Drug interactions
Dextroamphetamine + Doxepin
Severity: Major
Dextroamphetamine and Doxepin: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Tricyclic antidepressants can change the cardiovascular response to amphetamines. Amphetamine exposure and noradrenergic effects may rise, which increases the risk of hypertension, tachycardia, arrhythmia and serotonin toxicity. Some amphetamine effects may also be blunted by blocked uptake into neurons.
What this interaction means in plain words
Dextroamphetamine and Doxepin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Dextroamphetamine belongs to Central Nervous System; Doxepin belongs to Dermatology.
Why it happens
Tricyclics block norepinephrine reuptake and inhibit CYP2D6, giving additive adrenergic effects and possibly higher amphetamine levels.
What to do
Avoid the combination where possible. If both are needed, start at low doses and monitor blood pressure, heart rate, ECG and signs of serotonin toxicity.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Dextroamphetamine
- Dextroamphetamine + Isocarboxazid Contraindicated
- Dextroamphetamine + Linezolid Contraindicated
- Dextroamphetamine + Methylene blue Contraindicated
- Dextroamphetamine + Phenelzine Contraindicated
- Dextroamphetamine + Rasagiline Contraindicated
- Dextroamphetamine + Safinamide Contraindicated
Other interactions of Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Dextroamphetamine with Doxepin?
MediHelp rates the interaction as major. Dextroamphetamine and Doxepin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Tricyclic antidepressants can change the cardiovascular response to amphetamines. Amphetamine exposure and noradrenergic effects may rise, which increases the risk of hypertension, tachycardia, arrhythmia and serotonin toxicity. Some amphetamine effects may also be blunted by blocked uptake into neurons.
How serious is the interaction between Dextroamphetamine and Doxepin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible. If both are needed, start at low doses and monitor blood pressure, heart rate, ECG and signs of serotonin toxicity.
What other medicines interact with Dextroamphetamine?
MediHelp also lists interactions of Dextroamphetamine with, for example, Isocarboxazid, Linezolid, Methylene blue. The full list is on the Dextroamphetamine page.
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