(2)dexmethylphenidate and methamphetamine both decrease sedation. Use Caution/Monitor. dexmethylphenidate and methamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.methoxyfluraneSerious - Use Alternative (1)methoxyflurane increases toxicity of dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.methsuximideMinor (1)dexmethylphenidate increases effects of methsuximide by decreasing metabolism. Minor/Significance Unknown.methyldopaMonitor Closely (1)methyldopa increases effects of dexmethylphenidate by unknown mechanism. Use Caution/Monitor.methylenedioxymethamphetamineMonitor Closely (2)dexmethylphenidate and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor. dexmethylphenidate and methylenedioxymethamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.methylergonovineSerious - Use Alternative (1)methylergonovine, dexmethylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.methylphenidateMonitor Closely (1)dexmethylphenidate increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.midazolamMonitor Closely (1)midazolam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.midodrineMonitor Closely (2)dexmethylphenidate and midodrine both decrease sedation. Use Caution/Monitor. dexmethylphenidate and midodrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.milnacipranMinor (1)dexmethylphenidate increases effects of milnacipran by decreasing metabolism. Minor/Significance Unknown.mirtazapineMonitor Closely (1)mirtazapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.modafinilMonitor Closely (1)dexmethylphenidate and modafinil both decrease sedation. Use Caution/Monitor.morphineMonitor Closely (1)morphine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.motherwortMonitor Closely (1)motherwort increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.moxonidineMonitor Closely (1)moxonidine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nabiloneMonitor Closely (1)nabilone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nalbuphineMonitor Closely (1)nalbuphine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nefazodoneMinor (1)dexmethylphenidate increases effects of nefazodone by decreasing metabolism. Minor/Significance Unknown.nizatidineMonitor Closely (1)nizatidine will increase the level or effect of dexmethylphenidate by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. applies only to extended release formulationnorepinephrineMonitor Closely (2)norepinephrine and dexmethylphenidate both decrease sedation. Use Caution/Monitor. norepinephrine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.nortriptylineMonitor Closely (1)nortriptyline increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)nortriptyline, dexmethylphenidate. 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.Minor (1)dexmethylphenidate increases effects of nortriptyline by decreasing metabolism. Minor/Significance Unknown.olanzapineMonitor Closely (1)olanzapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.opium tinctureMonitor Closely (1)opium tincture increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxazepamMonitor Closely (1)oxazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxcarbazepineMinor (1)dexmethylphenidate increases effects of oxcarbazepine by decreasing metabolism. Minor/Significance Unknown.oxycodoneMonitor Closely (1)oxycodone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxymorphoneMonitor Closely (1)oxymorphone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxytocinMonitor Closely (1)oxytocin increases effects of dexmethylphenidate by pharmacodynamic synergism. Use Caution/Monitor.ozanimodSerious - Use Alternative (1)ozanimod increases toxicity of dexmethylphenidate by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.paliperidoneMonitor Closely (1)paliperidone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.papaveretumMonitor Closely (1)papaveretum increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.paroxetineMinor (1)dexmethylphenidate increases effects of paroxetine by decreasing metabolism. Minor/Significance Unknown.pentazocineMonitor Closely (1)pentazocine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pentobarbitalMonitor Closely (1)pentobarbital increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazineMonitor Closely (2)perphenazine, dexmethylphenidate. 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. perphenazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phendimetrazineMonitor Closely (2)dexmethylphenidate and phendimetrazine both decrease sedation. Use Caution/Monitor. dexmethylphenidate and phendimetrazine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.phenelzineContraindicated (1)phenelzine increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.phenindioneMinor (1)dexmethylphenidate increases effects of phenindione by decreasing metabolism. Minor/Significance Unknown.phenobarbitalMonitor Closely (1)phenobarbital increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dexmethylphenidate increases effects of phenobarbital by decreasing metabolism. Minor/Significance Unknown.phentermineMonitor Closely (2)dexmethylphenidate and phentermine both decrease sedation. Use Caution/Monitor. dexmethylphenidate and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.phenylephrineMonitor Closely (2)dexmethylphenidate and phenylephrine both decrease sedation. Use Caution/Monitor. dexmethylphenidate and phenylephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.phenylephrine POMonitor Closely (2)dexmethylphenidate and phenylephrine PO both decrease sedation. Use Caution/Monitor. dexmethylphenidate and phenylephrine PO both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.phenytoinMinor (1)dexmethylphenidate increases effects of phenytoin by decreasing metabolism. Minor/Significance Unknown.pholcodineMonitor Closely (1)pholcodine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozideMonitor Closely (1)pimozide increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pirbuterolMonitor Closely (2)pirbuterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor. pirbuterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.primidoneMonitor Closely (1)primidone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dexmethylphenidate increases effects of primidone by decreasing metabolism. Minor/Significance Unknown.procarbazineContraindicated (1)procarbazine increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.prochlorperazineMonitor Closely (2)prochlorperazine, dexmethylphenidate. 