What’s the Buzz

The Bee Healthy Blog

7 Drugs That Should Never Be Combined With Vyvanse

cartoon of man holding two pill bottles with question marks

Key Takeaways

  • Vyvanse, used to treat attention deficit hyperactivity disorder (ADHD), should not be combined with monoamine oxidase inhibitors (MAOI), antidepressants, triptans, lithium, acetazolamide, and St. John’s Wort. 

  • Serotonin syndrome is a potentially life-threatening condition that can occur when certain drugs, including Vyvanse, are taken together.

Vyvanse is a brand-name prescription drug used to treat attention deficit hyperactivity disorder (ADHD) in children and adults, as well as binge eating disorder in adults. available in chewable tablets and capsules. Vyvanse is a central nervous system stimulant, and its active ingredient is lisdexamfetamine dimesylate.

Certain drug interactions between Vyvanse and other drugs can lead to serious health complications. Continue reading to learn about Vyvanse interactions with examples of certain medications that should not be combined with Vyvanse.

Does Vyvanse interact with anything?

Vyvanse 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. 

Vyvanse and Serotonin Syndrome

Serotonin syndrome is a potentially life-threatening condition that can occur when certain drugs, including Vyvanse, are taken together. Symptoms may include agitation, hallucinations, rapid heartbeat, and high body temperature. If you experience any of these symptoms while taking Vyvanse, seek immediate medical attention.

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?

Both Vyvanse and caffeine are central nervous system (CNS) stimulants. When combined, they can cause similar side effects and potentially worsen these effects. It's important to note that certain medications, such as some migraine treatments, contain caffeine. Therefore, it's crucial to consult with your healthcare provider before combining Vyvanse with caffeine or any medication containing caffeine.

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. 

Can you take cold medicine with Vyvanse?

It's crucial to be aware that combining Vyvanse (lisdexamfetamine) with certain over-the-counter cold medicines, particularly those containing dextromethorphan, can lead to serious health risks. This combination can potentially trigger serotonin syndrome. 

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.  

Save on Your ADHD Medication with BuzzRx!

Manage your ADHD medication costs with BuzzRx coupons. Here are direct links to substantial savings for each medication:

  • Vyvanse Coupon: The retail price is about $406.28, but with BuzzRx, you might pay as low as $280.66.

  • Phenelzine Sulfate Coupon: Typical retail price is $79.99, and with BuzzRx coupons, you could pay as low as $67.01​​.

  • Marplan Coupon: Save with BuzzRx coupons, with prices as low as $593.76​​​​​​​​​​​​.

  • Tranylcypromine Sulfate Coupon: Pay as low as $126.30 with BuzzRx coupons​​​​​​​​​​​​.

  • Selegiline Coupon: Prices are normally around $67.52, but with BuzzRx coupons, you can pay as little as $22.32.

  • Methylene Blue Coupon: Pay as low as $1,135.71 with a BuzzRx coupon.

  • Fluoxetine Coupon: This drug typically costs between $28.04 and $69.99. With BuzzRx coupons, you can pay as low as $13.31.

  • Citalopram Hbr Coupon: While prices are typically around $62.16, BuzzRx coupons can bring this price down to as low as $3.93.

  • Sertraline Coupon: Prices are as high as $85.99 at some pharmacies. But with BuzzRx, you can pay as low as $7.76.

  • Venlafaxine ER Coupon: Prices are between $49.99 and $148.99. With BuzzRx, pay as little as $13.02.

  • Desvenlafaxine ER Coupon: Retail prices are around $182.99. With BuzzRx coupons, pay as low as $88.99.

  • Duloxetine Coupon: Prices are as high as $215.85. With BuzzRx, pay as little as $12.29.

  • Amitriptyline Coupon: Prices are about $23.99, but with BuzzRx coupons, pay as low as $5.97. 

  • Nortriptyline Coupon: Prices are about $25.99. With BuzzRx coupons, pay as little as $4.68.

  • Imipramine Coupon: Typical prices are about $49.69. With BuzzRx coupons, pay as low as $17.04.  

  • Zolmitriptan Coupon: Prices are between $297.86 and $533.99, but with BuzzRx coupons, the price is as low as $28.04.

  • Sumatriptan Coupon: With retail prices as high as $428.99, your BuzzRx coupons can lower this to as low as $81.82.

  • Frovatriptan Succinate Coupon: Retail prices are between $462.76 and $714.04. Use your BuzzRx coupons to get this medication for as low as $79.57. 

  • Rizatriptan Coupon: Prices are as high as $248.29. BuzzRx coupons can lower this to a price between $17.70 and $94.95. 

  • Naratriptan Coupon: The prices is between $123.76 and $186.99. Use your BuzzRx coupons to pay as low as $21.57.

  • Eletriptan Hbr Coupon: Prices are as high as $736.49. With BuzzRx coupons, pay as little as $56.29. 

  • Lithium Carbonate Coupon: Pay as little as $5.08 with your BuzzRx coupons. 

  • Acetazolamide Coupon: Retail prices are around $124.10. Pay as low as $16.95 with BuzzRx coupons. 

  • St. John's Wort Coupon: Use your BuzzRx coupons to pay as little as $6.23.

  • Tylenol Coupon: Pay as little as $3.80 with your BuzzRx coupons. 

Remember, these coupons are widely accepted at over 60,000 pharmacies, including major chains like CVS, Walgreens, and Rite Aid. Just present your coupon at the pharmacy to ensure you're getting the best possible price.



  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/