7 Interactions found for:
Drug Interactions
Major
Lexapro
+ Vyvanse
The following applies to the ingredients: Escitalopram (found in Lexapro) and Lisdexamfetamine (found in Vyvanse)
Using escitalopram together with lisdexamfetamine can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms during treatment. In addition, combining these medications can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Drug and Food Interactions
Moderate
Lexapro
+ Food
The following applies to the ingredients: Escitalopram (found in Lexapro)
Alcohol can increase the nervous system side effects of escitalopram such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with escitalopram. Do not use more than the recommended dose of escitalopram, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.
Moderate
Vyvanse
+ Food
The following applies to the ingredients: Lisdexamfetamine (found in Vyvanse)
Using lisdexamfetamine together with alcohol can increase the risk of cardiovascular side effects such as increased heart rate, chest pain, or blood pressure changes. You should avoid or limit the use of alcohol while being treated with lisdexamfetamine. Let your doctor know if you experience severe or frequent headaches, chest pain, and/or a fast or pounding heartbeat. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Drug and Pregnancy Interactions
Major
Lexapro
+ Pregnancy
The following applies to the ingredients: Escitalopram (found in Lexapro)
Professional Content
This drug should be used during pregnancy only if the benefit outweighs the risk to the fetus.
AU TGA Pregnancy Category: C
US FDA Pregnancy Category: C
Comments:
-Newborns should be monitored if the maternal use of this drug continues into the later stages of pregnancy, particularly, the third trimester.
-Abrupt discontinuation should be avoided during pregnancy.
Animal studies have revealed evidence of embryotoxicity (e.g., reduced fetal weight and reversible delay of ossification), offspring mortality, and delayed growth. Animal studies with racemic citalopram have revealed evidence of teratogenicity at doses greater than human therapeutic doses. There are no controlled data in human pregnancy. Human spontaneous abortion has been reported with racemic citalopram.
Neonates exposed to SSRIs late in the third trimester have uncommonly reported clinical findings including respiratory distress, cyanosis, apnea, seizures, temperature instability, feeding difficulty, vomiting, hypoglycemia, hypotonia, hypertonia, hyperreflexia, tremor, jitteriness, irritability, and constant crying. These effects have mostly occurred either at birth or within a few days of birth. These features are consistent with either a direct toxic effect of SSRIs, or possibly a drug discontinuation syndrome; in some cases, the clinical picture is consistent with serotonin syndrome.
Epidemiological data have suggested that the use of SSRIs, particularly in late pregnancy, may increase the risk of persistent pulmonary hypertension in the newborn.
Data from animal studies has shown that escitalopram may affect sperm quality. Human case reports from some SSRIs have shown this effect to be reversible. As yet, the impact of this on human fertility has not been observed.
To monitor the outcomes of pregnant women exposed to antidepressants, a National Pregnancy Registry for Antidepressants has been established. Physicians are encouraged to register patients and pregnant women are encouraged to register themselves. For additional information: https://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/antidepressants/
AU TGA pregnancy category C: Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts should be consulted for further details.
US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
References
- "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals (2002):
- Briggs GG, Freeman RK, Yaffe SJ.. "Drugs in Pregnancy and Lactation." Philadelphia, PA: Lippincott Williams & Wilkins (2005):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
Major
Vyvanse
+ Pregnancy
The following applies to the ingredients: Lisdexamfetamine (found in Vyvanse)
Professional Content
Benefit should outweigh risk.
AU TGA pregnancy category: B3
US FDA pregnancy category: C
Comments:
-The active metabolite of this drug, dexamphetamine, crosses the placenta.
-Premature delivery, low birth weight, and other adverse pregnancy outcomes have been seen in infants born to mothers dependent on amphetamines.
-Monitor infants born to mothers taking amphetamines for symptoms of withdrawal such as feeding difficulties, irritability, agitation, and excessive drowsiness.
There are no controlled data of this drug in human pregnancy, but there are some available data for amphetamines in pregnant women. Two case control studies of over a thousand patients exposed to amphetamines at different gestational ages did not show an increase in congenital abnormalities. Additionally, animal studies have revealed no effects on embryofetal morphological development and survival, nor on fertility.
AU TGA pregnancy category B3: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have shown evidence of an increased occurrence of fetal damage, the significance of which is considered uncertain in humans.
US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
- Cerner Multum, Inc. "Australian Product Information." O 0
Drug and Breastfeeding Interactions
Major
Vyvanse
+ Breastfeeding
The following applies to the ingredients: Lisdexamfetamine (found in Vyvanse)
Professional Content
Use should be avoided during breastfeeding.
Excreted into human milk: Yes
Comments:
-This drug is a prodrug of dextroamphetamine. The effect of dextroamphetamine in milk on the neurological development of a breastfed infant has not been well studied.
-Large dosages of this drug might interfere with milk production, especially in women whose lactation is not well established.
-Blood levels of dextroamphetamine in 3 breastfed infants were up to 14% of the maternal plasma level.
-Four breastfed infants whose mothers took an average dose of 18 mg/day of dextroamphetamine had no adverse effects and showed normal progress with weights between the 10th and 75th percentiles.
-In a study of 20 postpartum women, dextroamphetamine reduced serum prolactin by 25% to 32% (7.5 mg IV dose) and 30% to 37% (15 mg IV dose). Another study showed a 20 mg oral dose produced a sustained suppression of serum prolactin by 40%.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
- Cerner Multum, Inc. "Australian Product Information." O 0
- United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):
Minor
Lexapro
+ Breastfeeding
The following applies to the ingredients: Escitalopram (found in Lexapro)
Professional Content
Use with caution; the benefit to the mother should outweigh the risk to the infant.
Excreted into human milk: Yes
Comments:
-Breastfed infants should be monitored for drowsiness and decreased feeding.
-Mothers taking an SSRI during pregnancy and postpartum may have difficulty breastfeeding and may require additional breastfeeding support.
Escitalopram is not expected to cause adverse effects in breastfed infants, particularly in infants over 2 months of age. One case of necrotizing enterocolitis has been reported in a breastfed newborn whose mother was taking escitalopram during pregnancy and lactation; however, causality was not established.
Maternal doses of escitalopram up to 20 mg per day lead to low levels in milk, approximately 3.9% and 1.7% of the maternal weight-adjusted dose of escitalopram and desmethylcitalopram, respectively. Limited data suggest that escitalopram is preferable to racemic citalopram during breastfeeding due to lower dosage and milk levels, and general lack of side effects in breastfed infants.
References
- "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals (2002):
- Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
- Cerner Multum, Inc. "Australian Product Information." O 0
- United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):
Therapeutic Duplication Warnings
No warnings were found for your selected drugs.Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Switch to: Professional Interactions
| Drug Interaction Classification | |
|---|---|
These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication. |
|
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
| Unknown | No interaction information available. |
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