Key takeaways:
Adderall (mixed amphetamine salts) is a prescription stimulant medication. It’s thought to work by increasing dopamine, norepinephrine, and serotonin levels in the brain.
Adderall can interact with other medications that affect serotonin, including many antidepressants. It can also interact with blood pressure medications, caffeine, and alcohol.
Some Adderall interactions can be managed with lower dosages and close monitoring. Other interactions may need to be avoided. Your prescriber can determine how to manage these potential Adderall interactions.
Before you pick up your Adderall (mixed amphetamine salts) prescription from the pharmacy, your pharmacist reviews your medication profile to make sure it's safe for you to take. This includes checking for potential drug interactions that need to be addressed ahead of time.
But other things can interact with Adderall besides prescription medications. Certain over-the-counter (OTC) products, supplements, and even foods and beverages may affect how the medication works or increase the risk of side effects.
Here’s what you should know about relevant Adderall interactions.
Adderall interactions list
Below is a list of Adderall interactions to be aware of, including medications you shouldn’t take with Adderall and combinations that may require additional monitoring.
Keep in mind that this isn’t a complete list. So, it’s best to share your current medication list with your healthcare team to screen for interactions before starting Adderall.
You shouldn’t take Adderall with:
Monoamine oxidase inhibitors (MAOIs), such as selegiline (Emsam, Zelapar), rasagiline (Azilect), and phenelzine (Nardil)
Urine alkalinizers, such as Cytra-K (potassium citrate / citric acid)
Medications and substances that may require extra monitoring or dosage adjustments if taken with Adderall include:
Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil)
Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor XR) and duloxetine (Cymbalta)
Tricyclic antidepressants, such as amitriptyline
Antihistamines, such as doxylamine (Unisom)
Lithium (Lithobid)
Certain antiseizure medications, such as ethosuximide (Zarontin) and phenytoin (Dilantin, Phenytek)
Triptan migraine medications, such as sumatriptan (Imitrex), zolmitriptan (Zomig), and rizatriptan (Maxalt)
Opioid pain medications, such as tramadol (ConZip), fentanyl, and methadone
Blood pressure medications, such as lisinopril (Zestril), amlodipine (Norvasc), and metoprolol (Lopressor, Toprol XL)
Other stimulants, such as phentermine (Adipex-P) and pseudoephedrine (Sudafed)
Certain supplements, such as St. John’s wort, L-tryptophan, and vitamin C
Caffeine, including coffee, energy drinks, and caffeine pills
Below, let’s take a closer look at 11 potential Adderall interactions and how to manage them.
1. MAOIs, such as selegiline
MAOIs are an older class of medication used to treat depression and Parkinson’s disease symptoms.
You shouldn’t take Adderall with an MAOI or within 2 weeks of stopping an MAOI. That’s because this combination can cause dangerously high blood pressure levels, which could lead to heart attack, stroke, or even death.
What’s more, Adderall and MAOIs both increase serotonin levels in the brain. Taking them together can raise your risk of serotonin syndrome. This is a condition caused by too much serotonin in the body.
While many cases of serotonin syndrome may be mild, others can become life-threatening. Symptoms include sweating, tremors (shaking), and a fast heartbeat.
2. SSRIs, such as Prozac
SSRIs are often used to treat depression and other mental health conditions. They’re thought to work by making more serotonin available in your brain.
As with MAOIs, combining Adderall with an SSRI can increase the risk of serotonin syndrome.
Certain SSRIs, such as paroxetine and fluoxetine, may also interfere with how your body breaks down Adderall. This can raise Adderall levels in the body and increase your risk of side effects.
If you take an SSRI, your prescriber may recommend a lower Adderall dosage to minimize the risk of these interactions. They may also instruct you to watch for symptoms of serotonin syndrome and seek medical care if they occur.
3. SNRIs, such as Cymbalta
SNRIs are another class of antidepressants. They’re used to treat mental health conditions and certain types of pain. SNRIs increase serotonin levels, similar to SSRIs. But they also increase a chemical called norepinephrine. Adderall does, too.
Combining Adderall with an SNRI can increase your risk of serotonin syndrome. As with SSRIs, you may be told to watch for symptoms of high serotonin levels. If any symptoms feel severe or life-threatening, get emergency medical attention.
SNRIs can also increase your blood pressure and heart rate. Adderall can have a similar effect. These increases may be small if you’re just taking one of these medications. But they may be more pronounced if you take Adderall and an SNRI together. In this case, your prescriber may monitor your blood pressure and heart rate more closely during treatment.
4. Triptan migraine medications
Triptan medications are used to treat migraine headaches. They work by attaching to your brain's serotonin receptors (binding sites). As with SSRIs and SNRIs, taking a triptan with Adderall can increase the risk of serotonin syndrome.
