Epilepsy Talk

Colds, Flu and You…  | August 18, 2025

With all the colds and flu going around, it’s not easy to figure out which medications are safe to take.

Obviously, the best way to manage medication interactions is to avoid medications that are known to cause problems.

A few medicines that you pick up off the shelf at the drug store can potentially increase the frequency of seizures in people with epilepsy, or even cause first-time seizures.

The most common one of this kind is probably diphenhydramine, the active ingredient in medications like Benadryl, which is used for colds, allergies, and to promote sleep. If you have epilepsy, you should talk to your doctor before you use it.

You should also talk to your doctor before you start using any herbal medicines. Because they come from nature does not necessarily mean they are safe for you to use.

Other common medicines (even aspirin in some cases) can increase the unwanted side-effects of your seizure medicines or increase seizures by changing the level of medication in your blood.

Just check the label before purchasing any products.

Most cold medicines cause drowsiness, so it is recommended to start at the low dose.

Acetaminophen (Tylenol) is the safest to use for fever and pain.

Aspirin is safe for most adults, but should be avoided by children and anyone using Depakote or Dilantin.

Ibuprofen (Advil and Motrin) is another good drug for fever and pain but it can cause side-effects like dizziness and difficulty walking when used in combination with Dilantin.

Most antibiotics are problem-free when used with seizure medicines, but there are a few that cause problems.

Biaxin (clarithromycin), a frequently used antibiotic for colds and pneumonia, causes side-effects when used in combination with Tegretol.

So does erythromycin.

Cipro (ciprofloxacin) decreases blood levels of Dilantin and has been reported to increase seizure frequency.

Doxycycline is another commonly used medication that lowers the blood level of Tegretol and may make seizures more likely.

The new antiviral medications used for flu symptoms (Tamiflu and others) are reported to be safe with seizure medicines.

For colds, Robitussin DM, Mucinex) are approved.

The same for decongestants, pseudoephedrine (Sudafed), Afrin nasal spray, and normal saline nasal spray

Plus, Claritin and Zyrtec are considered non-sedating antihistamines.

However, no list of medication interactions is complete.

Doctors and pharmacists continue to learn of interactions between existing medications and new ones.

If you experience any symptoms from new or old medications used for cold or flu, make sure you report them to your doctor!

It is important that all your doctors (including your dentist) are aware that you have epilepsy.

This knowledge allows them to avoid prescribing any medication that may interact with your seizure medicine.

Consistently using the same pharmacy also helps screen for potential side-effects.

Providing the pharmacist with a list of over-the-counter medicines that you routinely use also helps.

It is recommended that all individuals with a chronic condition receive the flu vaccine, too.

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Resources:

http://www.epilepsy.com/article/2014/3/flu-season-do-you-need-worry-about-medication-interactions

http://www.epilepsy.com/learn/triggers-seizures/over-counter-medications

https://epilepsydisease.com/clinical/cold-flu-trigger-seizures

https://my.clevelandclinic.org/health/treatments/antihistamines

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