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Drug Interactions between deserpidine and Dyanavel XR

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

amphetamine deserpidine

Applies to: Dyanavel XR (amphetamine) and deserpidine

MONITOR: Central nervous system (CNS) stimulants, particularly the amphetamines, may decrease the hypotensive effect of postganglionic adrenergic blocking agents such as guanadrel, guanethidine and rauwolfia alkaloids, which work by depleting catecholamine stores from adrenergic nerve endings. CNS stimulants can have peripheral sympathetic activity, thus they may elevate blood pressure on their own as well as antagonize some of the antiadrenergic effect produced by these hypotensive agents. Amphetamines reportedly also may displace the blocking agent, guanethidine, and inhibit its uptake by adrenergic neurons. Other mechanisms have also been proposed. In addition to diminished hypotensive response, the interaction has also been reported to produce hypotension and ventricular tachycardia in a patient stabilized on guanethidine shortly after initiating treatment with methylphenidate.

MANAGEMENT: Alternatives to postganglionic adrenergic blocking agents should be considered in hypertensive patients treated with CNS stimulants. If the combination is used, blood pressure and heart rate should be monitored.

References

  1. Ober KF, Wang RI (1973) "Drug interactions with guanethidine." Clin Pharmacol Ther, 14, p. 190-5
  2. Sherman GP, Walton CA (1975) "Adrenergic transmission and drug interaction." J Am Pharm Assoc, 15, p. 86-90
  3. Flegin OT, Morgan DH, Oates JA, Shand DG, Turner P (1970) "The mechanism of the reversal of the effect of guanethidine by amphetamines in cat and man." Br J Pharmacol, 39, p253
  4. Follenfant MJ, Robson RD (1970) "The antagonism of adrenergic neurone blockade by amphetamine and dexamphetamine in the rat and guinea-pig." Br J Pharmacol, 38, p. 792
  5. Gerkens JF, McCulloch MW, Wilson J (1969) "Mechanism of the antagonism between guanethidine and dexamphetamine." Br J Pharmacol, 35, p. 563-72
  6. Gulati OD, Dave BT, Gokhale SD, Shah KM (1966) "Antagonism of adrenergic neuron blockade in hypertensive subjects." Clin Pharmacol Ther, 7, p. 510-4
  7. Obianwu HO (1969) "Some studies on the mechanism by which d-amphetamine antagonizes guanethidine induced adrenergic neurone blockade." Acta Physiol Scand, 75, p. 102-10
  8. Deshmankar BS, Leewis JA (1967) "Ventricular tachycardia associated with the administration of methylphenidate during guanethidine therapy." Can Med Assoc J, 97, p. 1166-71
View all 8 references

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Drug and food interactions

Moderate

amphetamine food

Applies to: Dyanavel XR (amphetamine)

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

  1. Mendelson J, Jones RT, Upton R, Jacob P 3rd (1995) "Methamphetamine and ethanol interactions in humans." Clin Pharmacol Ther, 57, p. 559-68
  2. 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

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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.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor 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.
Unknown No interaction information available.

Further information

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