decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.cyclizineMonitor Closely (1)cyclizine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.cyproheptadineMonitor Closely (1)cyproheptadine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dalteparinMinor (1)dexmethylphenidate increases effects of dalteparin by decreasing metabolism. Minor/Significance Unknown.desfluraneSerious - Use Alternative (1)desflurane increases toxicity of dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.desipramineMonitor Closely (1)desipramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)desipramine, 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 desipramine by decreasing metabolism. Minor/Significance Unknown.desmopressinMinor (1)desmopressin increases effects of dexmethylphenidate by pharmacodynamic synergism. Minor/Significance Unknown.dexchlorpheniramineMonitor Closely (1)dexchlorpheniramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexfenfluramineMonitor Closely (2)dexmethylphenidate and dexfenfluramine both decrease sedation. Use Caution/Monitor. dexfenfluramine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.dexmedetomidineMonitor Closely (1)dexmedetomidine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextroamphetamineMonitor 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.dextromoramideMonitor Closely (1)dextromoramide increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diamorphineMonitor Closely (1)diamorphine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diazepamMinor (1)dexmethylphenidate increases effects of diazepam by decreasing metabolism. Minor/Significance Unknown.diethylpropionMonitor Closely (2)dexmethylphenidate and diethylpropion both decrease sedation. Use Caution/Monitor. dexmethylphenidate 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 dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dihydroergotamineSerious - Use Alternative (1)dihydroergotamine, dexmethylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.dihydroergotamine intranasalSerious - Use Alternative (1)dihydroergotamine intranasal, dexmethylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.dimenhydrinateMonitor Closely (1)dimenhydrinate increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diphenhydramineMonitor Closely (1)diphenhydramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.diphenoxylate hclMonitor Closely (1)diphenoxylate hcl increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dipipanoneMonitor Closely (1)dipipanone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dobutamineMonitor Closely (2)dobutamine and dexmethylphenidate both decrease sedation. Use Caution/Monitor. dobutamine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.dopamineMonitor Closely (2)dexmethylphenidate and dopamine both decrease sedation. Use Caution/Monitor. dexmethylphenidate and dopamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.dopexamineMonitor Closely (2)dopexamine and dexmethylphenidate both decrease sedation. Use Caution/Monitor. dopexamine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.dosulepinMinor (1)dexmethylphenidate increases effects of dosulepin by decreasing metabolism. Minor/Significance Unknown.doxapramSerious - Use Alternative (1)doxapram increases effects of dexmethylphenidate by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.doxepinMonitor Closely (1)doxepin increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)doxepin, 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 doxepin by decreasing metabolism. Minor/Significance Unknown.droperidolMonitor Closely (1)droperidol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.droxidopaMonitor Closely (1)dexmethylphenidate and droxidopa both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. May increase risk for supine hypertensionduloxetineMinor (1)dexmethylphenidate increases effects of duloxetine by decreasing metabolism. Minor/Significance Unknown.enoxaparinMinor (1)dexmethylphenidate increases effects of enoxaparin by decreasing metabolism. Minor/Significance Unknown.ephedrineMonitor Closely (2)ephedrine and dexmethylphenidate both decrease sedation. Use Caution/Monitor. ephedrine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.epinephrineMonitor Closely (2)epinephrine and dexmethylphenidate both decrease sedation. Use Caution/Monitor. epinephrine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.epinephrine inhaledMonitor Closely (1)dexmethylphenidate, 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 dexmethylphenidate both decrease sedation. Use Caution/Monitor. epinephrine racemic and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.ergoloid mesylatesSerious - Use Alternative (1)ergoloid mesylates, dexmethylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.ergotamineSerious - Use Alternative (1)ergotamine, dexmethylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.escitalopramMonitor Closely (1)dexmethylphenidate increases effects of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.esketamine intranasalMonitor Closely (1)esketamine intranasal, dexmethylphenidate. 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. .eslicarbazepine acetateMonitor Closely (1)dexmethylphenidate increases effects of eslicarbazepine acetate by decreasing metabolism. Use Caution/Monitor.estazolamMonitor Closely (1)estazolam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ethanolMonitor Closely (1)ethanol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.etherSerious - Use Alternative (1)ether increases toxicity of dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.ethosuximideMinor (1)dexmethylphenidate increases effects of ethosuximide by decreasing metabolism. Minor/Significance Unknown.eucalyptusMinor (1)eucalyptus increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.famotidineMonitor Closely (1)famotidine 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 formulationfelbamateMinor (1)dexmethylphenidate increases effects of felbamate by decreasing metabolism. Minor/Significance