Lexapro (escitalopram) is a brand-name drug prescribed for anxiety and depression. Lexapro has interactions with medications and some supplements. Examples include Adderall and certain opioids.

Doctors prescribe Lexapro for major depressive disorder (also known as depression) in adults and certain children ages 12 years and older. They also prescribe it for generalized anxiety disorder in adults and certain children ages 7 years and older.

An interaction occurs when one substance causes another substance to have a different effect than expected.

Lexapro comes as a table that you swallow. It used to come as an oral liquid suspension, but this form has been discontinued.

To learn more about Lexapro’s interactions, keep reading. For additional information about Lexapro, including details about its uses, see this article.

Sometimes, factors or conditions could prevent your doctor from prescribing Lexapro due to the risk of harm. These are known as contraindications. The contraindications of Lexapro include:

Taking a monoamine oxidase inhibitor

Doctors typically will not prescribe Lexapro in combination with a type of antidepressant called a monoamine oxidase inhibitor (MAOI).

This is because taking Lexapro with an MAOI can increase your risk of serotonin syndrome. With this syndrome, your body has a high level of a brain chemical called serotonin. This can cause symptoms such as blood pressure changes, excessive sweating, and diarrhea, nausea, or vomiting. Serotonin syndrome can be life threatening for some people. For more information about the side effects of Lexapro, see this article.

Below are a few examples of MAOIs that can interact with Lexapro:

  • methylene blue (ProvayBlue)
  • linezolid (Zyvox)
  • phenelzine (Nardil)
  • selegiline (Emsam)
  • isocarboxazid (Marplan)

Before you start treatment with Lexapro, it’s important to tell your doctor if you take an MAOI. They’ll likely have you stop taking the MAOI and wait at least 2 weeks before starting treatment with Lexapro. Likewise, after you stop Lexapro, your doctor will typically have you wait at least 2 weeks before starting treatment with an MAOI.

Taking pimozide

Doctors typically will not prescribe Lexapro in combination with pimozide. This is an antipsychotic drug used to treat Tourette syndrome.

Taking Lexapro with pimozide could increase your risk of serious side effects from either drug. Specifically, you may have a higher risk of heart problems, including irregular heart rhythm.

If you take pimozide, talk with your doctor before starting Lexapro treatment. They can recommend a different treatment option for your condition.

Having had an allergic reaction to Lexapro or any of its ingredients

If you have had an allergic reaction to Lexapro or any of its ingredients, your doctor will likely not prescribe Lexapro. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Lexapro, it’s important to tell your doctor if these contraindications apply. They can determine whether to prescribe Lexapro.

There’s no known interaction between Lexapro and alcohol.

However, the manufacturer of Lexapro recommends that you avoid consuming alcohol while taking this drug. This is because alcohol can worsen certain side effects of Lexapro, such as sleepiness. (For information about the side effects of Lexapro, see this article.)

In addition, drinking alcohol can worsen symptoms of anxiety and depression, which Lexapro is approved to treat.

If you have questions about Lexapro and alcohol, talk with your doctor or pharmacist. You can also refer to this article on mixing Lexapro and alcohol.

