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Drug Info

Vyvanse interactions to avoid

Understanding which medications interact with Vyvanse can help you avoid serious side effects
Keith Gardner, RPh, medical writer and reviewer for SingleCare
By | Aug. 20, 2024
An Rx pill bottle and Rx prescription pad: Vyvanse interactions

Key takeaways

  • Vyvanse is a brand-name prescription drug for the treatment of attention deficit hyperactivity disorder (ADHD) in adults and children and binge eating disorder (BED) in adults.

  • Vyvanse is an amphetamine and central nervous system stimulant designed to be long-acting and provide a sustained effect when taken.

  • Vyvanse should not be taken within at least 14 days of monoamine oxidase inhibitors (MAOIs).

  • Vyvanse should not be taken with certain types of antidepressants and blood pressure medicines, which may increase blood levels of the active drug and cause serious side effects.

  • It is very important to tell your healthcare provider about any other prescription medications you may be taking and over-the-counter drugs, vitamins, herbs, and other supplements.

In this article:

Vyvanse is the branded version of the drug lisdexamfetamine dimesylate. The U.S. Food and Drug Administration (FDA) has approved it as a prescription medication for the treatment of attention deficit hyperactivity disorder (ADHD) in adults and pediatric patients older than six years. It’s also approved for binge-eating disorder (BED) in adult patients but is typically used as a second-line therapy. 

Vyvanse belongs to a class of central nervous system (CNS) stimulant drugs called amphetamines. Amphetamines help regulate certain chemicals in the brain (dopamine and norepinephrine) to increase cognitive control and improve focus, alertness, and attention for medical conditions such as ADHD. Unlike most other stimulant medications, Vyvanse is a prodrug, which means it has no effect until the body metabolizes it into its active form, dextroamphetamine. 

While the use of Vyvanse can be an effective treatment option for many patients, there are potential drug interactions that may occur to increase the risk of serious side effects:

  • Vyvanse should not be taken within at least 14 days of taking monoamine oxidase inhibitors (MAOIs)
  • It is not recommended Vyvanse be taken with the following antidepressants and other drug classes that increase serotonin levels in the brain: 
    • Selective serotonin reuptake inhibitors (SSRIs)
    • Serotonin-norepinephrine reuptake inhibitors (SNRIs)
    • Tricyclic antidepressants (TCAs)
    • Triptans
  • Vyvanse should not be taken with other CNS stimulant drugs:
    • Other ADHD medications
    • Appetite suppressants such as phendimetrazine
    • Drugs that treat narcolepsy
    • Sympathomimetic medications such as epinephrine or norepinephrine
  • It is not recommended Vyvanse be taken with specific types of medicines that are urinary alkalinizing or acidifying agents:

It is important to be aware of how Vyvanse may affect the action of other drugs and how different drugs (and foods) may affect Vyvanse. Read on for more information regarding known interactions from clinical studies of Vyvanse.

RELATED: Vyvanse alternatives: What can I take instead of Vyvanse?

Vyvanse interactions
Drug Class Condition Used For Drug Interactions with Vyvanse
MAO Inhibitors Treatment of depression and other neurologic conditions such as Parkinson’s disease and Alzheimer’s disease Taking Vyvanse within 14 days of an MAOI may slow its metabolism and increase the amphetamines’ effects, causing headaches and other signs of high blood pressure. Dangerous neurological effects and very high fever can occur, sometimes with fatal results.
Serotonergic drugs Treatment of depression, anxiety disorder, pain, migraine headaches, and epilepsy. Taking Vyvanse with drugs that increase the levels of serotonin leads to an increased risk of serotonin syndrome. This potentially life-threatening drug reaction results from having too much serotonin in the body. Symptoms include confusion, rapid heart rate, high blood pressure, dilated pupils, and loss of muscle coordination or twitching muscles.
Other CNS stimulants Treatment of ADHD, binge eating disorder, depression, 

narcolepsy, sleep apnea, weight loss, and nasal spray for runny or stuffy nose.

 Taking Vyvanse with other CNS prescription stimulants can enhance the stimulation effects, including increased blood pressure and heart rate.
Urinary alkalinizing and acidifying agents Treatment of high blood pressure, supplements Urinary alkalinizing agents can increase Vyvanse’s blood levels, which may increase the risk of side effects. 

Acidifying agents might lower blood levels, reducing Vyvanse’s efficacy. 

