Strattera interactions: Alcohol, medications, and other factors

Strattera interactions with other medications  

Before you start treatment with Strattera, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Strattera interacts with supplements, herbs, or vitamins, see the “Strattera and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Strattera. Keep in mind that this table doesn’t include all drugs that may interact with Strattera. Some of these interactions are described in detail just below in “Drug interactions in depth.”

When to avoid Strattera

Sometimes, certain factors or conditions could prevent your doctor from prescribing Strattera due to the risk of harm. These are known as contraindications. The contraindications of Strattera include:

Having narrow-angle glaucoma

Doctors typically won’t prescribe Strattera for people with an eye condition called narrow-angle glaucoma. This is because Strattera may cause your pupils to dilate more often than normal, which can worsen your condition.

If you have narrow-angle glaucoma, talk with your doctor before taking Strattera. They’ll likely prescribe a treatment other than Strattera for your condition.

Having a tumor in your adrenal glands

If you have a tumor in your adrenal glands called pheochromocytoma, you may experience symptoms such as high blood pressure and heart rate. Strattera can also cause these symptoms. Therefore, taking Strattera if you have pheochromocytoma can worsen these side effects.

Before you start taking Strattera, be sure to tell your doctor if you have or have had an adrenal gland tumor. They usually won’t prescribe Strattera and can discuss alternative treatments with you.

Having cardiovascular problems

Strattera can increase your blood pressure and heart rate. If you have a medical condition that affects your heart or blood vessels, taking Strattera can worsen your condition.

If you have a severe cardiovascular condition that could suddenly worsen because of small changes in blood pressure or heart rate, your doctor likely won’t prescribe Strattera. Be sure to tell your doctor if you have any cardiovascular conditions before you start taking Strattera.

Taking a monoamine oxidase inhibitor

Doctors typically will not prescribe Strattera in combination with a type of antidepressant called a monoamine oxidase inhibitor (MAOI).

This is because taking Strattera with an MAOI can increase your risk of serious and sometimes life-threatening side effects. These include an unusually high body temperature, muscle stiffness, sudden muscle jerking, and changes in mental status.

Below are a few examples of MAOIs that can interact with Strattera:

• methylene blue (Provayblue)
• linezolid (Zyvox)
• phenelzine (Nardil)
• selegiline (Emsam)
• isocarboxazid (Marplan)

Before you start treatment with Strattera, it’s important to tell your doctor if you take an MAOI. They typically won’t prescribe Strattera if you’ve taken an MAOI in the past 14 days.

Having had an allergic reaction to Strattera or any of its ingredients

If you have had an allergic reaction to Strattera or any of its ingredients, your doctor will likely not prescribe Strattera. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Strattera, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Strattera.

Strattera interaction with alcohol

There are no known interactions between Strattera and alcohol. However, your doctor may advise you to avoid or limit alcohol consumption during Strattera treatment.

This is because drinking alcohol while taking the drug may worsen some of Strattera side effects. For example, you may experience:

• nausea
• vomiting
• dizziness
• sleepiness
• headache

If you consume alcohol during Strattera treatment, these side effects may be more likely to occur. If you have questions about drinking alcohol while taking Strattera, talk with your doctor.

Drug interactions in depth

Here’s a closer look at certain drug interactions of Strattera.

Drugs that affect blood pressure or heart rate

Many drugs can increase your blood pressure or heart rate.

Interaction result:Taking Strattera with a drug known to affect your blood pressure or heart rate can make the drug less effective. It may also increase your risk of high blood pressure or tachycardia.

Interaction explained:Strattera may increase your blood pressure or heart rate. If you’re taking medications to lower your blood pressure or heart rate, Strattera can make these drugs less effective.

Taking Strattera with drugs that increase your blood pressure or heart rate can intensify this effect.

Examples of drugs that affect blood pressure or heart rate: Here are some drugs that affect blood pressure or heart rate that may interact with Strattera:

• phenylephrine
• lisinopril (Zestril)
• valsartan (Diovan)
• atenolol (Tenormin)
• amphetamine/dextroamphetamine (Adderall, Adderall XR)

Steps you or your doctor may take:Before starting Strattera treatment, tell your doctor about all of the medications you take. They can advise you on whether it’s safe to take Strattera with your medications. If you and your doctor decide to start Strattera treatment, they’ll likely monitor your blood pressure and heart rate before and during treatment. They may also ask you to monitor your blood pressure at home.

Certain antipsychotic medications

Antipsychotic medications are prescribed for various mental health conditions, including schizophrenia and bipolar disorder.

Interaction result: Taking Strattera with certain antipsychotic medications can increase the risk of long QT syndrome. (Long QT syndrome is a condition that affects the heart’s electrical activity.)

Interaction explained: In rare cases, Strattera may cause long QT syndrome. But it’s important to note that long QT syndrome wasn’t seen during clinical trials of Strattera. There have been reports of this side effect in people taking the drug, but it’s unclear how often this has happened or if Strattera was the cause. Certain antipsychotics may also cause long QT syndrome. Taking Strattera with these antipsychotics can increase your risk of long QT syndrome.

Examples of antipsychotic drugs: Here are some antipsychotics that may interact with Strattera:

• ziprasidone (Geodon)
• risperidone (Risperdal)
• iloperidone (Fanapt)
• paliperidone (Invega)
• quetiapine (Seroquel)

Steps you or your doctor may take: Before you start taking Strattera, tell your doctor if you take an antipsychotic medication. They can help determine whether it’s safe for you to take these medications together. In most cases, they won’t recommend that you take them together unless it’s the best or only option available. If they are prescribed together, they may monitor your heart and electrolyte levels closely.

