Interaction of Adderall with Other Drugs
Adderall can have unwanted effects when taken with certain medications. It is important for individuals to inform their doctor about all the prescription, non-prescription, illegal, and over-the-counter drugs they are taking, as well as any supplements or herbs.
Some acidifying agents can lower the blood levels and effectiveness of amphetamines. Doctors may need to adjust the dose based on each patient’s response. Examples of acidifying agents include reserpine, guanethidine, ascorbic acid, and glutamic acid.
Adderall inhibits adrenergic blockers, so using it with these medications can result in additive effects.
Alkalizing agents can increase the blood levels and enhance the action of amphetamines when taken with Adderall or Adderall XR. It is advisable to avoid using gastrointestinal alkalizing agents such as sodium bicarbonate and urinary alkalizing agents like acetazolamide and thiazides.
Adderall can enhance the activity of tricyclic antidepressants, leading to increased concentration of d-amphetamine in the brain and potentiation of cardiovascular effects. Close monitoring and adjustment of therapy may be necessary. Examples of tricyclic antidepressants include protriptyline and desipramine.
Using Adderall with CYP2D6 inhibitors can increase the exposure to the medication and the risk of serotonin syndrome. Starting with a lower dose and monitoring for symptoms of serotonin syndrome is recommended. Common CYP2D6 inhibitors include fluoxetine, paroxetine, quinidine, and ritonavir.
Combining Adderall with serotonergic drugs increases the risk of serotonin syndrome. Starting with a low dose and monitoring for symptoms is important. Serotonergic drugs include serotonin reuptake inhibitors (SRIs), selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, triptans, lithium, fentanyl, tryptophan, tramadol, buspirone, and St. John’s Wort.
Using Adderall with monoamine oxidase inhibitors can cause a hypertensive crisis. It is important to avoid using Adderall within 14 days after the last use of MAO inhibitors. Examples of MAO inhibitors include tranylcypromine, selegiline, phenelzine, isocarboxazid, methylene blue, and linezolid.
Adderall can interact with various other drugs, including antihistamines, antihypertensive drugs, chlorpromazine, ethosuximide, haloperidol, lithium carbonate, meperidine, methenamine therapy, norepinephrine, phenobarbital and phenytoin, propoxyphene, proton pump inhibitors like omeprazole, veratrum alkaloids, alcohol, foods or beverages containing caffeine, acidic foods like grapefruit juice, and medical marijuana. It is important to consult a healthcare provider for complete information on these interactions.