Norepinephrine: Amphetamines enhance the effect of norepinephrine.Methenamine therapy for bladder or kidney infections: Acidifying agents used in Hiprex (methenamine) increase urinary excretion of amphetamines, making them less effective.Opioid pain medications: Amphetamines may increase the analgesic effect of opioids, such as Demerol (meperidine).Lithobid (lithium) for bipolar disorder: The stimulatory effects of amphetamines may be inhibited by lithium carbonate.Chlorpromazine blocks dopamine and norepinephrine receptors, inhibiting the stimulant effects of amphetamines (which is why chlorpromazine can be used to treat amphetamine poisoning). Antipsychotics: Haloperidol for schizophrenia blocks dopamine receptors, inhibiting the stimulant effects of amphetamines.Blood thinners: There may be a harmful interaction when both drugs are used.In addition, this combination can also increases concentrations of d-amphetamine in the brain and increase the potential for cardiovascular effects. Antidepressants: Amphetamines may enhance the activity of tricyclic or sympathomimetic agents in antidepressants.Diamox (acetazolamide): Diomox decrease urinary excretion or amphetamines, raising blood levels of amphetamines.These gastrointestinal alkalinizing agents increase absorption and blood levels of amphetamines. Antacids (sodium bicarbonate): Do not take antacids with Adderall.Amphetamines also inhibit the effect of veratrum alkaloids that may be taken by those with high blood pressure. Guanethidine and reserpine are gastrointestinal acidifying agents that lower levels of amphetamines. Some thiazide diuretics decrease urinary excretion of amphetamines, raising blood levels of amphetamines. Alpha blockers (also called adrenergic blockers) are inhibited by amphetamines, making them ineffective. Blood pressure medications: These medications can interact with Adderall in a variety of ways. This can lead to hypertensive crises and a variety of neurological toxic effects and malignant hyperpyrexia, which can be fatal. MAOIs slow metabolism of amphetamines and increase their effects. Monoamine oxidase inhibitors (MAOIs) or other antidepressants: Do not take Adderall if you've taken MAOIs within 14 days.Pregnancy: There are no adequate and well-controlled studies in pregnant women and there may be a risk of long-term behavioral, including learning and memory deficits, or neurochemical changes for children born to mothers who took amphetamines while pregnant.Liver or kidney problems: These organs may be affected by long-term use of Adderall.Tics: The medication may exacerbate motor and phonic tics and Tourette’s syndrome. You don't need to worry that Adderall is causing tics, as some medications can, but it can cause tics that you otherwise have to become more noticeable.Bipolar disorder: Stimulants may induce mixed/manic episode in patients with bipolar disorder.Pre-existing psychosis: Stimulants may worsen symptoms of behavioral disturbance and thought disorder in patients with psychotic disorders.Seizures: Stimulants may lower the convulsive threshold and increase seizures in patients with prior history of seizure or those with prior EEG (brain wave test) abnormalities.In general, those with structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease or other serious heart problems should not take stimulants. Hypertension and other cardiovascular conditions: Stimulants cause an increase in average blood pressure and heart rate that can carry risks for those with any underlying conditions, such as mild hypertension, heart failure, recent myocardial infarction, or ventricular arrhythmia.
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