Lithium: (Moderate) Serotonin syndrome may occur during coadministration of serotonergic drugs such as amphetamines and lithium. Patients should be monitored to confirm that the desired antihypertensive effect is achieved. If significant changes in nicotine intake occur, the dosages of these drugs may need adjustment. Green Tea: (Major) Some green tea products contain caffeine. Although sympathomimetics are contraindicated for use with other non-selective monoamine oxidase inhibitors (MAOIs), hypertensive reactions generally are not expected to occur during concurrent use with rasagiline because of the selective monoamine oxidase-B (MAO-B) inhibition of rasagiline at manufacturer recommended doses. Epinephrine and other sympathomimetics, through stimulation of alpha- and beta- receptors, increase hepatic glucose production and glycogenolysis and inhibit insulin secretion. Antipsychotics and amphetamines may interact pharmacodynamically to diminish the therapeutic effects of either agent through opposing effects on dopamine. Alogliptin; Metformin: (Moderate) Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. Captopril: (Minor) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents, like angiotensin-converting enzyme inhibitors (ACE inhibitors). A dosage more than 40 mg/day is rarely necessary; however, some experts recommend a maximum dose of 60 mg/day in patients weighing more than 50 kg. It was 1966. Epinephrine and other sympathomimetics, through stimulation of alpha- and beta- receptors, increase hepatic glucose production and glycogenolysis and inhibit insulin secretion. Both drugs are similar, but there are some differences in how they are used. Obesity treatment with dextroamphetamine should be initiated only in weight reduction programs for patients in whom alternative therapies, including repeated dietary reduction, exercise, or other medications have been ineffective. Amlodipine; Olmesartan: (Minor) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents, like calcium-channel blockers. Empagliflozin; Metformin: (Moderate) Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. The time to maximum concentration (Tmax) of amphetamines is decreased compared to when administered alone, thus increasing amphetamine concentrations and exposure, which may be of particular significance with extended-release dosage forms. Increased blood pressure, bradycardia, or heart block may occur due to excessive alpha-adrenergic receptor stimulation. Monitor your child's weight ⦠Close monitoring of blood pressure is advised. Metformin: (Moderate) Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. Methylene blue also has the potential to interact with serotonergic agents, such as amphetamines, which may increase the risk for serotonin syndrome. 60 mg/day PO; individualize dosage based on response and tolerability. Phentolamine: (Major) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents. The effects of dextroamphetamine during labor and delivery are unknown. There are a number of possible side effects of Dexedrine, and weight loss appears to be one of them. In addition, the excretion of amphetamines is increased in acidic urine and decreased in alkaline urine. For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use (1 to 3 days) as an alternative to systemic decongestants in patients taking medications for diabetes. Increased blood pressure, bradycardia, or heart block may occur due to excessive alpha-adrenergic receptor stimulation. Close monitoring of blood pressure is advised. Ketamine: (Major) Inhalational general anesthetics may sensitize the myocardium to the effects of dextroamphetamine. The American Heart Association (AHA) states that it is reasonable to consider the use of these medications in pediatric patients with congenital heart disease without current hemodynamic or arrhythmic concerns or congenital heart disease that is considered stable by the patient's pediatric cardiologist, unless the cardiologist has specific concerns. per week. Seizure threshold may be reduced in those with EEG abnormalities and rarely in patients without a seizure history or EEG abnormalities. Aliskiren; Hydrochlorothiazide, HCTZ: (Minor) Amphetamines may counteract the activity of some antihypertensive agents, such as thiazide diuretics. Nefazodone: (Moderate) Serotonin syndrome may occur during coadministration of serotonergic drugs such as amphetamines and nefazodone. Potassium-sparing diuretics: (Minor) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents, like potassium-sparing diuretics. A large retrospective cohort study including over 1.2 million children and young adults 2—24 years of age did not find an increased risk of serious cardiovascular events in current users of drugs for the treatment