Does blood pressure medicine interact with Adderall?

If you have attention deficit hyperactivity disorder (ADHD), you may get relief from the prescription drug Adderall. It can improve focus, decrease restlessness, and help control impulsive behavior (including the hard-to-stop habit of interrupting people). But, like other medications, it comes with possible side effects.

Some Adderall side effects, like dry mouth, don’t need medical treatment. You should tell your doctor right away about others, such as pain when you pee.

Whether Adderall side effects are annoying or alarming to you, be sure you tell your doctor, who can help you find ways to feel better while the medication does its job.

Adderall is the trade name for a combination of two drugs: dextroamphetamine and amphetamine. If you take a generic version of Adderall, those two drug names will be on your medicine bottle.

The generic type costs less, but that’s about the only difference you’ll notice. Generic dextroamphetamine/amphetamine has the same risk of side effects as brand-name Adderall. It provides the same benefits, too.

Common Side Effects

Many common side effects will get better or go away as your body gets used to the medicine. They might include:

  • Anxiety
  • Dry mouth
  • Weakness
  • Stomachache
  • Weight loss
  • Constipation
  • Less interest in sex
  • Unusual sense of well-being
  • Difficulty keeping an erection
  • Twitching

If you have any of these side effects, ask your doctor how long they are likely to last, as well as what to do if they don’t get better.

Rare Side Effects

Rarely, Adderall causes more serious side effects. Tell your doctor at once if you have any of these:

  • A major increase in your blood pressure
  • Serious anxiety
  • Panic attack
  • Big mood swings
  • Hallucinations
  • Paranoia
  • Intense muscle pain or weakness
  • An erection that hurts or lasts too long
  • Changes of feeling or color in your fingertips or toes

Adderall and Your Heart

In the short term, Adderall can raise your blood pressure and heart rate, and cause you to breathe harder. If you take too much of it, you could put your heart and your health at risk.

To be on the safe side, doctors usually don’t prescribe Adderall to people with:

  • Serious heart problems
  • High blood pressure that is not controlled with medicine

But more research is needed. One large study found no link between ADHD medications -- including stimulants like Adderall -- and a higher risk of a heart attack or stroke.

Even without a perfect heart, you may still be able to take Adderall for ADHD. Expect to see a heart doctor (cardiologist) first. You'll need to get your heart rate and blood pressure checked at follow-up doctor visits.

Tips to Manage Side Effects

You can take steps to reduce some side effects of Adderall. Ask your doctor what might work for you. Some things you can try:

Have good sleep habits. Many people with ADHD have insomnia, or trouble sleeping. Stimulant medicines like Adderall can add to the problem. To get better sleep, limit caffeine and screen time (phone, TV, or video games) close to bedtime.

Don’t take Adderall after 5 p.m. If you miss a dose, take it as soon as you remember -- up to a point. The later you take this drug, the more likely it is to keep you awake at night. Try not to take any Adderall after 5 p.m. If you use an extended-release (XR) version, try not to take it after 2 p.m.

Limit or avoid alcohol. Alcohol affects the way your body processes Adderall. That could result in unusual side effects, including sleepiness.

Ask your doctor if you should switch antidepressants. A few antidepressants can increase Adderall’s side effects. These drugs include:

  • Bupropion (Wellbutrin)
  • Duloxetine (Cymbalta)
  • Fluoxetine (Prozac)
  • Venlafaxine (Effexor)

Reduce dry mouth. You can’t stop Adderall from causing dry mouth, but you can take steps to put moisture back in.

  • Chew sugar-free gum or suck on sugar-free candies, which get saliva flowing.
  • Avoid mouthwash that contains alcohol.
  • Sip water throughout the day.
  • Try over-the-counter saliva substitutes. (Your pharmacist can point you in the right direction.)
  • Try a “dry mouth” mouthwash.
  • Avoid antihistamines, which can contribute to dry mouth.
  • Put a humidifier in your bedroom.

