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Drug Interactions between Dexedrine and emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

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

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Interactions between your drugs

Moderate

dextroamphetamine ritonavir

Applies to: Dexedrine (dextroamphetamine) and emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Consumer information for this interaction is not currently available.

MONITOR: Coadministration with inhibitors of CYP450 2D6 may increase the plasma concentrations as well as the pharmacologic and adverse effects of amphetamines. The proposed mechanism involves the inhibition of CYP450 2D6, an isoenzyme partially responsible for the metabolic clearance of certain amphetamines. Furthermore, because CYP450 2D6 is genetically polymorphic, variations in amphetamine metabolism across populations may either increase or decrease the risk associated with this interaction. Increased exposure to amphetamines may potentiate the risk of serious adverse reactions such as serotonin syndrome, seizures, psychiatric adverse reactions (e.g., new psychotic or manic symptoms), peripheral vasculopathy (including Raynaud's Phenomenon), and cardiovascular effects (e.g., hypertension, tachycardia). However, data evaluating the interaction are not available.

MANAGEMENT: Caution and closer monitoring for adverse effects are recommended when amphetamines are used concurrently with CYP450 2D6 inhibitors, and a reduction in the initial amphetamine dose should be considered. Patients should be more closely monitored for signs and symptoms of serotonin syndrome, particularly during the initiation of amphetamine therapy and following any dosage increases. Additional caution is advised when amphetamines are coadministered with CYP450 2D6 inhibitors that lower the seizure threshold (e.g., bupropion). Patients should be instructed to notify their healthcare provider if they experience increased amphetamine-related side effects, such as seizures, cardiovascular effects (e.g., hypertension, tachycardia), or symptoms of serotonin syndrome (e.g., mental status changes, autonomic dysfunction like tachycardia or hyperthermia, neuromuscular abnormalities such as hyperreflexia, or gastrointestinal symptoms).

Moderate

ritonavir tenofovir

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir disoproxil and emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Ritonavir may increase the blood levels and effects of tenofovir. This can increase the risk of side effects including serious ones like kidney or liver damage and a condition known as lactic acidosis, which is a buildup of lactic acid in the blood. You should seek immediate medical attention if you develop symptoms of these conditions. Symptoms of kidney damage may include swelling, weight gain, shortness of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea, vomiting, pain in your lower back, and urinating more or less than usual or not at all. Symptoms of liver damage may include fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes. Symptoms of lactic acidosis may include fatigue, unusual muscle pain, difficulty breathing, stomach pain, nausea, vomiting, lightheadedness, dizziness, and a fast or irregular heartbeat. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

lopinavir tenofovir

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir disoproxil and emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Lopinavir may increase the blood levels and effects of tenofovir. This can increase the risk of side effects including serious ones like kidney or liver damage and a condition known as lactic acidosis, which is a buildup of lactic acid in the blood. You should seek immediate medical attention if you develop symptoms of these conditions. Symptoms of kidney damage may include swelling, weight gain, shortness of breath, drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea, vomiting, pain in your lower back, and urinating more or less than usual or not at all. Symptoms of liver damage may include fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes. Symptoms of lactic acidosis may include fatigue, unusual muscle pain, difficulty breathing, stomach pain, nausea, vomiting, lightheadedness, dizziness, and a fast or irregular heartbeat. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Drug and food interactions

Moderate

dextroamphetamine food

Applies to: Dexedrine (dextroamphetamine)

Using dextroamphetamine together with alcohol can increase the risk of cardiovascular side effects such as increased heart rate, chest pain, or blood pressure changes. You should avoid or limit the use of alcohol while being treated with dextroamphetamine. Let your doctor know if you experience severe or frequent headaches, chest pain, and/or a fast or pounding heartbeat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

ritonavir food

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Ritonavir should be taken with food to lessen gastrointestinal side effects. It is important that you take this medication exactly as prescribed by your doctor. Do not change your treatment or stop treatment without first talking to your doctor.

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Moderate

lopinavir food

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Food may affect the absorption of lopinavir-ritonavir (brand name Kaletra) depending on whether you are taking the oral solution or the tablet. The oral solution should be taken with food to enhance absorption and help it work better. The tablet formulation can be take with or without food. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Minor

tenofovir food

Applies to: emtricitabine / lopinavir / ritonavir / tenofovir disoproxil

Information for this minor interaction is available on the professional version.

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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.