of ADHD compared to nonusers (adjusted hazard ratio 0.75; 95% CI 0.31—1.85). Sympathomimetics, such as amphetamines, phentermine, and decongestants (e.g., pseudoephedrine, phenylephrine), and many other drugs, may increase both systolic and diastolic blood pressure and may counteract the activity of the beta-blockers. Concurrent use increases the risk of unopposed alpha-adrenergic activity. Urinary alkalinizers diminish the urinary excretion of amphetamines by increasing the proportion of non-ionized amphetamines, resulting in increased renal tubular reabsorption of the amphetamines. Serotonin syndrome is characterized by mental status changes (e.g., agitation, hallucinations, delirium, and coma), autonomic instability (e.g., tachycardia, labile blood pressure, dizziness, diaphoresis, flushing, hyperthermia), neuromuscular symptoms (e.g., tremor, rigidity, myoclonus, hyperreflexia, incoordination), seizures, gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea), and in rare instances, death. (Major) Urinary acidifying agents, such as ammonium chloride, phosphorus salts, and methenamine salts (e.g., methenamine; sodium acid phosphate), reduce the tubular reabsorption of amphetamines. Sustained-release dextroamphetamine is not recommended for children less than 6 years of age. Monitor for loss of glycemic control when pseudoephedrine, phenylephrine, and other sympathomimetics are administered to patients taking antidiabetic agents. This applies to sympathomimetics including stimulants for ADHD, narcolepsy or weight loss, nasal, oral, and ophthalmic decongestants and cold products, and even respiratory sympathomimetics (e.g., beta agonist drugs). Found inside â Page 27In the Dexedrine group , the only one in which there was a general worsening to which the high dosage may have contributed , there was a loss of weight ... To help limit an interaction, do not take antacids at the same time as the amphetamine product. To help limit an interaction, do not take antacids at the same time as the amphetamine product. Cases of serotonin syndrome have been reported, primarily following administration of standard infusions of methylene blue (1 to 8 mg/kg) as a visualizing agent in parathyroid surgery, in patients receiving selective serotonin reuptake inhibitors, serotonin/norepinephrine reuptake inhibitors, or clomipramine. Increased blood pressure, bradycardia, or heart block may occur due to excessive alpha-adrenergic receptor stimulation. Concurrent use increases the risk of unopposed alpha-adrenergic activity. Your doctor may increase the dose without exceeding 10 mg per week. Found inside â Page 36Dextroamphetamine ( Dexedrine : Celltech Pharmaceuticals Inc , Rochester ... less weight on a maintenance diet than did patients who took a lower dose of ... Safinamide: (Severe) Safinamide, a selective monoamine oxidase-B inhibitor, is contraindicated for use with amphetamines due to the risk of hypertensive crisis. Also, adrenergic medications may decrease glucose uptake by muscle cells. Ibritumomab Tiuxetan: (Major) Concurrent use of amphetamines with urinary alkalinizing agents should be avoided if possible. Urinary alkalinizers diminish the urinary excretion of amphetamines by increasing the proportion of non-ionized amphetamines, resulting in increased renal tubular reabsorption of the amphetamines. Due to the risk of unopposed alpha-adrenergic activity, amphetamines should be used cautiously with beta-blockers. For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use (1 to 3 days) as an alternative to systemic decongestants in patients taking medications for diabetes. At high doses, amphetamines can increase serotonin release, as well as act as serotonin agonists. Patients should not significantly alter their diets, however, as these changes in urinary pH from foods are not expected to be clinically significant for most patients. Close monitoring of blood pressure is advised. Patients should be monitored for reduced efficacy of ambrisentan. Thiazide diuretics may also increase and prolong the actions of amphetamines by increasing the urinary pH. Discontinue all serotonergic agents if serotonin syndrome occurs and implement appropriate medical management. Thiazolidinediones: (Moderate) Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. The amphetamines may also delay the intestinal absorption of ethosuximide; the extent of absorption of these seizure medications is not known to be affected. Additionally, amphetamines may delay the intestinal absorption of ethosuximide, ethotoin (hydantoin), phenobarbital, and phenytoin, the extent of absorption of these seizure medications is not known to be affected. Sympathomimetics, such as amphetamines, phentermine, and decongestants (e.g., pseudoephedrine, phenylephrine), and