Adderall (amphetamine/dextroamphetamine) is a brand-name prescription drug used to treat attention deficit hyperactivity disorder (ADHD). It’s also used to treat narcolepsy.

As with other medications, Adderall can interact with alcohol and certain other drugs. It can also interact with some supplements and foods. An interaction occurs when one substance causes another substance to have a different effect than expected.

For more about Adderall’s interactions, keep reading. For additional information about Adderall, including details about its uses, see this article.

In some cases, a factor or condition could prevent your doctor from prescribing Adderall due to the risk of harm. This is known as a contraindication. The contraindications of Adderall include the ones mentioned below.

If you have a serious heart or blood vessel problem. Taking Adderall can increase your heart rate and blood pressure. If you have a serious heart or blood vessel problem, the side effects could lead to heart attack or stroke. The side effects could also, in rare cases, lead to sudden death. In addition, Adderall could make your condition worse. Examples of serious heart and blood vessel problems include:

  • moderate to severe hypertension (high blood pressure)
  • advanced arteriosclerosis (hardening of the arteries)
  • heart disease that causes symptoms such as chest pain or shortness of breath

If you have hyperthyroidism. Taking Adderall can increase your heart rate and blood pressure. Hyperthyroidism (an overactive thyroid gland) can also cause these symptoms. If you have hyperthyroidism, Adderall could worsen your symptoms.

If you have glaucoma. Adderall can increase the pressure in your eyes. If you have glaucoma, taking Adderall could worsen your condition.

If you have had an allergic reaction to Adderall or any of its ingredients. If you’ve had an allergic reaction to Adderall or any of its ingredients, taking the drug could cause such a reaction. You could also have an allergic reaction with Adderall if you’ve had such a reaction to other drugs called amphetamines. (Adderall is a type of amphetamine.)

If you’re in an agitated state. If you’re in an agitated state, taking Adderall could worsen it. Agitation refers to feeling restless, nervous, or annoyed. Sometimes it can be due to a mental health condition.

If you have a history of drug misuse or dependence. Adderall has a risk of misuse and dependence. If you’ve misused or been dependent on drugs in the past, you may have an increased risk of these problems with Adderall. In fact, the drug has a boxed warning about this risk. This is a serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warning: Risk of misuse and dependence” at the top of this article.

If you have recently taken a monoamine oxidase inhibitor drug. Monoamine oxidase inhibitors (MAOIs) are an older class of antidepressant drugs. Adderall typically should not be taken within 14 days of taking an MAOI drug. Doing so can cause dangerous side effects, including kidney failure, heart attack, and unsafe rises in blood pressure.

If you’ve taken an MAOI recently, be sure to let your doctor know. They may still prescribe Adderall. However, they’ll likely have you wait at least 14 days from your last dose of the MAOI before you start Adderall treatment.

To learn more, see “Drug interactions in depth” below.

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

Adderall may interact with alcohol. For example, drinking alcohol with Adderall can reduce the effects of alcohol, so you may drink more than you usually would. This can have dangerous results, such as loss of consciousness.

Drinking alcohol while taking Adderall may also increase the risk of certain side effects of the drug. These can include increased blood pressure and a fast or irregular heartbeat. Such side effects can increase your risk of heart attack or stroke.

Drinking alcohol can also worsen symptoms of attention deficit hyperactivity disorder (ADHD), which Adderall is used to treat.

If you drink alcohol, talk with your doctor about how much is safe to drink with Adderall. However, in general, it’s safest to avoid drinking alcohol while you take the medication.

Before you start treatment with Adderall, 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.

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

Here’s a chart of drugs that can interact with Adderall. Keep in mind that this chart does not include all drugs that may interact with Adderall. Some of these interactions are described in detail below in “Drug interactions in depth.”

* To learn more, see “When to avoid Adderall” above.
† Buspar, a brand-name version of buspirone, used to be available but has been discontinued.