Triptans are taken only as needed for migraines. So, it’s not the type of medication you take every day or on a scheduled basis. This means the risk of serotonin syndrome with this combination is lower. But it’s still a good idea to be aware that it can happen.
Good to know: Adderall can sometimes cause headaches as a side effect. If you’re experiencing migraines or taking a triptan more often after starting Adderall, let your healthcare team know. They may need to adjust your medications.
5. Opioid pain medications, such as tramadol
Tramadol (ConZip) is a prescription opioid medication used to treat pain. In addition to its effects on opioid receptors, tramadol also increases serotonin levels. Some other opioids are known to have a similar effect, such as fentanyl and methadone.
Taking Adderall and tramadol together can increase your risk of serotonin syndrome. This may be the case with Adderall and other opioids, too. In fact, opioids have a serotonin syndrome warning if they’re taken with medications that increase serotonin.
You may only take an opioid for a short time. Even so, it’s a good idea to watch for serotonin syndrome symptoms. Let your healthcare team know right away if you think you’re experiencing them. They can also discuss nonopioid pain reliever options and other tips for managing pain.
6. Blood pressure medications
As mentioned above, Adderall can sometimes increase your blood pressure and heart rate. This increase is often small. But it may be more significant for some people, especially if you’re living with a heart condition. If you’re taking medications to manage your blood pressure, adding Adderall to your regimen may make them less effective.
Your healthcare team may have you monitor your blood pressure at home more often if you’re taking Adderall. Let them know if your readings are higher than usual. They may adjust your blood pressure medication or suggest a nonstimulant ADHD medication, such as guanfacine extended-release (Intuniv). If you have a pre-existing heart condition, you may need to avoid Adderall.
7. Other stimulants, such as phentermine and Sudafed
As mentioned, Adderall and other stimulant medications can cause side effects such as increased blood pressure and a faster heart rate. They can also cause sleeping problems and make you feel anxious or restless. These effects may be worse if you combine Adderall with other stimulants, such as phentermine or pseudoephedrine.
In some cases, combining stimulants may increase the risk of dangerously high blood pressure and irregular heartbeats. So, it’s a good idea to check with your healthcare team before taking them with Adderall.
If you’re treating sinus congestion, there are safer alternatives you can try instead of pseudoephedrine. This includes home remedies, such as nasal saline rinses. There are also nonstimulant phentermine alternatives for weight loss. Discuss your options with a healthcare professional.
8. Urine alkalinizers, such as Cytra-K
Urine alkalinizers, such as Cytra-K, are used to prevent kidney stones and gout. They work by making your urine less acidic (more alkaline). Making your urine more alkaline can decrease how well your kidneys remove Adderall, leading to higher levels of Adderall in your body.
Higher Adderall levels can increase the likelihood of side effects, so it’s recommended to avoid taking urine alkalinizers with Adderall.
9. Certain supplements, such as St. John's wort and vitamin C
Prescription and OTC medications aren’t the only substances that can interact with Adderall. Supplements such as St. John’s wort and vitamin C can also pose risks.
Similar to SSRIs and SNRIs, St. John’s wort and L-tryptophan supplements can increase serotonin levels in the brain. If you take them with Adderall, there’s a higher risk of serotonin syndrome. So, it’s a good idea to talk to your healthcare team before starting St. John’s wort, L-tryptophan, or any other OTC supplement.
Vitamin C, on the other hand, can potentially lower Adderall levels in the body. That’s because it’s an acidifying substance, which may affect how much Adderall is absorbed and removed from the body. To manage this interaction, your prescriber may need to increase your Adderall dosage. They may also recommend separating when you take Adderall from when you take vitamin C supplements or consume citrus fruits or juices.
10. Caffeine
Adderall and caffeine are both stimulants. As mentioned earlier, taking two stimulants together can worsen Adderall side effects, such as sleeping problems and an elevated heart rate.
Caffeine comes in many different forms, including coffee, energy drinks, and pills. If consuming caffeine is part of your usual routine, it’s a good idea to limit it while taking Adderall. You can also try some noncaffeinated ways to start your day with energy, such as eating an avocado or getting some morning sunshine.
11. Alcohol
Another beverage that interacts with Adderall is alcohol. While Adderall acts to stimulate your brain, alcohol does the opposite. So, consuming alcohol can potentially counteract the therapeutic effects of Adderall.
On the flip side, Adderall can mask the effects of alcohol. So you may not be able to tell how much you’ve had to drink based on how you feel. In this case, you may consume more alcohol than intended. And the more you drink, the greater the risk of negative health effects, including alcohol poisoning.
In general, it’s best to avoid or minimize alcohol consumption if you’re taking Adderall. Speak with your healthcare team about your individual risks and any recommendations for your specific situation. They can also provide assistance if you need help to stop drinking.
