Drug interactions
Methylenedioxymethamphetamine + Pseudoephedrine
Severity: Major
Methylenedioxymethamphetamine and Pseudoephedrine: major interaction.
Last updated Sources: UK SmPC
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
MDMA strongly increases monoamine release, and pseudoephedrine can compound the rises in heart rate and blood pressure and the risk of hyperthermia and arrhythmia. MDMA is an illicit substance, so this combination may be encountered in overdose or recreational use.
What this interaction means in plain words
Methylenedioxymethamphetamine and Pseudoephedrine 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 sympathomimetic effects through release of norepinephrine, dopamine and serotonin.
What to do
Advise against combining and counsel on avoiding decongestants with recreational stimulants. In suspected toxicity, monitor temperature, ECG and blood pressure and treat symptomatically.
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 Pseudoephedrine
- Isocarboxazid + Pseudoephedrine Contraindicated
- Phenelzine + Pseudoephedrine Contraindicated
- Pseudoephedrine + Rasagiline Contraindicated
- Pseudoephedrine + Selegiline Contraindicated
- Pseudoephedrine + Selegiline transdermal Contraindicated
- Pseudoephedrine + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Methylenedioxymethamphetamine with Pseudoephedrine?
MediHelp rates the interaction as major. Methylenedioxymethamphetamine and Pseudoephedrine 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. MDMA strongly increases monoamine release, and pseudoephedrine can compound the rises in heart rate and blood pressure and the risk of hyperthermia and arrhythmia. MDMA is an illicit substance, so this combination may be encountered in overdose or recreational use.
How serious is the interaction between Methylenedioxymethamphetamine and Pseudoephedrine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise against combining and counsel on avoiding decongestants with recreational stimulants. In suspected toxicity, monitor temperature, ECG and blood pressure and treat symptomatically.
What other medicines interact with Pseudoephedrine?
MediHelp also lists interactions of Pseudoephedrine with, for example, Isocarboxazid, Phenelzine, Rasagiline. The full list is on the Pseudoephedrine page.
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