Common use of Drug Interactions Clause in Contracts

Drug Interactions. Methylphenidate, dexamfetamine and lisdexamfetamine: • Methylphenidate may possibly enhance anticoagulant effect of coumarins. • Risk of hypertensive crisis when stimulants given with MAOIs and moclobemide. Amfetamine should not be administered during or within 14 days following the administration of monoamine oxidase inhibitors (MAOI) as it can increase the release of norepinephrine and other monoamines. This can cause severe headaches and other signs of hypertensive crisis. A variety of toxic neurological effects and malignant hyperpyrexia can occur, sometimes with fatal outcomes. • Methylphenidate possibly inhibits metabolism of SSRIs and tricyclics and so contributes to increase risk of side effects from these medications. • Stimulants may decrease the effect of drugs used to treat hypertension. • Because a predominant action of stimulants is to increase extracellular dopamine levels, caution is recommended when administering stimulants with dopaminergic drugs, including antipsychotics. • Seizures are a potential risk with stimulant medication. Caution is advised with concomitant use of medicinal drugs which are known to lower the seizure threshold (such as antidepressants, neuroleptics, mefloquine, bupropion, or tramadol). • QT interval prolongation is an increased risk when stimulants are administered with other QT prolonging drugs (such as antipsychotics, anti-arrhythmics, moxifloxacin, erythromycin, methadone, mefloquine, tricyclic antidepressants, lithium) and drugs that cause electrolyte imbalance (such as thiazide diuretics). • Methylphenidate possibly increases plasma concentration of phenytoin, phenobarbital and primidone. • Alcohol may exacerbate adverse CNS effects therefore it is advisable to abstain from alcohol during treatment. • Ascorbic acid and other agents and conditions (diets high in fruits and vegetables, urinary tract infections and vomiting) that acidify urine increase urinary excretion and decrease the half-life of amfetamine. Sodium bicarbonate and other agents and conditions (thiazide diuretics, diets high in animal protein, diabetes, respiratory acidosis) that alkalinise urine decrease urinary excretion and extend the half-life of amfetamine.

Drug Interactions. Methylphenidate, dexamfetamine and lisdexamfetamine: •  Methylphenidate may possibly enhance anticoagulant effect of coumarins. •  Risk of hypertensive crisis when stimulants given with MAOIs XXXXx and moclobemide. Amfetamine should not be administered during or within 14 days following the administration of monoamine oxidase inhibitors (MAOI) as it can increase the release of norepinephrine and other monoamines. This can cause severe headaches and other signs of hypertensive crisis. A variety of toxic neurological effects and malignant hyperpyrexia can occur, sometimes with fatal outcomes. •  Methylphenidate possibly inhibits metabolism of SSRIs and tricyclics and so contributes to increase risk of side effects from these medications. •  Stimulants may decrease the effect of drugs used to treat hypertension. •  Because a predominant action of stimulants is to increase extracellular dopamine levels, caution is recommended when administering stimulants with dopaminergic drugs, including antipsychotics. •  Seizures are a potential risk with stimulant medication. Caution is advised with concomitant use of medicinal drugs which are known to lower the seizure threshold (such as antidepressants, neuroleptics, mefloquine, bupropion, or tramadol). •  QT interval prolongation is an increased risk when stimulants are administered with other QT prolonging drugs (such as antipsychotics, anti-arrhythmics, moxifloxacin, erythromycin, methadone, mefloquine, tricyclic antidepressants, lithium) and drugs that cause electrolyte imbalance (such as thiazide diuretics). •  Methylphenidate possibly increases plasma concentration of phenytoin, phenobarbital and primidone. •  Alcohol may exacerbate adverse CNS effects therefore it is advisable to abstain from alcohol during treatment. •  Ascorbic acid and other agents and conditions (diets high in fruits and vegetables, urinary tract infections and vomiting) that acidify urine increase urinary excretion and decrease the half-life of amfetamine. Sodium bicarbonate and other agents and conditions (thiazide diuretics, diets high in animal protein, diabetes, respiratory acidosis) that alkalinise urine decrease urinary excretion and extend the half-life of amfetamine.