Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mgSerious - Use Alternative (1)dextroamphetamine and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexfenfluramineMonitor Closely (3)dextroamphetamine and dexfenfluramine both decrease sedation. Use Caution/Monitor. dexfenfluramine and dextroamphetamine both increase serotonin levels. Use Caution/Monitor. dexfenfluramine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.dexlansoprazoleMonitor Closely (1)dexlansoprazole, dextroamphetamine. Other (see comment). Use Caution/Monitor. Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .dexmedetomidineMonitor Closely (1)dexmedetomidine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexmethylphenidateMonitor Closely (2)dexmethylphenidate and dextroamphetamine both decrease sedation. Use Caution/Monitor. dexmethylphenidate and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.dextromethorphanMonitor Closely (1)dextroamphetamine, dextromethorphan. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when amphemtamines are coadministered with dextromethorphan. .dextromoramideMonitor Closely (1)dextromoramide increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of dextromoramide by unspecified interaction mechanism. Minor/Significance Unknown.diamorphineMonitor Closely (1)diamorphine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of diamorphine by unspecified interaction mechanism. Minor/Significance Unknown.diethylpropionMonitor Closely (2)dextroamphetamine and diethylpropion both decrease sedation. Use Caution/Monitor. dextroamphetamine and diethylpropion both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.difenoxin hclMonitor Closely (1)difenoxin hcl increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of difenoxin hcl by unspecified interaction mechanism. Minor/Significance Unknown.dihydroergotamineMonitor Closely (1)dextroamphetamine and dihydroergotamine both increase serotonin levels. Use Caution/Monitor.Serious - Use Alternative (1)dihydroergotamine, dextroamphetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.dihydroergotamine intranasalMonitor Closely (1)dextroamphetamine and dihydroergotamine intranasal both increase serotonin levels. Use Caution/Monitor.Serious - Use Alternative (1)dihydroergotamine intranasal, dextroamphetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.dimenhydrinateMonitor Closely (1)dimenhydrinate increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diphenhydramineMonitor Closely (1)diphenhydramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)diphenhydramine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.diphenoxylate hclMonitor Closely (1)diphenoxylate hcl increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of diphenoxylate hcl by unspecified interaction mechanism. Minor/Significance Unknown.dipipanoneMonitor Closely (1)dipipanone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of dipipanone by unspecified interaction mechanism. Minor/Significance Unknown.dobutamineMonitor Closely (2)dobutamine and dextroamphetamine both decrease sedation. Use Caution/Monitor. dobutamine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.dopamineMonitor Closely (2)dextroamphetamine and dopamine both decrease sedation. Use Caution/Monitor. dextroamphetamine and dopamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.dopexamineMonitor Closely (2)dopexamine and dextroamphetamine both decrease sedation. Use Caution/Monitor. dopexamine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.doxapramSerious - Use Alternative (1)doxapram increases effects of dextroamphetamine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.doxepinMonitor Closely (3)doxepin increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor. doxepin and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely. doxepin increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)doxepin, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.dronedaroneMinor (1)dronedarone will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.droperidolMonitor Closely (1)droperidol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.droxidopaMonitor Closely (1)dextroamphetamine and droxidopa both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. May increase risk for supine hypertensionduloxetineMonitor Closely (2)duloxetine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely. duloxetine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.eletriptanMonitor Closely (1)eletriptan and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.ephedrineMonitor Closely (2)ephedrine and dextroamphetamine both decrease sedation. Use Caution/Monitor. ephedrine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.epinephrineMonitor Closely (2)epinephrine and dextroamphetamine both decrease sedation. Use Caution/Monitor. epinephrine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.epinephrine inhaledMonitor Closely (1)dextroamphetamine, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.epinephrine racemicMonitor Closely (2)epinephrine racemic and dextroamphetamine both decrease sedation. Use Caution/Monitor. epinephrine racemic and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.ergoloid mesylatesSerious - Use Alternative (1)ergoloid mesylates, dextroamphetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.ergotamineMonitor Closely (1)dextroamphetamine and ergotamine both increase serotonin levels. Use Caution/Monitor.Serious - Use Alternative (1)ergotamine, dextroamphetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.escitalopramMonitor Closely (1)escitalopram and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.esketamine intranasalMonitor Closely (1)esketamine intranasal, dextroamphetamine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .esomeprazoleMonitor Closely (1)esomeprazole, dextroamphetamine. Other (see comment). Use Caution/Monitor. Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .estazolamMonitor Closely (1)estazolam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ethanolMonitor Closely (1)ethanol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.etherSerious - Use Alternative (1)ether increases toxicity of dextroamphetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.ethosuximideMinor (1)dextroamphetamine decreases levels of ethosuximide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.eucalyptusMinor (1)eucalyptus increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.fenfluramineMonitor Closely (3)dextroamphetamine and fenfluramine both decrease sedation. Use Caution/Monitor. dextroamphetamine and fenfluramine both increase serotonin levels. Use Caution/Monitor. dextroamphetamine and fenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.fluoxetineMonitor Closely (2)fluoxetine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. fluoxetine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.fluphenazineMonitor Closely (2)fluphenazine, dextroamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only. fluphenazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.flurazepamMonitor Closely (1)flurazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.fluvoxamineMonitor Closely (1)fluvoxamine and dextroamphetamine both decrease serotonin levels. Modify Therapy/Monitor Closely.formoterolMonitor Closely (2)formoterol and dextroamphetamine both decrease sedation. Use Caution/Monitor. formoterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.frovatriptanMonitor Closely (1)frovatriptan and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.green teaMonitor Closely (1)green tea, dextroamphetamine. Other (see comment). Use Caution/Monitor. Comment: Green tea may include caffeine. Caffeine is a CNS-stimulant and additive effects may be seen when coadministered with other CNS stimulants. Caffeine should be avoided or used cautiously.guaranaMinor (1)guarana increases effects of dextroamphetamine by pharmacodynamic synergism. Minor/Significance Unknown.haloperidolMonitor Closely (1)haloperidol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)haloperidol will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.hydralazineMonitor Closely (1)hydralazine, dextroamphetamine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Sympathomimetics can antagonize the activity of some antihypertensive agents.hydrocodoneMonitor Closely (1)hydrocodone, dextroamphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.hydromorphoneMonitor Closely (1)hydromorphone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of hydromorphone by unspecified interaction mechanism. Minor/Significance Unknown.hydroxyzineMonitor Closely (1)hydroxyzine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.iloperidoneMonitor Closely (1)iloperidone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.imatinibMinor (1)imatinib will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.imipramineMonitor Closely (3)imipramine increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor. imipramine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely. imipramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)imipramine, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.iobenguane I 123Contraindicated (1)dextroamphetamine decreases effects of iobenguane I 123 by receptor binding competition. Contraindicated. If clinically appropriate, discontinue drugs that compete for NE receptor sites for at least 5 half-lives; may cause false-negative imaging results.iobenguane I 131Serious - Use Alternative (1)dextroamphetamine will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.ioflupane I 123Monitor Closely (1)dextroamphetamine decreases effects of ioflupane I 123 by receptor binding competition. Use Caution/Monitor. Drugs that bind to dopamine transporter receptor with high affinity may interfere with the image following ioflupane I 123 administration.isocarboxazidContraindicated (1)isocarboxazid increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.Serious - Use Alternative (1)isocarboxazid and dextroamphetamine both increase serotonin levels. Avoid or Use Alternate Drug.isofluraneSerious - Use Alternative (1)isoflurane increases toxicity of dextroamphetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.isoniazidMonitor Closely (1)dextroamphetamine and isoniazid both increase serotonin levels. Use Caution/Monitor.isoproterenolMonitor Closely (2)isoproterenol and dextroamphetamine both decrease sedation. Use Caution/Monitor. isoproterenol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.ketotifen, ophthalmicMonitor Closely (1)ketotifen, ophthalmic increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.L-tryptophanMonitor Closely (1)dextroamphetamine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.lansoprazoleMonitor Closely (1)lansoprazole, dextroamphetamine. Other (see comment). Use Caution/Monitor. Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .levalbuterolMonitor Closely (2)levalbuterol and dextroamphetamine both decrease sedation. Use Caution/Monitor. levalbuterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.levomilnacipranMonitor Closely (1)levomilnacipran and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.levorphanolMonitor Closely (1)levorphanol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of levorphanol by unspecified interaction mechanism. Minor/Significance Unknown.linezolidContraindicated (1)linezolid increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.Serious - Use Alternative (1)linezolid and dextroamphetamine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.lisdexamfetamineMonitor Closely (2)dextroamphetamine and lisdexamfetamine both decrease sedation. Use Caution/Monitor. dextroamphetamine and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.lithiumMonitor Closely (1)dextroamphetamine and lithium both increase serotonin levels. Use Caution/Monitor.lofepramineMonitor Closely (3)lofepramine increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor. lofepramine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely. lofepramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)lofepramine,