Before you start treatment with Lexapro, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Lexapro interacts with supplements, herbs, or vitamins, see the “Lexapro and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Lexapro. Keep in mind that this table doesn’t include all drugs that may interact with Lexapro. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Drug class or drug nameDrug examplesInteraction result with Lexapro
MAOIs*• methylene blue (ProvayBlue)
• linezolid (Zyvox)
• phenelzine (Nardil)
• selegiline (Emsam)
• isocarboxazid (Marplan)
can increase the risk of side effects from Lexapro† and MAOIs
antipsychotics• pimozide*
• olanzapine (Zyprexa, Zyprexa Zydis, others)
• aripiprazole (Abilify, Abilify Maintena, others)
can increase the risk of side effects from Lexapro† and antipsychotics
triptanssumatriptan (Imitrex, Tosymra)
• zolmitriptan (Zomig)
• eletriptan (Relpax)
can increase the risk of side effects from Lexapro† and triptans
amphetamines• dextroamphetamine (Dexedrine, Xelstrym)
methamphetamine (Desoxyn)
• amphetamine/ dextroamphetamine (Adderall, Adderall XR, Mydayis)
can increase the risk of side effects from Lexapro† and amphetamines
nonsteroidal anti-inflammatory drugs (NSAIDs)ibuprofen (Advil, Motrin)
naproxen (Aleve, Naprosyn, others)
• magnesium salicylate
can increase the risk of side effects from Lexapro† and NSAIDs
blood thinners• dabigatran (Pradaxa)
rivaroxaban (Xarelto)
warfarin (Jantoven)
can increase the risk of side effects from Lexapro† and blood thinners
certain antidepressantssertraline (Zoloft)
fluoxetine (Prozac)
• mirtazapine (Remeron)
• trazodone
can increase the risk of side effects from Lexapro† and certain other antidepressants
certain opioidsfentanyl (Actiq, Fentora)
tramadol (Conzip, Qdolo)
can increase the risk of side effects from Lexapro† and certain opioids
certain antifungalsfluconazole (Diflucan)
• itraconazole (Sporanox, Tolsura)
ketoconazole
can increase the risk of side effects from Lexapro† and certain antifungals, or make certain antifungals less effective than usual
carbamazepine (Carbatrol, Epitol, Tegretol, others)can make Lexapro less effective than usual
metoprolol (Lopressor, Toprol XL, Kapsargo Sprinkle)can increase the risk of side effects from metoprolol
hydroxyzine (Vistaril)can increase the risk of side effects from Lexapro† and hydroxyzine
lithium (Lithobid)can increase the risk of side effects from Lexapro† and lithium
buspironecan increase the risk of side effects from Lexapro† and buspirone
cimetidinecan increase the risk of side effects from Lexapro†

* For details about this interaction, see the “When to avoid Lexapro” section above.
† For information about the side effects of Lexapro, see this article.

Here’s a closer look at certain drug interactions of Lexapro.

Nonsteroidal anti-inflammatory drugs

People take nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve inflammation, fever, and pain.

Interaction result:Taking Lexapro with an NSAID can increase your risk of bleeding as a side effect of either drug. (For information about the side effects of Lexapro, see this article.)

Interaction explained: Lexapro is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). The drug works by affecting a chemical in your body called serotonin.

Serotonin helps platelets (a type of red blood cell) cluster together to form a blood clot. By affecting this chemical, Lexapro can prevent platelets from forming blood clots. If your blood cannot clot correctly, your risk of bleeding may increase.

NSAIDs can also keep platelets from clumping together to form a blood clot. By doing so, NSAIDs also increase your risk of bleeding.

When Lexapro is taken with an NSAID, the risk of bleeding with either drug is increased further.

Examples of NSAID drugs: Here are some NSAIDs that may interact with Lexapro:

Steps you or your doctor may take: Before starting treatment with Lexapro, tell your doctor if you take an NSAID. They can advise whether it’s safe to take Lexapro with the NSAID.

Keep in mind that certain NSAIDs are available over the counter (OTC). This means you don’t need a prescription from a doctor to buy them. If you’d like to take an NSAID or other OTC pain reliever with Lexapro, talk with your doctor or pharmacist. They can advise you on which OTC pain reliever is safe to take with this drug. For example, it may be safe to take Lexapro with acetaminophen (Tylenol).

Certain other antidepressants

Doctors prescribe antidepressants to treat depression and certain other mental health conditions.

Interaction result: Taking Lexapro with certain other antidepressants can increase your risk of serious side effects with either drug. (For information about the side effects of Lexapro, see this article.)

Interaction explained: Lexapro is a type of antidepressant called an SSRI. It works by affecting the level of a chemical in your body called serotonin.

Other antidepressants can also affect the level of this chemical. Examples include serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs). If you take Lexapro with these medications, your serotonin level may increase even further.

A very high level of serotonin could lead to serotonin syndrome, which can be life threatening in some cases. Symptoms can include nausea and vomiting, hallucinations, and changes in blood pressure.

In addition, Lexapro and certain other antidepressants may cause long QT syndrome (a type of irregular heart rhythm). This condition may not cause symptoms but can be measured using an EKG. Taking Lexapro with certain antidepressants could increase your risk of this side effect.