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. prochlorperazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.promazineMonitor Closely (1)promazine, dexmethylphenidate. 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.promethazineMonitor Closely (2)promethazine, dexmethylphenidate. 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. promethazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.propylhexedrineMonitor Closely (2)dexmethylphenidate and propylhexedrine both decrease sedation. Use Caution/Monitor. dexmethylphenidate and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.protamineMinor (1)dexmethylphenidate increases effects of protamine by decreasing metabolism. Minor/Significance Unknown.protriptylineMonitor Closely (1)protriptyline increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)protriptyline, dexmethylphenidate. 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.Minor (1)dexmethylphenidate increases effects of protriptyline by decreasing metabolism. Minor/Significance Unknown.pseudoephedrineMonitor Closely (1)dexmethylphenidate and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.quazepamMonitor Closely (1)quazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.quetiapineMonitor Closely (1)quetiapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.rasagilineContraindicated (1)rasagiline increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Dexmethylphenidate use is contraindicated during treatment with MAOIs and also within a minimum of 14 days following discontinuation of treatment with an MAOI.risperidoneMonitor Closely (1)risperidone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.rufinamideMinor (1)dexmethylphenidate increases effects of rufinamide by decreasing metabolism. Minor/Significance Unknown.safinamideContraindicated (1)dexmethylphenidate, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.sageMinor (1)sage increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.salmeterolMonitor Closely (2)salmeterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor. salmeterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.scullcapMonitor Closely (1)scullcap increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.secobarbitalMonitor Closely (1)secobarbital increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.selegilineContraindicated (1)selegiline increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Dexmethylphenidate use is contraindicated during treatment with MAOIs and also within a minimum of 14 days following discontinuation of treatment with an MAOI.selegiline transdermalContraindicated (1)selegiline transdermal increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.sertralineMinor (1)dexmethylphenidate increases effects of sertraline by decreasing metabolism. Minor/Significance Unknown.sevofluraneSerious - Use Alternative (1)sevoflurane increases toxicity of dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.shepherd's purseMonitor Closely (1)shepherd's purse increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.sodium zirconium cyclosilicateMonitor Closely (1)sodium zirconium cyclosilicate will increase the level or effect of dexmethylphenidate by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate. Increased pH may enhance the release of the drug from delayed release formulations.solriamfetolMonitor Closely (1)dexmethylphenidate and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.sufentanilMonitor Closely (1)sufentanil increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tapentadolMonitor Closely (1)tapentadol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.temazepamMonitor Closely (1)temazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.terbutalineMonitor Closely (2)terbutaline and dexmethylphenidate both decrease sedation. Use Caution/Monitor. terbutaline and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.thioridazineMonitor Closely (2)thioridazine, dexmethylphenidate. 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. thioridazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.thiothixeneMonitor Closely (1)thiothixene increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tiagabineMinor (1)dexmethylphenidate increases effects of tiagabine by decreasing metabolism. Minor/Significance Unknown.topiramateMonitor Closely (1)topiramate increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.Minor (1)dexmethylphenidate increases effects of topiramate by decreasing metabolism. Minor/Significance Unknown.tramadolMonitor Closely (1)tramadol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tranylcypromineContraindicated (1)tranylcypromine increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.trazodoneMonitor Closely (1)trazodone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, dexmethylphenidate. 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.Minor (1)dexmethylphenidate increases effects of trazodone by decreasing metabolism. Minor/Significance Unknown.triazolamMonitor Closely (1)triazolam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triclofosMonitor Closely (1)triclofos increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trifluoperazineMonitor Closely (2)trifluoperazine, dexmethylphenidate. 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. trifluoperazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trimipramineMonitor Closely (1)trimipramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trimipramine, dexmethylphenidate. 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.Minor (1)dexmethylphenidate increases effects of trimipramine by decreasing metabolism. Minor/Significance Unknown.triprolidineMonitor Closely (1)triprolidine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.valproic acidMinor (1)dexmethylphenidate increases effects of valproic acid by decreasing metabolism. Minor/Significance Unknown.venlafaxineMinor (1)dexmethylphenidate