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7 Drugs That Should Never Be Combined With Vyvanse

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Key points:

  • Vyvanse is a prescription CNS (central nervous system) stimulant
  • This medication is approved to treat ADHD in children and adults; Using Vyvanse for binge eating disorder is only approved for adults.
  • Vyvanse is a schedule II controlled substance, meaning it can be habit-forming with high risk of drug abuse. In fact, Vyvanse has a boxed warning about risk of misuse and dependence. 
  • Vyvanse is available as capsule and chewable tablet along with seven different strengths - this is an advantage as these different options help the provider and patient find the dosing regimen that is the most effective.

Vyvanse is a brand-name prescription drug that is available as extended-release chewable tablets and capsules. This medicine is taken by mouth once a day to treat attention deficit hyperactivity disorder (ADHD) in children and adults. It is also used to treat binge eating disorder in adults. Vyvanse belongs to a drug class called central nervous system stimulants. Lisdexamfetamine dimesylate is the active ingredient of Vyvanse. 

As with all medications, there are certain risks associated with Vyvanse treatment. Along with side effects and withdrawal symptoms, this medication can be habit-forming and has a potential for misuse and abuse. Also, certain drug interactions between Vyvanse and other drugs can lead to serious health complications. 

This article will discuss some Vyvanse interactions with examples of certain medications that should not be combined with Vyvanse.

Does Vyvanse interact with anything?

Vyvanse (Vyvanse coupon) can interact with certain prescription drugs, non-prescription (over-the-counter) medications, and nutritional supplements. There can also be some food interactions. What medications should not be taken with Vyvanse?

Monoamine Oxidase Inhibitors

Monoamine oxidase inhibitors (MAOI) are usually used to treat depression. You should not take Vyvanse if you are taking or have taken an MAOI in the last 14 days. In fact, concurrent use of Vyvanse and an MAOI within the last 14 days is contraindicated. MAOI slows the breakdown of the amphetamine, causing headaches and a potentially life-threatening hypertensive crisis in which blood pressure is dangerously high, leading to potential organ damage and other cardiovascular complications. A hypertensive crisis occurs when your blood pressure rises quickly with readings of 120/80 mmHg or higher.

Some examples of FDA-approved monoamine oxidase inhibitors to treat depression are phenelzine (Nardil), isocarboxazid (Marplan), and tranylcypromine (Parnate). Other well-known MAOIs include selegiline (Emsam) for the treatment of Parkinson’s disease, and methylene blue (ProvayBlue) for acquired methemoglobinemia, a rare blood disorder.

Antidepressant Medications

Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs) are used to treat a wide variety of mental health conditions like depression, anxiety, mood swings, obsessive-compulsive disorder (OCD), panic disorder, phobias, and post-traumatic stress disorder (PTSD). SSRIs, SNRIs, TCAs, and MAOIs are classified as serotonergic drugs since they can affect the serotonin levels in the brain. Taking Vyvanse with these antidepressants can increase the risk of side effects and lead to high serotonin levels in the brain - this condition is known as serotonin syndrome. Serotonin syndrome is a rare but potentially life-threatening condition. Symptoms of serotonin syndrome are sweating, fast heart rate, fever, muscle stiffness, and confusion. Talk with your doctor about the risks of combining CNS stimulants and antidepressants for treating your mental illness. There are different strategies to reduce the risk of these harmful side effects. You should inform your doctor as soon as you experience any of the above signs of serotonin syndrome.

Examples of SSRIs include fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft); Examples of SNRIs include venlafaxine (Effexor XR), desvenlafaxine (Pristiq), and duloxetine (Cymbalta); some of the most common TCAs are amitriptyline, nortriptyline (Pamelor), and imipramine (Tofranil).


This is a group of medications that are used to treat migraine headaches. Triptans bind to serotonin receptors in the central nervous system. Taking Vyvanse with triptans can lead to an increased risk of serotonin syndrome. 