Examples of antidepressant drugs: Below are some antidepressants that may interact with Lexapro:

Steps you or your doctor may take: If you already take an antidepressant, be sure to tell your doctor before starting Lexapro treatment. They’ll advise you on whether you can take certain antidepressants with Lexapro.

For example, it may be safe to take Lexapro with antidepressants that aren’t known to affect serotonin or cause long QT syndrome. An example is bupropion (Wellbutrin SR, Wellbutrin XL, others). Your doctor can tell you more about whether it’s safe to take these medications together.

Buspirone

Buspirone is used to treat anxiety.

Interaction result: Taking Lexapro with buspirone can increase your risk of serotonin syndrome as a side effect of either drug. (For information about the side effects of Lexapro, see this article.)

Interaction explained: Lexapro and buspirone can increase the level of a chemical in your body called serotonin. A very high level of serotonin could lead to serotonin syndrome. Symptoms of this syndrome include nausea and vomiting, hallucinations, and changes in blood pressure. This condition can be life threatening for some people.

Steps you or your doctor may take: Before starting Lexapro treatment, tell your doctor if you’re taking buspirone. Your doctor can advise you on whether it’s safe for you to take these medications together.

Note: Buspirone is a generic drug that was previously available under the brand name Buspar. However, Buspar is no longer available.

Lexapro may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Lexapro.

Lexapro interactions with supplements

Before you start treatment with Lexapro, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Lexapro interactions with herbs

It’s possible for Lexapro to interact with the herbal supplements St. John’s wort and tryptophan. Taking Lexapro with these supplements could increase your risk of serotonin syndrome as a side effect of the drug. (With serotonin syndrome, your body has a high level of a chemical called serotonin. This can cause serious side effects and be life threatening for some people.)

Before taking any herbal products during Lexapro treatment, talk with your doctor or pharmacist.

Lexapro and vitamins

There are no specific reports of vitamins interacting with Lexapro. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Lexapro.

Lexapro and food

There are no specific reports of food interactions with Lexapro. If you’d like to learn more about eating certain foods during treatment with Lexapro, talk with your doctor.

Lexapro and vaccines

There are no specific reports of vaccine interactions with Lexapro. If you’d like to learn more about getting certain vaccines during treatment with Lexapro, talk with your doctor.

Lexapro and lab tests

There are no specific reports of lab tests interacting with Lexapro. If you’d like to learn more about getting specific lab tests during treatment with Lexapro, talk with your doctor.

LEXAPRO AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Lexapro. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Lexapro. The impact of cannabis may affect how well you stick to your Lexapro treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Lexapro. Before you take this drug, be sure to talk with your doctor about your health history. Lexapro may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Lexapro include:

  • Being younger than 25 years old: Taking Lexapro may increase the risk of suicidal thoughts and behaviors, particularly in children and in adults younger than 25 years old. In fact, the drug has a boxed warning about this risk. A boxed warning is the most serious warning from the FDA. For more information, see “Boxed warning: Risk of suicidal thoughts and behaviors” at the top of this article.
  • Seizures: Lexapro may cause seizures as a side effect. Your risk may increase if you have a seizure disorder, such as epilepsy. Before starting Lexapro treatment, tell your doctor if you have a seizure disorder. They can tell you whether Lexapro is safe to take.
  • Mania or bipolar disorder: If you have mania or bipolar disorder, taking Lexapro may increase your risk of a mixed or manic episode. Before taking Lexapro, tell your doctor about any mental health conditions you have. They can recommend whether it’s safe for you to take Lexapro.
  • Dehydration or taking diuretics: Taking Lexapro may cause a low level of sodium in the blood. Your risk of this side effect may increase if you’re dehydrated or take a diuretic medication. Your doctor can recommend whether Lexapro is right for you.
  • Narrow eye angles: Before taking Lexapro, tell your doctor if you have narrow eye angles. Lexapro can cause dilated pupils, which may lead to closed-angle glaucoma in people with narrow eye angles. Closed-angle glaucoma is a medical emergency that can cause severe eye pain and vision loss. Your doctor may recommend that you have an eye exam before starting Lexapro treatment.
  • Bleeding problems: Before taking Lexapro, tell your doctor if you have a bleeding problem such as hemophilia. Lexapro may increase your risk of bleeding. And this risk may be even higher in people with bleeding problems. Your doctor can recommend whether Lexapro is the right treatment option for your condition.
  • Severe kidney problems: It is unknown whether Lexapro is safe for people with severe kidney problems, such as kidney failure. Before taking Lexapro, tell your doctor if you have a severe kidney problem. They’ll recommend whether Lexapro is right for you.
  • Liver problems: If you have a liver problem, such as liver failure, tell your doctor before starting Lexapro treatment. People with liver problems may have an increased risk of side effects from the drug. For this reason, your doctor may prescribe a lower dosage of Lexapro than usual.
  • Pregnancy: It may not be safe to take SSRIs during the last 3 months of pregnancy. This risk applies to Lexapro, which is an SSRI. If you’re pregnant or planning a pregnancy, talk with your doctor before you take this medication. For details about Lexapro’s use during pregnancy, see this article.
  • Breastfeeding: Lexapro can pass into breast milk, which may lead to side effects in a child who’s breastfed. If you’re considering breastfeeding while taking Lexapro, talk with your doctor. To learn more about Lexapro’s use while breastfeeding, see this article.
  • Allergic reaction: If you’ve had an allergic reaction to Lexapro or any of its ingredients, your doctor will likely not prescribe Lexapro. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Here are some frequently asked questions about Lexapro and possible interactions.

