Drug Interactions between Adderall and dacomitinib
This report displays the potential drug interactions for the following 2 drugs:
- Adderall (amphetamine/dextroamphetamine)
- dacomitinib
Interactions between your drugs
amphetamine dacomitinib
Applies to: Adderall (amphetamine / dextroamphetamine) and dacomitinib
MONITOR: Coadministration with dacomitinib may increase the plasma concentrations of drugs that are substrates of the CYP450 2D6 isoenzyme. The mechanism is reduced clearance due to inhibition of CYP450 2D6 by dacomitinib. When dextromethorphan, a probe substrate for CYP450 2D6, was coadministered with a single 45 mg dose of dacomitinib, dextromethorphan peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 9.7- and 9.6-fold, respectively. The interaction may be particularly important for sensitive CYP450 2D6 substrates or those that demonstrate a narrow therapeutic index.
MANAGEMENT: Caution is advised if dacomitinib is used in combination with CYP450 2D6 substrates. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate whenever dacomitinib is added to or withdrawn from therapy. Avoid concomitant use with dacomitinib where minimal increases in concentration of the CYP450 2D6 substrate may lead to serious or life-threatening toxicities.
References
- (2018) "Product Information. Vizimpro (dacomitinib)." Pfizer U.S. Pharmaceuticals Group
Drug and food interactions
amphetamine food
Applies to: Adderall (amphetamine / dextroamphetamine)
GENERALLY AVOID: Alcohol may potentiate the cardiovascular effects of amphetamines. The exact mechanism of interaction is unknown. In one study, concurrent administration of methamphetamine (30 mg intravenously) and ethanol (1 gm/kg orally over 30 minutes) increased heart rate by 24 beats/minute compared to methamphetamine alone. This increases cardiac work and myocardial oxygen consumption, which may lead to more adverse cardiovascular effects than either agent alone. Subjective effects of ethanol were diminished in the eight study subjects, but those of methamphetamine were not affected. The pharmacokinetics of methamphetamine were also unaffected except for a decrease in the apparent volume of distribution at steady state. The interaction was suspected in a case report of a 20-year-old male who experienced retrosternal chest pain shortly after drinking alcohol and taking a double dose of his amphetamine/dextroamphetamine medication (Adderall 15 mg X 2) to stay alert. The patient had no family history of cardiovascular diseases, and his past medical history was remarkable only for ADHD. Prior to the episode, the patient had not taken his medication for weeks and had been drinking whiskey the previous three nights before going to bed. The patient was diagnosed with myocardial infarction likely secondary to amphetamine-induced coronary vasospasm.
MANAGEMENT: Concomitant use of amphetamines and alcohol should be avoided if possible, especially in patients with a history of heart disease.
References
- Mendelson J, Jones RT, Upton R, Jacob P 3rd (1995) "Methamphetamine and ethanol interactions in humans." Clin Pharmacol Ther, 57, p. 559-68
- Jiao X, Velez S, Ringstad J, Eyma V, Miller D, Bleiberg M (2009) "Myocardial infarction associated with Adderall XR and alcohol use in a young man." J Am Board Fam Med, 22, p. 197-201
dextroamphetamine food
Applies to: Adderall (amphetamine / dextroamphetamine)
GENERALLY AVOID: Alcohol may potentiate the cardiovascular effects of amphetamines. The exact mechanism of interaction is unknown. In one study, concurrent administration of methamphetamine (30 mg intravenously) and ethanol (1 gm/kg orally over 30 minutes) increased heart rate by 24 beats/minute compared to methamphetamine alone. This increases cardiac work and myocardial oxygen consumption, which may lead to more adverse cardiovascular effects than either agent alone. Subjective effects of ethanol were diminished in the eight study subjects, but those of methamphetamine were not affected. The pharmacokinetics of methamphetamine were also unaffected except for a decrease in the apparent volume of distribution at steady state. The interaction was suspected in a case report of a 20-year-old male who experienced retrosternal chest pain shortly after drinking alcohol and taking a double dose of his amphetamine/dextroamphetamine medication (Adderall 15 mg X 2) to stay alert. The patient had no family history of cardiovascular diseases, and his past medical history was remarkable only for ADHD. Prior to the episode, the patient had not taken his medication for weeks and had been drinking whiskey the previous three nights before going to bed. The patient was diagnosed with myocardial infarction likely secondary to amphetamine-induced coronary vasospasm.
MANAGEMENT: Concomitant use of amphetamines and alcohol should be avoided if possible, especially in patients with a history of heart disease.
References
- Mendelson J, Jones RT, Upton R, Jacob P 3rd (1995) "Methamphetamine and ethanol interactions in humans." Clin Pharmacol Ther, 57, p. 559-68
- Jiao X, Velez S, Ringstad J, Eyma V, Miller D, Bleiberg M (2009) "Myocardial infarction associated with Adderall XR and alcohol use in a young man." J Am Board Fam Med, 22, p. 197-201
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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