Unknown.fenfluramineMonitor Closely (2)dexmethylphenidate and fenfluramine both decrease sedation. Use Caution/Monitor. dexmethylphenidate and fenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.fluoxetineMinor (1)dexmethylphenidate increases effects of fluoxetine by decreasing metabolism. Minor/Significance Unknown.fluphenazineMonitor Closely (2)fluphenazine, 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. fluphenazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.flurazepamMonitor Closely (1)flurazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.fondaparinuxMinor (1)dexmethylphenidate increases effects of fondaparinux by decreasing metabolism. Minor/Significance Unknown.formoterolMonitor Closely (2)formoterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor. formoterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.fosphenytoinMinor (1)dexmethylphenidate increases effects of fosphenytoin by decreasing metabolism. Minor/Significance Unknown.gabapentinMinor (1)dexmethylphenidate increases effects of gabapentin by decreasing metabolism. Minor/Significance Unknown.gabapentin enacarbilMinor (1)dexmethylphenidate increases effects of gabapentin enacarbil by decreasing metabolism. Minor/Significance Unknown.guaranaMinor (1)guarana increases effects of dexmethylphenidate by pharmacodynamic synergism. Minor/Significance Unknown.haloperidolMonitor Closely (1)haloperidol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.heparinMinor (1)dexmethylphenidate increases effects of heparin by decreasing metabolism. Minor/Significance Unknown.hydralazineMonitor Closely (1)hydralazine, dexmethylphenidate. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Sympathomimetics can antagonize the activity of some antihypertensive agents.hydromorphoneMonitor Closely (1)hydromorphone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.hydroxyzineMonitor Closely (1)hydroxyzine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ibuprofen/famotidineMonitor Closely (1)ibuprofen/famotidine 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 formulationiloperidoneMonitor Closely (1)iloperidone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.imipramineMonitor Closely (1)imipramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)imipramine, 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 imipramine by decreasing metabolism. Minor/Significance Unknown.iobenguane I 123Contraindicated (1)dexmethylphenidate 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)dexmethylphenidate 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.isavuconazonium sulfateMonitor Closely (1)dexmethylphenidate will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.isocarboxazidContraindicated (1)isocarboxazid increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.isofluraneSerious - Use Alternative (1)isoflurane increases toxicity of dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.isoproterenolMonitor Closely (2)isoproterenol and dexmethylphenidate both decrease sedation. Use Caution/Monitor. isoproterenol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.ketotifen, ophthalmicMonitor Closely (1)ketotifen, ophthalmic increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lacosamideMinor (1)dexmethylphenidate increases effects of lacosamide by decreasing metabolism. Minor/Significance Unknown.lamotrigineMinor (1)dexmethylphenidate increases effects of lamotrigine by decreasing metabolism. Minor/Significance Unknown.levalbuterolMonitor Closely (2)levalbuterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor. levalbuterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.levetiracetamMinor (1)dexmethylphenidate increases effects of levetiracetam by decreasing metabolism. Minor/Significance Unknown.levomilnacipranSerious - Use Alternative (1)dexmethylphenidate and levomilnacipran both increase serotonin levels. Avoid or Use Alternate Drug.levorphanolMonitor Closely (1)levorphanol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.linezolidContraindicated (1)linezolid increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.lisdexamfetamineMonitor Closely (2)dexmethylphenidate and lisdexamfetamine both decrease sedation. Use Caution/Monitor. dexmethylphenidate and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.lofepramineMonitor Closely (1)lofepramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)lofepramine, 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 lofepramine by decreasing metabolism. Minor/Significance Unknown.lofexidineMonitor Closely (1)lofexidine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.loprazolamMonitor Closely (1)loprazolam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lorazepamMonitor Closely (1)lorazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dexmethylphenidate increases effects of lorazepam by decreasing metabolism. Minor/Significance Unknown.lormetazepamMonitor Closely (1)lormetazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.loxapineMonitor Closely (1)loxapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)loxapine inhaled increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.maprotilineMonitor Closely (1)maprotiline increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)maprotiline, 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 maprotiline by decreasing metabolism. Minor/Significance Unknown.marijuanaMonitor Closely (1)marijuana increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.melatoninMonitor Closely (1)melatonin increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.meperidineMonitor Closely (1)meperidine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.meprobamateMonitor Closely (1)meprobamate increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metaproterenolMonitor Closely (2)metaproterenol and dexmethylphenidate both decrease sedation. Use Caution/Monitor. metaproterenol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.methadoneMonitor Closely (1)methadone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.methamphetamineMonitor Closely