Is there an interaction between Lexapro and benzodiazepines, such as lorazepam (Ativan), alprazolam (Xanax), and clonazepam (Klonopin)?

Lexapro is not known to interact with benzodiazepines.

Lexapro and benzodiazepines can both be used to treat generalized anxiety disorder. In addition, benzodiazepines may be used to treat seizures and panic disorders.

Below are examples of benzodiazepines:

In certain situations, your doctor may prescribe Lexapro in combination with a benzodiazepine. This is because Lexapro may take several weeks to ease your anxiety symptoms. Your doctor may prescribe a benzodiazepine to treat anxiety short term until Lexapro is working effectively.

Keep in mind that Lexapro and benzodiazepines may cause some of the same side effects, such as sleepiness and dizziness. Taking Lexapro with these medications could increase your risk of these side effects. (To learn more about Lexapro’s side effects, see this article.)

Your doctor or pharmacist can tell you more about Lexapro and benzodiazepines.

Do Lexapro and Mucinex interact?

There’s no known interaction between Lexapro and Mucinex (guaifenesin).

Mucinex is a type of drug called an expectorant. It’s used to treat chest congestion and cough. Delsym (dextromethorphan), a different treatment for cough, is known to interact with Lexapro. This medication can increase your risk of serotonin syndrome as a side effect from either drug. However, Mucinex does not have this effect. (With serotonin syndrome, your body has a high level of a chemical called serotonin. This can cause serious side effects and be life threatening for some people.)

For more information about taking Lexapro with Mucinex, talk with your doctor or pharmacist.

Does Lexapro interact with over-the-counter sleep aids, such as melatonin?

Lexapro is not known to interact with OTC sleep aids. Examples of OTC sleep aids include melatonin and Unisom (doxylamine).

It’s important to remember that Lexapro may cause sleepiness as a side effect. Taking Lexapro with an OTC sleep aid could lead to extreme sleepiness. For this reason, it’s best to talk with your doctor or pharmacist before taking Lexapro with an OTC sleep aid. They’ll advise you on whether it’s safe to take these medications together.

Can I take Lexapro with magnesium supplements, such as magnesium glycinate?

It should be safe to take Lexapro with magnesium supplements, including magnesium glycinate. There is no known interaction between Lexapro and these supplements.

However, your doctor may advise you not to take Lexapro with magnesium salicylate. This form of magnesium is an NSAID. It can be used to relieve inflammation, fever, and pain. For details about the interaction between Lexapro and NSAIDs, see the “Drug interactions in depth” section above.

You can take certain steps to help prevent interactions with Lexapro. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

  • Let them know if you drink alcohol.
  • Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
  • Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Lexapro label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions. (If Lexapro doesn’t come with paperwork, you can ask your pharmacist to print a copy.) If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Lexapro by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.