Frequently asked questions
Yes, Adderall can increase your blood pressure. This small change is unlikely to cause problems for most people. But it may be more concerning for people who are living with high blood pressure or other heart conditions. In addition, long-term use of ADHD medications such as Adderall is linked to a higher risk of heart-related conditions.
Because of these risks, your healthcare team will usually monitor your blood pressure and weigh the benefits and risks of continuing treatment long term. If your blood pressure becomes a concern, your prescriber may recommend lifestyle changes or discuss alternative ADHD treatment options to find the safest approach for you.
Possibly. Some people have reported alopecia (the medical term for hair loss) while taking Adderall, but it isn’t clear how common it is or if Adderall was the true reason behind it. A small study shows a possible link between stimulant ADHD medications and alopecia universalis, a rare autoimmune condition that causes total hair loss. However, the study found no link between stimulants and other types of hair loss.
Keep in mind that Adderall may reduce your appetite. And nutritional deficiencies can lead to hair loss in some cases. If you notice unusual hair loss or thinning while taking Adderall, let your prescriber know. They can help look for possible causes and discuss your treatment options.
One of the most common Adderall side effects is loss of appetite. This is because it increases chemicals in the brain that can affect your hunger level. As a result, some people taking Adderall lose weight during treatment.
You shouldn’t take Adderall if you’re allergic to any of its ingredients, or if you’re currently taking or have taken an MAOI within the last 14 days.
For other people, Adderall’s risks may outweigh its benefits in certain situations. Your prescriber will decide if Adderall is safe for you to take if you:
Have certain health conditions, such as heart disease, high blood pressure, kidney problems, or seizures
Have a mental health condition, such as bipolar disorder or depression
Have a history of a substance use disorder
Are pregnant or planning to become pregnant
Are nursing or planning to nurse
The following foods can potentially interfere with how Adderall works:
Citrus fruits and juices, which can interfere with how well your body absorbs Adderall
Acidic foods, such as tomatoes, which can also affect Adderall’s absorption
High-fat meals, which can make it take longer for Adderall to start working
Alcohol, which can counteract Adderall’s effects
Yes, Adderall can increase your blood pressure. This small change is unlikely to cause problems for most people. But it may be more concerning for people who are living with high blood pressure or other heart conditions. In addition, long-term use of ADHD medications such as Adderall is linked to a higher risk of heart-related conditions.
Because of these risks, your healthcare team will usually monitor your blood pressure and weigh the benefits and risks of continuing treatment long term. If your blood pressure becomes a concern, your prescriber may recommend lifestyle changes or discuss alternative ADHD treatment options to find the safest approach for you.
Possibly. Some people have reported alopecia (the medical term for hair loss) while taking Adderall, but it isn’t clear how common it is or if Adderall was the true reason behind it. A small study shows a possible link between stimulant ADHD medications and alopecia universalis, a rare autoimmune condition that causes total hair loss. However, the study found no link between stimulants and other types of hair loss.
Keep in mind that Adderall may reduce your appetite. And nutritional deficiencies can lead to hair loss in some cases. If you notice unusual hair loss or thinning while taking Adderall, let your prescriber know. They can help look for possible causes and discuss your treatment options.
One of the most common Adderall side effects is loss of appetite. This is because it increases chemicals in the brain that can affect your hunger level. As a result, some people taking Adderall lose weight during treatment.
You shouldn’t take Adderall if you’re allergic to any of its ingredients, or if you’re currently taking or have taken an MAOI within the last 14 days.
For other people, Adderall’s risks may outweigh its benefits in certain situations. Your prescriber will decide if Adderall is safe for you to take if you:
Have certain health conditions, such as heart disease, high blood pressure, kidney problems, or seizures
Have a mental health condition, such as bipolar disorder or depression
Have a history of a substance use disorder
Are pregnant or planning to become pregnant
Are nursing or planning to nurse
The following foods can potentially interfere with how Adderall works:
Citrus fruits and juices, which can interfere with how well your body absorbs Adderall
Acidic foods, such as tomatoes, which can also affect Adderall’s absorption
High-fat meals, which can make it take longer for Adderall to start working
Alcohol, which can counteract Adderall’s effects
The bottom line
Adderall (mixed amphetamine salts) can interact with other medications that increase serotonin levels or have stimulant effects. Examples include antidepressants, triptans, and phentermine (Adipex-P). Over-the-counter (OTC) medications and supplements can also interact with Adderall. Examples include pseudoephedrine (Sudafed), St. John’s wort, and vitamin C.
For some Adderall interactions, your healthcare team may monitor you or lower your dosage. Other interactions may need to be avoided altogether. Speak with your prescriber or pharmacist if you have questions about Adderall interactions.
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