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Adderall XR and Meridia

Determining the interaction of Adderall XR and Meridia and the possibility of their joint administration.

Check result:
Adderall XR <> Meridia
Relevance: 05.10.2022 Reviewer: Shkutko P.M., M.D., in

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Consumer:

Using sibutramine together with amphetamine is not recommended. Sibutramine can increase the effects of amphetamine, and side effects such as jitteriness, nervousness, anxiety, restlessness, and racing thoughts may occur. Combining these medications can also increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, blurred vision, muscle spasm or stiffness, tremor, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Professional:

CONTRAINDICATED: Sibutramine is a potent inhibitor of norepinephrine and serotonin reuptake, and a less potent inhibitor of dopamine reuptake. As such, it may potentiate the pharmacologic response to sympathomimetic agents due to additive or synergistic effects. Although the interaction has not been studied with sibutramine, it has been reported with the selective serotonin reuptake inhibitor, fluoxetine. In one case report, a patient experienced jitteriness, racing thoughts, stomach cramps, dry eyes, palpitations, tremors, and restlessness following a single dose of phentermine ingested approximately a week after she had discontinued fluoxetine. Because of the long half-life of fluoxetine and its metabolite, an interaction with fluoxetine is possible. Similar toxic reactions have been reported when fluoxetine was used concomitantly with amphetamine or phenylpropanolamine. Additionally, some sympathomimetic agents such as amphetamines may possess serotonergic activity and should generally not be administered with serotonin reuptake inhibitors because of the additive risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea. The interaction was suspected in a patient treated with dexamphetamine and venlafaxine, a serotonin-norepinephrine reuptake inhibitor. The medications were discontinued and the patient was given cyproheptadine for suspected serotonin syndrome, whereupon symptoms promptly resolved. A second episode occurred when dexamphetamine was subsequently resumed and citalopram added. The patient improved following cessation of citalopram on his own, and residual symptoms were successfully treated with cyproheptadine.

MANAGEMENT: The use of sibutramine in combination with amphetamines and other centrally-acting appetite suppressants is considered contraindicated.

References
  • Walters AM "Sympathomimetic-fluoxetine interaction." J Am Acad Child Adolesc Psychiatry 31 (1992): 565-6
  • Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, Hauser SL, Longo DL, eds. "Harrison's Principles of Internal Medicine. 14th ed." New York, NY: McGraw-Hill Health Professionals Division (1998):
  • "Product Information. Meridia (sibutramine)." Knoll Pharmaceutical Company, Whippany, NJ.
  • Martin TG "Serotonin syndrome." Ann Emerg Med 28 (1996): 520-6
  • Barrett J, Meehan O, Fahy T "SSRI and sympathomimetic interaction." Br J Psychiatry 168 (1996): 253
  • Prior FH, Isbister GK, Dawson AH, Whyte IM "Serotonin toxicity with therapeutic doses of dexamphetamine and venlafaxine." Med J Aust 176 (2002): 240-1
  • Bostwick JM, Brown TM "A toxic reaction from combining fluoxetine and phentermine." J Clin Psychopharmacol 16 (1996): 189-90
Adderall XR

Generic Name: amphetamine / dextroamphetamine

Brand name: Adderall, Adderall XR, Mydayis

Synonyms: n.a.

Meridia

Generic Name: sibutramine

Brand name: Meridia

Synonyms: n.a.

In the course of checking the drug compatibility and interactions, data from the following reference sources was used: Drugs.com, Rxlist.com, Webmd.com, Medscape.com.

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