Drug interactions
Dextroamphetamine transdermal + Fluoxetine
Severity: Major
Dextroamphetamine transdermal and Fluoxetine: 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
Amphetamines release serotonin and norepinephrine, and fluoxetine inhibits CYP2D6, which can raise amphetamine levels. Together they raise the risk of serotonin syndrome and cardiovascular stimulation.
What this interaction means in plain words
Dextroamphetamine transdermal and Fluoxetine 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.
Why it happens
Additive serotonergic activity combined with CYP2D6 inhibition by fluoxetine reducing amphetamine clearance.
What to do
Start with low doses and titrate slowly while monitoring for tremor, agitation, hyperthermia, clonus and tachycardia. Stop both drugs and treat if serotonin syndrome develops.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Dextroamphetamine transdermal with Fluoxetine?
MediHelp rates the interaction as major. Dextroamphetamine transdermal and Fluoxetine 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. Amphetamines release serotonin and norepinephrine, and fluoxetine inhibits CYP2D6, which can raise amphetamine levels. Together they raise the risk of serotonin syndrome and cardiovascular stimulation.
How serious is the interaction between Dextroamphetamine transdermal and Fluoxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with low doses and titrate slowly while monitoring for tremor, agitation, hyperthermia, clonus and tachycardia. Stop both drugs and treat if serotonin syndrome develops.
What other medicines interact with Fluoxetine?
MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Methylene blue. The full list is on the Fluoxetine page.
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