Written and medically reviewed by Dorcas Morak, Pharm.D
Vyvanse (lisdexamfetamine), commonly prescribed for ADHD and binge eating disorder, is a powerful central nervous system stimulant. However, when combined with certain medications, it can lead to serious or even life-threatening interactions. This article outlines seven medications that should be avoided when taking Vyvanse and highlights the importance of discussing your full medical history and current prescriptions with your healthcare provider before starting treatment.
- Monoamine Oxidase Inhibitors (MAOIs) Monoamine oxidase inhibitors (MAOIs), such as phenelzine (Nardil), isocarboxazid (Marplan), and tranylcypromine (Parnate), are prescribed for depression and mood disorders. Taking Vyvanse with an MAOI is strictly contraindicated, as it can cause a life-threatening hypertensive crisis by slowing the breakdown of amphetamines and dangerously raising blood pressure. Symptoms may include severe headaches, blurred vision, shortness of breath, and chest pain. Avoid Vyvanse if you are taking or have recently taken an MAOI.
- Antidepressant Medications Vyvanse can interact with various classes of antidepressant medications, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). These medications, such as fluoxetine (Prozac), citalopram (Celexa), sertraline (Zoloft), venlafaxine (Effexor XR), and amitriptyline (Elavil), are used to manage conditions like depression, anxiety, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). When taken together, these antidepressants and Vyvanse can cause serotonin syndrome, a severe condition characterized by agitation, hallucinations, rapid heartbeat, and high body temperature.
- Triptans Triptans are a group of medications primarily used to treat migraine headaches. Common triptans include zolmitriptan (Zomig), sumatriptan (Imitrex), frovatriptan (Frova), and rizatriptan (Maxalt). Like antidepressants, triptans can increase serotonin levels in the brain and raise the risk of serotonin syndrome, a condition that can lead to severe complications if not treated promptly.
- Lithium Lithium (Lithobid) is a mood stabilizer used to treat bipolar disorder. Combining lithium with Vyvanse can also increase the risk of serotonin syndrome. Patients with a history of bipolar disorder should inform their healthcare provider if they are considering Vyvanse, as it may not be the safest option for managing ADHD. Your doctor may recommend adjusting the dose or exploring alternative treatments for ADHD to avoid potential drug interactions.
- Acetazolamide Acetazolamide (Diamox) is often prescribed to treat certain types of glaucoma and prevent or reduce altitude sickness symptoms. When taken with Vyvanse, acetazolamide can lead to higher plasma levels of the stimulant, increasing the risk of side effects such as jitteriness, anxiety, and cardiovascular complications. If you are taking acetazolamide (Diamox) or have glaucoma, it is crucial to consult your doctor before starting Vyvanse to avoid any potential drug interactions.
- St. John’s Wort St. John’s Wort is a common herbal supplement used to treat mild depression. However, this supplement can interact with Vyvanse and increase the risk of serotonin syndrome, causing symptoms such as confusion, rapid heart rate, and elevated blood pressure.
- Over-the-counter Cold and Cough Medications Many over-the-counter cold medications contain decongestants like pseudoephedrine (Sudafed) and dextromethorphan (Delsym). These ingredients, especially dextromethorphan (Delsym), can increase the risk of serotonin syndrome when taken with Vyvanse.
How do I Reduce the Risk of Vyvanse Interactions?
When using Vyvanse, inform your healthcare provider of your complete health history and medications, as it may not be suitable for conditions like high blood pressure, heart disease, or glaucoma. Share any prescriptions, OTC drugs, or supplements to avoid dangerous interactions, and discuss side effects to identify potential issues.
What to Do If You Experience Side Effects
If you experience unusual symptoms such as a rash, swelling, trouble breathing, or symptoms of serotonin syndrome while taking Vyvanse, seek medical attention immediately.
Maximizing Safety and Savings
When managing conditions like ADHD or binge eating disorder, it's essential to be aware of potential drug interactions and ensure your prescribed medications are affordable. Prescription costs can add up, but the RxLess app can help you save money on Vyvanse (lisdexamfetamine) and other medications. By joining the RxLess Assurance Plan, which provides accurate, real-time discounts on prescriptions, you can adhere to your treatment plan without financial stress. Always consult your healthcare provider before starting any new medication and explore RxLess to find the best savings on your prescriptions.