many other drugs, may increase both systolic and diastolic blood pressure and may counteract the activity of the beta-blockers. (Minor) Amphetamines may counteract the activity of some antihypertensive agents, such as thiazide diuretics. The medication is not suitable for children below three years. Close monitoring of blood pressure is advised. As a result, amphetamine clearance is accelerated and the duration of effect is reduced. Close monitoring of blood pressure is advised. Also, adrenergic medications may decrease glucose uptake by muscle cells. Also, adrenergic medications may decrease glucose uptake by muscle cells. Found inside â Page 430Recommended dosage Take no more Dexedrine than your doctor prescribes, ... such as insomnia or loss of appetite appear, the dosage will probably be reduced. Increased blood pressure, bradycardia, or heart block may occur due to excessive alpha-adrenergic receptor stimulation. Acetaminophen; Aspirin, ASA; Caffeine: (Moderate) Avoid excessive caffeine intake during use of the amphetamine salts. Dexedrine contains one potent form of amphetamine, while Adderall has two. Patients should not significantly alter their diets, however, as these alkaline changes in urinary pH from foods are not expected to be clinically significant for most patients. Close monitoring of blood pressure is advised. Daily dose may be given in 1 to 3 divided doses at 4 to 6 hour intervals. Proton pump inhibitors: (Moderate) The use of proton pump inhibitors (PPIs) with amphetamine and/or dextroamphetamine therapy may change the onset of action of these amphetamines due to the increase in gastric pH. Close monitoring of blood pressure is advised. This may lead to increased amphetamine concentrations. Acetaminophen; Caffeine: (Moderate) Avoid excessive caffeine intake during use of the amphetamine salts. 5 mg PO once or twice daily initially; then, may increase by 5 mg at weekly intervals until optimal response is obtained. How to identify and begin achieving your life goals today! Untapped Brilliance does more than just explain what changes to make and why..it shows you how to make those changes forever Amphetamines may decrease the seizure threshold and may increase the risk of seizures. Potassium Citrate: (Major) Concurrent use of amphetamines with urinary alkalinizing agents should be avoided if possible. Also, adrenergic medications may decrease glucose uptake by muscle cells. Monitor for the emergence of serotonin syndrome particularly after a dose increase or the addition of other serotonergic medications to an existing regimen. Alogliptin; Pioglitazone: (Moderate) Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. Increased blood pressure, bradycardia, or heart block may occur due to excessive alpha-adrenergic receptor stimulation. Close monitoring of blood pressure is advised. Sevoflurane: (Major) Inhalational general anesthetics (e.g., enflurane, halothane, isoflurane, and methoxyflurane) may sensitize the myocardium to the effects of stimulants. If seizures occur, amphetamine discontinuation may be necessary. Dexedrine Vs. Adderall: Which One Is Stronger? By the end of the third week, weight loss had plateaued. Isoflurane: (Major) Inhalational general anesthetics (e.g., enflurane, halothane, isoflurane, and methoxyflurane) may sensitize the myocardium to the effects of stimulants. Dextroamphetamine may cause hypercortisolism, as amphetamines can cause a significant elevation in plasma corticosteroid concentrations. For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use (1 to 3 days) as an alternative to systemic decongestants in patients taking medications for diabetes. Close monitoring of blood pressure is advised. Aluminum Hydroxide; Magnesium Trisilicate: (Moderate) Antacids and other gastrointestinal alkalinizing agents increase the oral absorption of amphetamines. Patients should be closely monitored if these combinations are necessary. Found inside â Page 166Dexedrine and other prescription medications containing dextroamphetamine for their patients who wanted to lose weight. At first, this seemed like a good ... Also, adrenergic medications may decrease glucose uptake by muscle cells. Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ: (Minor) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents, like calcium-channel blockers. Atropine; Hyoscyamine; Phenobarbital; Scopolamine: (Major) Patients who are taking anticonvulsants for epilepsy/seizure control should use dextroamphetamine with caution. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Hydrochlorothiazide, HCTZ; Propranolol: (Minor) Amphetamines may counteract the activity of some antihypertensive agents, such as thiazide diuretics. 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