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.lofexidineMonitor Closely (1)lofexidine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.loprazolamMonitor Closely (1)loprazolam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lorazepamMonitor Closely (1)lorazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lorcaserinSerious - Use Alternative (1)dextroamphetamine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.lormetazepamMonitor Closely (1)lormetazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.loxapineMonitor Closely (1)loxapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.loxapine inhaledMonitor Closely (1)loxapine inhaled increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.lsdMonitor Closely (1)dextroamphetamine and lsd both increase serotonin levels. Use Caution/Monitor.lumefantrineMonitor Closely (1)lumefantrine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.maprotilineMonitor Closely (3)maprotiline increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor. maprotiline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely. maprotiline increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)maprotiline, 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.maravirocMinor (1)maraviroc will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.marijuanaMonitor Closely (1)marijuana increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)marijuana will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.melatoninMonitor Closely (1)melatonin increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.meperidineMonitor Closely (2)dextroamphetamine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely. meperidine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of meperidine by unspecified interaction mechanism. Minor/Significance Unknown.meprobamateMonitor Closely (1)meprobamate increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.metaproterenolMonitor Closely (2)metaproterenol and dextroamphetamine both decrease sedation. Use Caution/Monitor. metaproterenol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.methadoneMonitor Closely (1)methadone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of methadone by unspecified interaction mechanism. Minor/Significance Unknown.methamphetamineMonitor Closely (2)dextroamphetamine and methamphetamine both decrease sedation. Use Caution/Monitor. dextroamphetamine 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 dextroamphetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.methyldopaMonitor Closely (1)methyldopa increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.methylene blueSerious - Use Alternative (1)methylene blue and dextroamphetamine both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.methylenedioxymethamphetamineMonitor Closely (2)dextroamphetamine and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor. dextroamphetamine and methylenedioxymethamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.methylergonovineSerious - Use Alternative (1)methylergonovine, dextroamphetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.methylphenidateMonitor Closely (1)dextroamphetamine increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.midazolamMonitor Closely (1)midazolam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.midodrineMonitor Closely (2)dextroamphetamine and midodrine both decrease sedation. Use Caution/Monitor. dextroamphetamine and midodrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.milnacipranMonitor Closely (1)milnacipran and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.mirtazapineMonitor Closely (2)mirtazapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. dextroamphetamine and mirtazapine both increase serotonin levels. Use Caution/Monitor.modafinilMonitor Closely (1)dextroamphetamine and modafinil both decrease sedation. Use Caution/Monitor.morphineMonitor Closely (2)morphine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. dextroamphetamine and morphine both increase serotonin levels. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of morphine by unspecified interaction mechanism. Minor/Significance Unknown.motherwortMonitor Closely (1)motherwort increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.moxonidineMonitor Closely (1)moxonidine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nabiloneMonitor Closely (1)nabilone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.nalbuphineMonitor Closely (1)nalbuphine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of nalbuphine by unspecified interaction mechanism. Minor/Significance Unknown.naratriptanMonitor Closely (1)naratriptan and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.nefazodoneMonitor Closely (1)nefazodone and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.norepinephrineMonitor Closely (2)norepinephrine and dextroamphetamine both decrease sedation. Use Caution/Monitor. norepinephrine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.nortriptylineMonitor Closely (3)nortriptyline increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor. nortriptyline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely. nortriptyline increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)nortriptyline, 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.olanzapineMonitor Closely (1)olanzapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.omeprazoleMonitor Closely (1)omeprazole, 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. .opium tinctureMonitor Closely (1)opium tincture increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of opium tincture by unspecified interaction mechanism. Minor/Significance Unknown.oxazepamMonitor Closely (1)oxazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.oxycodoneMonitor Closely (1)oxycodone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of oxycodone by unspecified interaction mechanism. Minor/Significance Unknown.oxymorphoneMonitor Closely (1)oxymorphone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of oxymorphone by unspecified interaction mechanism. Minor/Significance Unknown.oxytocinMonitor Closely (1)oxytocin increases effects of dextroamphetamine by pharmacodynamic synergism. Use Caution/Monitor.ozanimodSerious - Use Alternative (1)ozanimod increases toxicity of dextroamphetamine 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 dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pantoprazoleMonitor Closely (1)pantoprazole, 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. .papaveretumMonitor Closely (1)papaveretum increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of papaveretum by unspecified interaction mechanism. Minor/Significance Unknown.parecoxibMinor (1)parecoxib will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.paroxetineMonitor Closely (2)paroxetine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely. paroxetine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.pentazocineMonitor Closely (2)pentazocine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. dextroamphetamine and pentazocine both increase serotonin levels. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of pentazocine by unspecified interaction mechanism. Minor/Significance Unknown.pentobarbitalMonitor Closely (1)pentobarbital increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.perphenazineMonitor Closely (2)perphenazine, 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. perphenazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)perphenazine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.phendimetrazineMonitor Closely (2)dextroamphetamine and phendimetrazine both decrease sedation. Use Caution/Monitor. dextroamphetamine and phendimetrazine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.phenelzineContraindicated (1)phenelzine increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.Serious - Use Alternative (1)phenelzine and dextroamphetamine both increase serotonin levels. Avoid or Use Alternate Drug.phenobarbitalMonitor Closely (1)phenobarbital increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.phentermineMonitor Closely (2)dextroamphetamine and phentermine both decrease sedation. Use Caution/Monitor. dextroamphetamine and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.phenylephrineMonitor Closely (2)dextroamphetamine and phenylephrine both decrease sedation. Use Caution/Monitor. dextroamphetamine and phenylephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.phenylephrine POMonitor Closely (2)dextroamphetamine and phenylephrine PO both decrease sedation. Use Caution/Monitor. dextroamphetamine and phenylephrine PO both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.pholcodineMonitor Closely (1)pholcodine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozideMonitor Closely (1)pimozide increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.pirbuterolMonitor Closely (2)pirbuterol and dextroamphetamine both decrease sedation. Use Caution/Monitor. pirbuterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.primidoneMonitor Closely (1)primidone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.procarbazineContraindicated (1)procarbazine increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.Serious - Use Alternative (1)procarbazine and dextroamphetamine both increase serotonin levels. Avoid or Use Alternate Drug.prochlorperazineMonitor Closely (2)prochlorperazine, 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. prochlorperazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.promazineMonitor Closely (1)promazine, 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.promethazineMonitor Closely (2)promethazine, 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. promethazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.propafenoneMinor (1)propafenone will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.propylhexedrineMonitor Closely (2)dextroamphetamine and propylhexedrine both decrease sedation. Use Caution/Monitor. dextroamphetamine and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.protriptylineMonitor Closely (3)protriptyline increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor. protriptyline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely. protriptyline increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)protriptyline, 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.pseudoephedrineMonitor Closely (1)dextroamphetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.quazepamMonitor Closely (1)quazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.quetiapineMonitor Closely (1)quetiapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.quinacrineMinor (1)quinacrine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.quinidineMonitor Closely (1)quinidine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.rabeprazoleMonitor Closely (1)rabeprazole, 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. .ranolazineMinor (1)ranolazine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.rasagilineContraindicated (1)rasagiline increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Coadministration is contraindicated during or within 14 days following the administration of MAOIs.risperidoneMonitor