Examples of triptans include zolmitriptan (Zomig), sumatriptan (Imitrex), frovatriptan (Frova), rizatriptan (Maxalt), naratriptan (Amerge), and eletriptan (Relpax).


Lithium (Eskalith, Lithobid) is a mood stabilizer used for the treatment of bipolar disorder. The drug interactions between Vyvanse and lithium can increase your risk of serotonin syndrome. If your healthcare professional is going to prescribe Vyvanse, you should inform your provider about any personal or family history of mental health problems, including bipolar disorder, and medications you may be taking to treat this condition. Your doctor can modify the dosing of Vyvanse and have a discussion with you regarding other alternatives to treat ADHD


Acetazolamide (Diamox) is used to treat certain types of glaucoma. It is also used to prevent or reduce the symptoms of altitude sickness. Combining acetazolamide and Vyvanse can lead to higher plasma levels of Vyvanse and an increased risk of side effects.

St. John’s Wort

Supplements like St. John’s Wort used for depression can have serious drug interactions with Vyvanse leading to serotonin syndrome. If your doctor prescribes Vyvanse, be sure to tell them about all the dietary supplements, herbal remedies, and over-the-counter medications you are taking. This can help avoid unwanted drug effects, increased side effects, and health complications.

How to reduce the risk of Vyvanse interactions?

Before starting Vyvanse treatment for ADHD (attention deficit hyperactivity disorder) or severe binge eating disorder, be sure to tell your doctor or pharmacist about your health history. Taking Vyvanse may not be right for people with certain medical conditions like high blood pressure, heart disease, coronary artery disease, heart attack, blood flow problems, tics, Tourette’s syndrome, bipolar disorder, depression, seizures, glaucoma, hyperthyroidism (overactive thyroid gland), kidney disease, or substance abuse.

You should also give your healthcare professional a complete list of your current medications, including prescription drugs, over-the-counter medications, and herbal supplements. This can help avoid serious and potentially fatal drug interactions between Vyvanse and your other drugs.

In addition to reading the medication guide, talk to your doctor about common side effects that you should be expecting with Vyvanse treatment. This way, you will know what side effects are expected and what signs and symptoms are unusual while taking Vyvanse. Possible side effects of Vyvanse include dry mouth, headache, increased heart rate, nausea, vomiting, stomach pain, decreased appetite, weight loss, and problems sleeping. Also, talk with your healthcare professional about when to seek medical attention when taking Vyvanse, for example, if you experience an allergic reaction. Signs and symptoms of allergic reactions may include skin rash, swelling, or trouble breathing.

Frequently Asked Questions

Can I take Tylenol with Vyvanse?

There is no known drug interaction between Tylenol (acetaminophen) and Vyvanse (lisdexamfetamine). This combination of medications is generally safe to take. However, if your doctor prescribes Vyvanse for ADHD, it is a good idea to talk with them about any potential Vyvanse interactions.

Should I avoid caffeine on Vyvanse?

It is a good idea to limit or avoid caffeine while on Vyvanse. Caffeine, which is found in colas, coffees, and teas, can cause increased irritability, insomnia, rapid heartbeat, and other side effects. In some people, consuming caffeine while using Vyvanse can worsen these side effects.

Can you drink alcohol if you take Vyvanse?

Drinking alcohol with CNS stimulants like Vyvanse is not recommended. Alcohol may raise your blood pressure; therefore, combining alcohol and Vyvanse can further increase this risk of increasing blood pressure. 

How to make Vyvanse more effective?

With the two dosage forms and seven different strengths, finding the right dose is the best way to make Vyvanse the most effective for you. Keep a journal to keep track of the effects of different dosing regimens. Having this information on hand will make your discussion with your provider more productive.  



  1. https://medlineplus.gov/druginfo/meds/a607047.html
  2. https://www.ncbi.nlm.nih.gov/books/NBK554507/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309786/