CONTRAINDICATIONS TABLE
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1 CONTRAINDICATIONS TABLE Generic Name Brand Name Contraindications Amphetamine Salts Adderall, Adderall XR Hypersensitivity to amphetamine, dextroamphetamine, or other sympathomimetic amines Advanced arteriosclerosis Agitated state Glaucoma History of drug abuse Hyperthyroidism Moderate to severe hypertension Symptomatic cardiovascular disease Use of an MAO inhibitor (MAOI) within the last 14 days Aripiprazole Abilify, Abilify Discmelt Hypersensitivity to aripiprazole Asenapine Saphris Hypersensitivity to asenapine Atomoxetine Strattera Hypersensitivity to atomoxetine Cardiovascular disorders severe enough to deteriorate with an increase in blood pressure or heart rate Current or history of pheochromocytoma Narrow-angle glaucoma Clonidine Catapres ; Catapres TTS 1, 2, or 3; Duraclon, Kapvay Use of an MAOI within the last 14 days Hypersensitivity to clonidine Bleeding diathesis Concurrent anticoagulant therapy for epidural use for bleeding issues Clozapine Clozaril, FazaClo Hypersensitivity to clozapine History of agranulocytosis or severe granulocytopenia with clozapine Myeloproliferative disorder or concomitant use with other agents with wellknown risk of agranulocytosis or bone marrow suppression Paralytic ileus Severe central nervous system Uncontrolled epilepsy Dexmethylphenidate Focalin, Focalin XR Hypersensitivity to dexmethylphenidate or methylphenidate Glaucoma Marked anxiety, tension, or agitation Use of an MAOI within the last 14 days Contraindications Table Page 0
2 CONTRAINDICATIONS TABLE Generic Name Brand Name Contraindications Dextroamphetamine Dexedrine, Spanule, Hypersensitivity to dextramphetamine or other sympathomimetic amines ProCentra Advanced arteriosclerosis Agitated states Glaucoma History of drug abuse Hyperthyroidism Moderate to severe hypertension Symptomatic cardiovascular disease Use of an MAOI within the last 14 days Guanfacine Intuniv, Tenex Hypersensitivity to guanfacine Iloperidone Fanapt Hypersensitivity to iloperidone Lisdexamfetamine Vyvanse Hypersensitivity to amphetamine products Use of an MAOI within the last 14 days Lurasidone Latuda Hypersensitivity to lurasidone Use with strong inducers (rifampin) or inhibitors (ketoconazole) Contraindications Table Page 1
3 CONTRAINDICATIONS TABLE Generic Name Brand Name Contraindications Methylphenidate Concerta, Daytrana, Metadate CD, Metadate ER, Methylin, Quillivant XR, Ritalin LA, Ritalin SR, Ritalin Hypersensitivity to methylphenidate Glaucoma Marked anxiety, tension, and agitation Use of an MAOI within the last 14 days Olanzapine Zyprexa, Zyprexa IntraMuscular, Zyprexa Relprevv, Zyprexa Zydis None listed Paliperidone Invega, Invega Sustenna Hypersensitivity to paliperidone or risperidone Quetiapine Seroquel, Seroquel XR None listed Risperidone Risperdal, Risperdal Consta, Risperdal M-Tab Hypersensitivity to risperidone Ziprasidone Geodon Hypersensitivity to ziprasidone Concurrent use of other agents (trioxide, chlorpromazine; class Ia antiarrhythmics: disopyramide, quinidine, procainamide; class III antiarrhythmics: amiodarone, dofetilide, ibutilide, sotalol; droperidol; gatifloxacin; moxifloxacin; pimozide; tacrolimus; thioridazine) Congenital long QT interval Current or history of prolonged QT interval Recent myocardial infarction Uncompensated heart failure Contraindications Table Page 2
4 Name Information Efficacy of Other s Other s Amphetamine salts Antacids: Decrease excretion of amphetamines Atomoxetine, MAOIs, and Enhanced hypertensive and tachycardic effects Opiates: Enhanced analgesic effect Proton pump inhibitors: May increase the rate of absorption of amphetamine salts Tricyclic Enhance stimulatory effects of amphetamine salts Antihistamines (diphenhydramine): Decreased sedation Phenobarbital: Decreased phenobarbital serum Antipsychotics, lithium: Diminish stimulatory effects of amphetamine salts Phenytoin: Decreased phenytoin serum Multi-vitamins: May amphetamine salts Aripiprazole inhibitors (fluoxetine, paroxetine): Increase of aripiprazole inducers (carbamazepine, phenobarbital, phenytoin): Decrease of aripiprazole : Serotonergic Drug Interaction Table Page 0