Vyvanse drug interactions

There are several prescription and over-the-counter (OTC) drugs that can interact with Vyvanse. Some may increase the risk of serious side effects:

MAO inhibitors

Monoamine oxidase inhibitors (MAOIs) are medications used to treat depression symptoms. They’re not commonly prescribed due to safety concerns around food and drug interactions. Taking Vyvanse within 14 days of taking an MAOI is contraindicated. Concurrent use of MAOI slows the breakdown of dextroamphetamine, increasing the likelihood of serious side effects such as headaches, a sudden increase in blood pressure (a hypertensive crisis) and heart rate, stroke, and heart attacks, and even sudden death in patients who have preexisting heart problems or heart defects. Patients experiencing symptoms of a hypertensive crisis should seek immediate medical attention.

MAOIs that healthcare providers can currently prescribe in the United States include:

  • Marplan (isocarboxazid)
  • Nardil (phenelzine)
  • Emsam (selegiline)
  • Parnate (tranylcypromine)

Serotonergic drugs

Serotonergic drugs increase serotonin levels in the brain. Serotonin is a neurotransmitter that carries messages between nerve cells in the brain and other body parts. Serotonergic drug classes are used to treat a variety of mental health issues such as depression, bipolar disorder, anxiety, substance use disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), as well as pain, migraine, bulimia, and epilepsy.

Use of serotonergic drugs with Vyvanse may increase the risk of serotonin syndrome, a serious condition caused by serotonin buildup in the body. Serotonin syndrome symptoms may be mild, such as having diarrhea or nausea, or be more severe, such as experiencing high fever or seizures. In some rare cases, severe serotonin syndrome can be life-threatening if not recognized and treated quickly.

Drug classes and medication examples that can increase serotonin levels include:

  • Selective serotonin reuptake inhibitors (SSRIs): 
    • Prozac (fluoxetine)
    • Celexa (citalopram)
    • Zoloft (sertraline)
    • Paxil (paroxetine)
    • Lexapro (escitalopram) 
    • Pristiq (desvenlafaxine )
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs): 
    • Pristiq (desvenlafaxine )
    • Cymbalta (duloxetine
    • Effexor (venlafaxine)
  • Tricyclic antidepressants (TCAs): 
    • Elavil (amitriptyline)
    • Anafranil (clomipramine)
    • Pamelor (nortriptyline)
    • Norpramin (desipramine)
    • Sinequan (doxepin)
    • Tofranil (imipramine)
    • Surmontil (trimipramine)
  • Headache drugs in the triptan family:
    • Zomig (zolmitriptan)
    • Imitrex (sumatriptan)
    • Relpax (eletriptan)
    • Imitrex (sumatriptan)
    • Zomig (zolmitriptan)
  • Other:
    • Lithium 
    • BuSpar (buspirone)
    • Tramadol 
    • Fentanyl

Other CNS stimulants

CNS stimulant drug classes include other ADHD medicines, drugs for narcolepsy and sleep apnea, weight-loss medicines, and certain nasal sprays for congestion. Combining them with Vyvanse can enhance the likelihood of serious adverse events, including increased heart rate and blood pressure. It may also result in chest pain or a pounding heartbeat, particularly if you already have a history of heart disease or high blood pressure.

Urinary alkalinizing and acidifying agents 

Drugs that decrease the acid content in the urine (alkalinizing agents) will reduce the body’s ability to eliminate Vyvanse, increasing the likelihood of side effects. Drugs that increase the acid content in the urine (acidifying agents) increase the excretion of Vyvanse, lowering blood levels and the drug’s efficacy.

Other interactions

Vyvanse can interact with several other non-prescription medications and certain supplements. Always get medical advice from your prescribing doctor, pharmacist, or other healthcare professional before taking the following:

  • Some OTC antacid medications that contain aluminum hydroxide, magnesium hydroxide, or calcium carbonate (e.g., brand name drugs Maalox and Tums) may increase the risk of side effects from Vyvanse. 
  • Certain supplements, such as St. John’s wort, tryptophan, and sodium bicarbonate (baking soda), may increase the risk of side effects from Vyvanse.
  • Caffeine may interact with Vyvanse because both are CNS stimulants. The combination can worsen side effects such as irritability, nervousness, and nausea.
  • Avoid drinking alcohol while taking Vyvanse because it may mask the depressant effects of alcohol. Also, if you have certain side effects with Vyvanse, such as nausea, dizziness, or diarrhea, drinking alcohol could make them worse.