Drug interactions
Lisdexamfetamine + Protriptyline
Severity: Major
Lisdexamfetamine and Protriptyline: major interaction.
Last updated
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
Protriptyline strongly inhibits norepinephrine reuptake. With amphetamine from lisdexamfetamine it can cause exaggerated cardiovascular stimulation including hypertension, tachycardia and arrhythmia, and amphetamine levels may rise.
What this interaction means in plain words
Lisdexamfetamine and Protriptyline 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
Norepinephrine reuptake blockade and CYP2D6 inhibition give additive adrenergic effects and possibly higher amphetamine exposure.
What to do
Avoid if possible. If both are required, use low doses and monitor blood pressure, heart rate, ECG and serotonin toxicity signs.
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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Other interactions of Lisdexamfetamine
- Isocarboxazid + Lisdexamfetamine Contraindicated
- Linezolid + Lisdexamfetamine Contraindicated
- Lisdexamfetamine + Phenelzine Contraindicated
- Lisdexamfetamine + Procarbazine Contraindicated
- Lisdexamfetamine + Rasagiline Contraindicated
- Lisdexamfetamine + Safinamide Contraindicated
Frequently asked questions
Can I take Lisdexamfetamine with Protriptyline?
MediHelp rates the interaction as major. Lisdexamfetamine and Protriptyline 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. Protriptyline strongly inhibits norepinephrine reuptake. With amphetamine from lisdexamfetamine it can cause exaggerated cardiovascular stimulation including hypertension, tachycardia and arrhythmia, and amphetamine levels may rise.
How serious is the interaction between Lisdexamfetamine and Protriptyline?
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 if possible. If both are required, use low doses and monitor blood pressure, heart rate, ECG and serotonin toxicity signs.
What other medicines interact with Lisdexamfetamine?
MediHelp also lists interactions of Lisdexamfetamine with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Lisdexamfetamine page.
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