5 Name other Asenapine CYP 1A2 CYP 1A2 inhibitors (cimetidine, ciprofloxacin, fluoxetine): Increase of asenapine CYP 1A2 inducers (carbamazepine, phenobarbital): Decrease serum asenapine MAO inhibitors: May enhance orthostatic hypotensive effects Serotonergic Atomoxetine CYP 2C19 inhibitors (fluoxetine, paroxetine): May atomoxetine Beta 2 agonists (albuterol): May enhance tachycardic effects of atomoxetine : hypertensive and tachycardic effects of stimulants Clonidine Antihypertensives: Enhance hypotensive effects Alpha2-antagonist antidepressant (mirtazapine): Diminish Beta blockers: May enhance rebound hypertension with abrupt withdrawal of clonidine Beta blockers, calcium channel blockers, and cardiac glycosides: Enhanced AV blocking effect and sinus node dysfunction SSRIs (citalopram, sertraline): May have enhanced adverse effects with these antidepressants Drug Interaction Table Page 1
6 Name Clonidine (cont.) antihypertensive effect of clonidine SSRIs (venlafaxine, duloxetine) and May decrease antihypertensive effects of clonidine MAO inhibitors: May enhance orthostatic hypotension with clonidine other May diminish antihypertensive effects of clonidine Clozapine CYP 1A2 CYP 2A6 CYP 2C19 CYP 2C9 (Minor) (moderate) CYP 1A2 CYP 2C19 CYP 2C9 CYP 2E1 CYP 1A2 inhibitors (amlodipine, cimetidine, fluoxetine, nefazodone): May clozapine CYP 1A2 inducers (aromatic hydrocarbons in cigarette smoke, carbamazepine, phenytoin): May clozapine (benzodiazepines, hydroxyzine, MAO inhibitors: May enhance orthostatic hypotensive effects Myelosuppressive (carbamazepine): May increase risk for bone marrow suppression substrates (metoprolol, nebivolol, thioridazine): May have increased serum Tamoxifen: May have decreased active metabolite due to enzyme inhibition Anticholinergics (ipratropium, tiotropium): Enhanced adverse anticholinergic effects (sedation, constipation, dry mouth, urinary retention) (benzodiazepines): Increased sedation and CNS Serotonergic Drug Interaction Table Page 2
7 Name other Dexmethylphenidate Antacids, H2-antagonists, proton pump inhibitors: Increase absorption of dexmethylphenidate Atomoxetine MAO inhibitors: Enhanced hypertensive effects Phenobarbital: May phenobarbital Phenytoin: May phenytoin Tricyclic May have enhanced adverse effects Vitamin K antagonists (warfarin): May vitamin K antagonists Dextroamphetamine Proton pump inhibitors: May increase the rate of absorption of dextroamphetamine Tricyclic Enhance stimulatory effects of dextroamphetamine Atomoxetine and Enhanced hypertensive and tachycardic effects Antacids: Decrease excretion of amphetamines Opiates: Enhanced analgesic effect Antihistamines (diphenhydramine): Decreased sedation Antipsychotics Lithium: Diminish stimulatory effects of dextroamphetamine Multi-vitamins: May dextroamphetamine Phenobarbital: Decreased phenobarbital serum Phenytoin: Decreased phenytoin serum Guanfacine Antihypertensives: Enhance hypotensive effects of guanfacine inhibitors (diltiazem, fluconazole, indinavir): Increase Enhance sedation and depressant effects Beta blockers: May enhance rebound hypertension with Beta blockers: Enhanced AV blocking effect and sinus node dysfunction Dopamine agonists (pramipexole, ropinirole): sedative effects with dopamine agonists SSRIs (citalopram, sertraline): Drug Interaction Table Page 3
