Interactions : אינטראקציות

4.5 Interaction with other medicinal products and other forms of interaction
MAO Inhibitors
Concomitant use of MAOIs and CNS stimulants can cause hypertensive crisis. Potential outcomes include death, stroke, myocardial infarction, aortic dissection, ophtalmological complications, eclampsia, pulmonary edema and renal failure. Do not administer ATTENT tablets concomitantly or within 14 days after discontinuation MAOI (see Contraindications and Warnings).

Serotonergic Drugs
The concomitant use of ATTENT tablets and serotonergic drugs increases the risk of serotonin syndrome. Initiate with lower doses and monitor patients for signs and symptoms of serotonin syndrome, particularly during ATTENT tablets initiation or dosage increase. If serotonin syndrome occurs, discontinue ATTENT tablets and the concomitant serotonergic drug(s) [see WARNINGS and PRECAUTIONS].

CYP2D6 Inhibitors
The concomitant use of ATTENT tablets and CYP2D6 inhibitors may increase the exposure of ATTENT tablets compared to the use of the drug alone and increase the risk of serotonin syndrome. Initiate with lower doses and monitor patients for signs and symptoms of serotonin syndrome particularly during ATTENT tablets initiation and after a dosage increase. If serotonin syndrome occurs, discontinue ATTENT tablets and the CYP2D6 inhibitor [see WARNINGS, OVERDOSAGE].

Acidifying Agents
Lower blood levels and efficacy of amphetamines. Increase dose based on clinical response.
Examples of acidifying agents include gastrointestinal acidifying agents and urinary acidifying.

Adrenergic Blockers
Adrenergic blockers are inhibited by amphetamines.

Alkalinizing Agents
Increase blood levels and potentiate the action of amphetamine. Co-administration of ATTENT tablets and gastrointestinal alkalizing agents should be avoided. Examples of alkalizing agents include gastrointestinal alkalizing agents and urinary alkalinizing agents.

Tricyclic Antidepressants
Amphetamines may enhance the activity of tricyclic or sympathomimetic agents causing striking and sustained increases in the concentration of d-amphetamine in the brain; cardiovascular effects can be potentiated. Monitor frequently and adjust or use alternative therapy based on clinical response.

Antihistamines
Amphetamines may counteract the sedative effect of antihistamines.

Antihypertensives
Amphetamines may antagonize the hypotensive effects of antihypertensives.

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Chlorpromazine
Chlorpromazine blocks dopamine and norepinephrine receptors, thus inhibiting the central stimulant effects of amphetamines, and can be used to treat amphetamine poisoning.

Ethosuximide
Amphetamines may delay intestinal absorption of ethosuximide.

Haloperidol
Haloperidol blocks dopamine receptors, thus inhibiting the central stimulant effects of amphetamines.
Lithium Carbonate
The anorectic and stimulatory effects of amphetamines may be inhibited by lithium carbonate.
Meperidine (Pethidine)
Amphetamines potentiate the analgesic effect of meperidine.
Methenamine Therapy
Urinary excretion of amphetamines is increased, and efficacy is reduced, by acidifying agents used in methenamine therapy.
Norepinephrine
Amphetamines enhance the adrenergic effect of norepinephrine.
Phenobarbital
Amphetamine may delay intestinal absorption of phenobarbital; co-administration of phenobarbital may produce a synergistic anticonvulsant action.
Phenytoin
Amphetamines may delay intestinal absorption of phenytoin; co-administration of phenytoin may produce a synergistic anticonvulsant action.
Propoxyphene
In cases of propoxyphene overdosage, amphetamine CNS stimulation is potentiated and fatal convulsions can occur.
Proton Pump Inhibitors (PPIs)
Time to maximum concentration (Tmax) of amphetamine is decreased compared to when administered alone. Monitor patients for changes in clinical effect and adjust therapy based on clinical response. An example of proton pump inhibitor is omeprazole.
Veratrum Alkaloids
Amphetamines inhibit the hypotensive effect of veratrum alkaloids.
Drug/ Laboratory Test Interactions
Amphetamines can cause a significant elevation in plasma corticosteroid levels. This increase is greatest in the evening. Amphetamines may interfere with urinary steroid determinations.