7 Focalin Interactions to Watch Out For

Focalin (dexmethylphenidate) is a prescription-only medication that treats attention-deficit hyperactivity disorder (ADHD) in adults and children. Like most medications, it has interactions to be aware of while you’re taking it. Knowing about these interactions can help you avoid unwanted side effects and help protect your safety. 

Below are details on seven Focalin interactions to be aware of. 

1. Monoamine oxidase inhibitors

Monoamine oxidase inhibitors (MAOIs) are an older class of medications that treat depression and symptoms of Parkinson’s disease. Examples include:

• Nardil (phenelzine)

• Emsam (selegiline)

• Parnate (tranylcypromine)

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The antibiotic Zyvox (linezolid) is another type of MAOI that treats certain bacterial infections.

Taking Focalin along with an MAOI can cause a hypertensive crisis (dangerously high blood pressure). This could lead to a heart attack, a stroke, or kidney failure. It can even be fatal in some cases. Because of this risk, you shouldn’t take Focalin and an MAOI at the same time. In fact, you should wait at least 14 days after your last MAOI dose to start taking Focalin.

Let your prescriber know if you’re taking an MAOI before starting Focalin. They can suggest a different ADHD treatment that’s a safer option for you.

2. Blood pressure medications

Focalin can have several effects on your heart. It can raise your blood pressure and heart rate. It may also increase your risk of an irregular heartbeat or a heart attack.

If you’re taking medication to manage high blood pressure, Focalin may make it less effective. Common blood pressure medications include:

• Angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril (Zestril)

• Angiotensin II receptor blockers, such as candesartan (Atacand)

• Calcium channel blockers, such as amlodipine (Norvasc)

• Beta blockers, such as metoprolol (Lopressor, Toprol XL)

• Diuretics (water pills), such as chlorthalidone (Thalitone)

EXPERT PICKS: WHAT TO READ NEXT

• Focalin side effects: Learn about Focalin (dexmethylphenidate) side effects to watch for and what to do if they occur.

• Which type of ADHD do you have? There are three types of attention-deficit hyperactivity disorder (ADHD). Understanding which type you or your child has may help you better manage symptoms.

• How long does Focalin last? Learn more about how long Focalin’s effects last in the body.

You may be able to take Focalin and blood pressure medications at the same time in some cases. But you shouldn’t do so without your prescriber’s OK. They may want you to check your blood pressure at home more often to keep an eye out for any issues. So be sure to follow their instructions carefully.

3. Other heart-related medications

Other heart-related medications may not interact directly with Focalin. But if you’re taking a heart-related medication, it’s a sign that you may be more at risk for Focalin’s heart-related side effects.

Common examples of heart-related medications include the above blood pressure medications as well as:

• Cholesterol medications, such as statins

• Medications to regulate your heartbeat, such as Pacerone (amiodarone)

• Medications for heart failure, such as Lanoxin (digoxin)

Let your prescriber know if you’re living with a heart condition or taking a heart-related medication before starting Focalin. They can determine if it’s a safe option for you based on your personal history.

4. Antipsychotic medications

Antipsychotic medications treat conditions such as bipolar disorder and schizophrenia. Common examples include:

• Haldol (haloperidol)

• Perphenazine

• Latuda (lurasidone)

• Zyprexa (olanzapine)

• Abilify (aripiprazole)

Focalin may cause or worsen psychotic symptoms in some people. (This includes mania, hallucinations, and other mood or behavioral changes.) So it’s possible that it may also worsen the underlying conditions antipsychotic medications treat.

Let your prescriber know if you’re taking an antipsychotic medication before starting Focalin. They can determine if Focalin is a safe option for you based on your medical history.

5. Risperdal

Risperdal (risperidone) is an antipsychotic with a more unique Focalin interaction. Combining risperidone and Focalin may raise the risk of extrapyramidal symptoms (EPS). These are movement-related side effects, such as:

• Akathisia: an internal feeling of restlessness and inability to remain still

• Dystonia: abnormal flexing, stiffening, or twisting of the body

• Tardive dyskinesia: uncontrollable movements in the face, arms, or trunk

• Parkinsonism: tremors similar to those caused by Parkinson’s disease

Focalin can raise the risk of EPS if you take it along with any antipsychotic. But the risk is higher with Risperdal. This is because Risperdal is more likely to cause EPS in the first place. The risk of EPS is particularly high when starting or stopping treatment or changing the dosage of either medication.

If you need to take Risperdal and Focalin together, your prescriber will closely monitor you for EPS. Immediately report these symptoms to your prescriber if they appear. And don’t change your dosages or stop taking either medication without speaking to them first.

6. Other stimulants

Focalin is considered a stimulant medication. Combining it with other stimulants can raise your risk of side effects. This includes serious side effects such as dangerously high blood pressure, fast heart rate, and substance misuse.

Common stimulants include:

• Other ADHD medications, such as Adderall (mixed amphetamine salts)

• Sudafed (pseudoephedrine), a decongestant

• Adipex-P (phentermine), a weight-loss medication

• Narcolepsy medications, such as Provigil (modafinil)

• Caffeine

You shouldn’t take more than one stimulant at a time to treat ADHD. And it’s best to check with your prescriber before taking Focalin with stimulants for other conditions. They’ll likely recommend alternative options.

It’s also a good idea to avoid or limit your caffeine intake while taking Focalin. Your prescriber can let you know how much caffeine, if any, is safe for you based on your medical history.

7. Alcohol

It’s best to avoid or limit alcohol while taking Focalin. Combining these substances could lead to dizziness, drowsiness, or trouble thinking clearly.

Focalin may also mask the intoxicating effects of alcohol. This may lead you to consume more alcohol than usual, raising your risk for intoxication or even alcohol overdose.

Your prescriber can let you know how much, if any, alcohol is safe for you to drink while taking Focalin. They can also offer support to help you cut back or stop drinking if you’re having trouble doing so on your own.

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Written by:

Alex Brewer, PharmD, MBA

Alex Brewer, PharmD, MBA, is a licensed pharmacist specializing in chronic disease and health and wellness. Upon completing his residency, he worked in the managed care field, conducting medication therapy management and adherence counseling sessions with Medicaid, Medicare, and private insurance patients, before transitioning to a career in medical writing.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Ferras Bashqoy, PharmD, BCCCP, BCPPS

Ferras Bashqoy, PharmD, BCCCP, BCPPS, is a clinical pharmacotherapy specialist in the Neonatal Intensive Care Unit (NICU) at Hassenfeld Children’s Hospital in New York City. His favorite part of the job is working with preterm newborns because they are strong and mighty despite their size.

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