8 Name Guanfacine (cont.) of guanfacine Alpha 2 -antagonist antidepressant (mirtazapine): Diminish antihypertensive effect of guanfacine abrupt withdrawal of guanfacine MAO inhibitors: May enhance orthostatic hypotension of guanfacine Divalproex sodium/valproic acid derivatives: May divalproex sodium or the valproic acid derivative other May have enhanced adverse effects with these antidepressants inducers (carbamazepine, phenobarbital, phenytoin): Decrease of guanfacine Serotonin/norepinephr ine reuptake inhibitors (venlafaxine, duloxetine) and May decrease antihypertensive effects of guanfacine May diminish antihypertensive effects of guanfacine Iloperidone (moderate) inhibitor (fluoxetine, paroxetine): Increased of iloperidone inhibitor (diltiazem, fluconazole, indinavir): Increased of iloperidone inducers (carbamazepine, phenobarbital, phenytoin): Decrease of iloperidone substrates (aripiprazole): May increase these Dopamine agonists (ropinirole): Diminished anti- Parkinson s effects : Diminished stimulant Serotonergic Drug Interaction Table Page 4
9 Name other Lisdexamfetamine Antacids: Decrease excretion of amphetamines Proton pump inhibitors: May increase the rate of absorption of amphetamine salts Tricyclic Enhance stimulatory effects of amphetamine salts Antipsychotics, lithium: Diminish stimulatory effects of amphetamine salts Atomoxetine, MAOIs, and Enhanced hypertensive and tachycardic effects Opiates: Enhanced analgesic effect Antihistamines (diphenhydramine): Decreased sedation Phenobarbital: Decreased phenobarbital serum Phenytoin: Decreased phenytoin serum Multi-vitamins: May amphetamine salts Lurasidone inhibitor (diltiazem, fluconazole, indinavir): Increased of lurasidone inducers (carbamazepine, phenobarbital, phenytoin): Decrease of lurasidone MAO inhibitors: May enhance orthostatic hypotension of lurasidone Dopamine agonists (ropinirole): Diminished anti- Parkinson s effects : Diminished stimulant May increase risk of prolonged QTc Serotonergic Drug Interaction Table Page 5
10 Name other Methylphenidate CYP 2D6 Antacids, H2-antagonists, proton pump inhibitors: Increase absorption of methylphenidate and interfere with normal release of the extended release capsules Atomoxetine MAO inhibitors: Enhanced hypertensive effects Phenobarbital: May phenobarbital Phenytoin: May phenytoin Tricyclic May have enhanced adverse effects Vitamin K antagonists (warfarin): May vitamin K antagonists Olanzapine CYP 1A2 CYP1A2 CYP 2C19 CYP 1A2 inhibitors (amlodipine, cimetidine, fluoxetine, nefazodone): May olanzapine (benzodiazepines, hydroxyzine, Anticholinergics (ipratropium, tiotropium): Enhanced adverse anticholinergic effects (sedation, constipation, dry mouth, urinary retention) (hydroxyzine): Increased sedation and CNS Paliperidone CYP 2C9 CYP 1A2 inducers (aromatic hydrocarbons in cigarette smoke, carbamazepine, phenytoin): May olanzapine Divalproex sodium, itraconazole, valproic acid derivatives: May paliperidone MAO inhibitors: May enhance orthostatic hypotensive effects Serotonergic Serotonergic Drug Interaction Table Page 6
11 Name Paliperidone (cont.) Carbamazepine: May paliperidone risperidone, other Quetiapine inhibitor (diltiazem, fluconazole, indinavir): Increased of quetiapine inducers (carbamazepine, phenobarbital, phenytoin): Decrease of quetiapine Anticholinergics (ipratropium, tiotropium): Enhanced adverse anticholinergic effects (sedation, constipation, dry mouth, urinary retention) (hydroxyzine): Increased sedation and CNS Serotonergic Risperidone inhibitor (fluoxetine, paroxetine): Increased of risperidone Anticholinergics (ipratropium, tiotropium): Enhanced adverse anticholinergic effects (sedation, constipation, dry mouth, urinary retention) Serotonergic Drug Interaction Table Page 7
12 Name Risperidone (cont.) Loop diuretics (furosemide), paliperidone, valproic acid derivatives: May increase the adverse effects seen with risperidone other Ziprasidone CYP 1A2 Azole antifungals (fluconazole): May ziprasidone Carbamazepine: May ziprasidone Serotonergic Drug Interaction Table Page 8
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