Albuterol

Albuterol is used to treat or help prevent bronchospasm. It’s available in many forms, including an inhalation suspension, inhalation powder, nebulizer solution, oral tablet, oral syrup, and injection.

Interaction result: Using albuterol oral tablet, oral syrup, or injection with Strattera can increase the risk of high blood pressure or tachycardia.

Interaction explained: Albuterol may increase your heart rate and blood pressure. Strattera can also raise your heart rate and blood pressure. Taking these medications together can increase your risk of high blood pressure or tachycardia.

Steps you or your doctor may take: If you take albuterol, be sure to tell your doctor before you start taking Strattera. They can discuss whether it’s safe for you to take these medications together. If you and your doctor decide to start Strattera treatment, your doctor will likely monitor your blood pressure and heart rate closely before and during treatment.

Strattera and other interactions

Strattera may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Strattera.

Strattera interactions with supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Strattera interactions with herbs

There are no specific reports of herbs interacting with Strattera. However, that doesn’t mean herbal interactions won’t occur or be recognized in the future. Because of this, it’s important to check with your doctor or pharmacist before taking any of these products during Strattera treatment.

Strattera interactions with vitamins

There are no specific reports of Strattera interactions with vitamins. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Strattera.

Strattera interactions with food

There were no reports of food interactions with Strattera. If you’d like to learn more about foods to avoid while taking Strattera, talk with your doctor.

Strattera interactions with vaccines

There are no known interactions between Strattera and vaccines. Talk to your doctor or pharmacist to see whether you’re due for any vaccines.

Strattera interactions with lab tests

Strattera is not known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk to your doctor.

STRATTERA INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Strattera. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Strattera. The impact of cannabis may affect how well you stick to your Strattera treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Strattera and health-related interactions

Certain medical conditions and other factors may increase the risk of interactions with Strattera. Before you take this drug, be sure to talk with your doctor about your health history. Strattera may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Strattera include:

• Heart problems: Strattera can increase your blood pressure and heart rate. If you have heart problems that affect your blood pressure or heart rate, taking Strattera can worsen your condition. Examples include heart defects, irregular heartbeat, high blood pressure, or low blood pressure. For more information about this interaction, see the “When to avoid Strattera” section.
• Mental health conditions: Strattera can cause changes in your mood, thoughts, or behavior. Your risk of this side effect may be higher if you have mental health conditions, such as psychosis, mania, bipolar disorder, or depression. Be sure to let your doctor know about any mental health conditions you have before you start taking Strattera.
• Liver problems: Strattera is broken down in your body by your liver. If you have liver problems, your body may break down Strattera more slowly, which can cause it to build up in your system. This can increase your risk of Strattera-related side effects. If you have liver problems, tell your doctor before you start Strattera. They may prescribe a lower dose of Strattera for you.
• Adrenal gland tumor: An adrenal gland tumor called pheochromocytoma can raise your blood pressure and heart rate. Strattera may also increase your blood pressure and heart rate. If you have pheochromocytoma, taking Strattera can increase your risk of these effects. For more information about this interaction, see the “When to avoid Strattera” section.
• Narrow-angle glaucoma: Strattera can cause your pupils to dilate more often than normal. If you have narrow-angle glaucoma, this may worsen your condition. For more information about this interaction, see the “When to avoid Strattera” section.
• Allergic reaction: If you’ve had an allergic reaction to Strattera or any of its ingredients, your doctor will likely not prescribe Strattera. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you. For more information about this interaction, see the “When to avoid Strattera” section.
• Breastfeeding: It is unknown whether it’s safe to use Strattera while breastfeeding. There isn’t enough information to determine whether the drug passes into breast milk or what effects Strattera may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before using Strattera. They can talk with you about treatment options and ways to feed your child.
• Pregnancy: There haven’t been enough clinical trials to determine whether Strattera is safe to use while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Strattera. They can advise you on the right treatment plan for you.
• Risk of suicidal thoughts and behaviors: Strattera has a boxed warning about the risk of suicidal thoughts and behaviors in children and adolescents. This is a serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous. For details, see the boxed warning at the top of this article.

FAQs about Strattera and interactions

Here are some frequently asked questions about Strattera and possible interactions.

What is the best antidepressant you can take with Strattera?

It depends. Your doctor may prescribe an antidepressant based on several factors, including your medical history, other medications you take, your age, and the severity of your condition. But keep in mind that everyone responds to medications differently.

However, certain antidepressants may interact with Strattera. Examples include bupropion (Wellbutrin) and fluoxetine (Prozac). Taking Strattera with these drugs can increase the risk of Strattera side effects, including long QT syndrome.

Before starting an antidepressant, tell your doctor if you take Strattera. They’ll likely prescribe an antidepressant that does not interact with Strattera.

What drugs should not be taken with Strattera?

You should avoid certain drugs during Strattera treatment because of interactions.

To see examples of such medications, refer the “Strattera interactions with other medications” section above. Also, talk with your doctor about what drugs you should not take with Strattera.

Is there an interaction between Strattera and SSRIs?

Yes. Strattera can interact with certain selective serotonin reuptake inhibitors (SSRIs), causing an increased risk of side effects from Strattera. Examples include fluoxetine (Prozac) and paroxetine (Paxil).

If you take an SSRI, talk with your doctor about your risk of an interaction. They can advise whether you should start Strattera treatment while taking an SSRI.

Preventing interactions

You can take certain steps to help prevent interactions with Strattera. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Strattera label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Strattera doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Strattera by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.