (hydrocodone) OxyContin (oxycodone) Codeine	Sedation, confusion, dizziness

Other drug interactions: 

• Cyclobenzaprine

• Tramadol

• Trazodone 

Mucinex D and monoamine oxidase inhibitors (MAOI)

Mucinex D contains both guaifenesin and pseudoephedrine. According to DailyMed at the NIH, Mucinex D should not be combined with a monoamine oxidase inhibitor (MAOI). MAOIs are drugs used to treat psychiatric conditions and Parkinson’s disease. Combining any drug containing pseudoephedrine with an MAOI can elevate your heart rate and cause high blood pressure.

Mucinex DM and monoamine oxidase inhibitors (MAOI)

DailyMed also warns against combining Mucinex DM—which contains both guaifenesin and dextromethorphan—with MAOIs. The reason for this is that combining any medication containing dextromethorphan with MAOIs raises your risk of serotonin syndrome, which is when too much serotonin builds up in your body from taking medications that raise your serotonin levels. Serotonin syndrome can cause agitation, muscle tremors, disorientation, increased heart rate, and can be potentially life threatening. 

Mucinex DM and SSRIs, SNRIs, and TCAs

At times, combining Mucinex DM with SSRIs, SNRIs, and TCAs can be problematic in the same way that combining Mucinex DM with MAOIs can be. “Dextromethorphan can raise serotonin levels, so combining it with MAO inhibitors or other serotonergic drugs increases the risk of serotonin syndrome,” Dr. Abroon says. “Agitation, tremor, and high blood pressure are red flags.”

Mucinex DM and respiratory suppressants

According to StatPearls at the National Library of Medicine, combining Mucinex DM (dextromethorphan/guaifenesin) with any medication that causes respiratory depression can be risky. Examples of medications to be cautious with include opioids and benzodiazepines. Alcohol is also a respiratory depressant, so take precautions while on Mucinex DM. Concerning symptoms include sedation, confusion, and dizziness.

Mucinex food interactions

There aren’t any specific foods or non-alcoholic beverages you need to stay away from when you take Mucinex, Mucinex D, or Mucinex DM. There are also no interactions between these medications and grapefruit. “Grapefruit, which often interferes with drug metabolism, doesn’t pose a concern with guaifenesin,” Dr. Abroon says.

Mucinex and alcohol

Mucinex DM (dextromethorphan/guaifenesin) shouldn’t be combined with respiratory depressants like alcohol. “Mixing alcohol with dextromethorphan can make side effects like dizziness and drowsiness worse, making it harder to think clearly and move around,” explains Menachem Jacobs, MD, co-founder of Outlive Biology and a resident physician at Yale New Haven Hospital. “You should limit or avoid alcohol because it can make side effects more likely and may make the medication less effective.”

Mucinex and caffeine

Caffeine, whether in coffee, tea, energy drinks or other products, can cause negative side effects when combined with medications containing pseudoephedrine. As such, you should be cautious when combining Mucinex D with caffeine. “Taking caffeine and pseudoephedrine together can make side effects like anxiety, a fast heartbeat, and trouble sleeping more likely,” Dr. Jacobs warns.

How to minimize Mucinex interactions

Again, if you are taking Mucinex products containing only guaifenesin, you likely don’t need to change your behavior, as there are no known medications that should be avoided. The same goes for foods or other substances that interact poorly with guaifenesin.

However, if you are taking Mucinex D or Mucinex DM, consider the other medications you are currently taking. This doesn’t necessarily mean that you can’t take the medication altogether, but you may need to be cautious with dosing and timing. Contact your healthcare provider or pharmacist for medical advice if you are taking medications like MAOIs, SSRIs, SNRIs, or respiratory depressants.

According to Dr. Jacobs, if you are taking Mucinex D or DM with other medications, you should be aware of potential unusual symptoms, such as an irregular heartbeat, trouble breathing, or changes in blood pressure. “If there is a known interaction, the drug combination may need to be completely avoided to avoid bad effects,” he advises. “Changing the dose by itself may not be enough to lower the risks that come with these interactions.”

If you are unable to take Mucinex D or Mucinex DM, there are many over-the-counter alternatives to consider, according to Dr. Jacobs. Saline nasal sprays, steam inhalation, and drinking more water can help with coughing and chest congestion. You may also be able to take an alternative cold medicine or cold product that doesn’t cause serious side effects when combined with other medications you are taking.

“Depending on each person’s health needs and preferences, these options may be good for them,” he says. “A healthcare professional can help you find the best option for you.”

When to talk to a healthcare provider about Mucinex interactions 

MAOIs, SSRIs, SNRIs, and respiratory depressants are just some of the medications that can be problematic when combined with Mucinex D or Mucinex DM. Mucinex products may interact with other medications, vitamins, or supplements.

Each of us is unique, and it’s essential to stay in contact with your healthcare provider when starting a new medication. In particular, you should also contact your healthcare provider if you are pregnant, nursing, elderly, or have underlying health conditions.