Here’s a closer look at certain drug interactions with Adderall.

Serotonergic drugs

Serotonergic drugs are drugs that increase levels of the chemical serotonin in your body.

Interaction result. Increased risk of serotonin syndrome.

Interaction explained. Adderall and serotonergic drugs can increase levels of serotonin in your body. Taking Adderall with a serotonergic drug can cause your serotonin level to rise too much, leading to serotonin syndrome.

Examples of serotonergic drugs. Here are some serotonergic drugs:

  • selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac)
  • serotonin noradrenaline reuptake inhibitors (SNRIs), such as venlafaxine (Effexor XR)
  • tricyclic antidepressants, such as amitriptyline
  • certain other antidepressants, such as mirtazapine (Remeron)
  • triptans for migraine, such as sumatriptan (Imitrex)
  • the anxiety drug buspirone
  • lithium (Lithobid)
  • certain opioids, such as fentanyl (Subsys, Fentora, Lazanda, Actiq)

Steps you or your doctor may take. If you take Adderall with a serotonergic drug, your doctor may prescribe a dosage of Adderall that’s lower than usual. See your doctor right away if you have symptoms of serotonin syndrome while taking Adderall with a serotonergic drug.

Symptoms of serotonin syndrome can include dry mouth, dilated pupils, hallucinations, and sweating more than usual. Other symptoms can include a very high body temperature, stiff muscles, and delirium (sudden confusion about what’s real).

Monoamine oxidase inhibitors

Adderall has a serious interaction with drugs called monoamine oxidase inhibitors (MAOIs). These include MAOI antidepressants, and certain drugs for Parkinson’s disease or infections.

Interaction result. Risk of dangerous side effects.

Interaction explained. Taking Adderall with an MAOIcan cause a hypertensive crisis (a dangerous increase in blood pressure), heart attack, or stroke. The drug combination can also cause serotonin syndrome. This is a serious condition caused by a buildup of the chemical serotonin in your body. (To learn about symptoms of serotonin syndrome, see “Serotonergic drugs” above.)

Examples of MAOI drugs. Here are some MAOIs:

  • isocarboxazid (Marplan)
  • linezolid (Zyvox)
  • methylene blue (ProvayBlue)
  • phenelzine (Nardil)
  • selegiline (Emsam, Zelapar)
  • tranylcypromine (Parnate)

Steps you or your doctor may take. Adderall typically should not be taken within 14 days of taking an MAOI drug. If you’ve taken an MAOI recently, be sure to let your doctor know. They may still prescribe Adderall. However, they’ll likely have you wait at least 14 days from your last dose of the MAOI before starting Adderall treatment.

Acid-reducing drugs

Acid-reducing drugs reduce the level of acid in your stomach. The medications are used to treat conditions such as indigestion, heartburn, or stomach ulcers.

Interaction result. Increased risk of side effects from Adderall.

Interaction explained. Acid-reducing drugs can increase the absorption of Adderall into your body. This can raise the level of Adderall in your blood, which can make side effects from Adderall more likely.

Examples of acid-reducing drugs. Here are some acid-reducing drugs:

  • antacids, such as calcium carbonate (TUMS)
  • H2 blockers, such as famotidine (Pepcid AC)
  • proton pump inhibitors, such as esomeprazole (Nexium)

Steps you or your doctor may take. If you take Adderall with an acid-reducing drug, your doctor may prescribe a dosage of Adderall that’s lower than usual. Also, keep in mind that you should not take antacids at the same time of day as Adderall.

Adderall may have other interactions, such as with supplements, herbs, or foods. You’ll find details below.

Adderall interactions with supplements

Before you start treatment with Adderall, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

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

Adderall interaction with supplements

Certain supplements can raise the level of the chemical serotonin in your body. Taking Adderall with one of these supplements can increase your risk of serotonin syndrome. This is a serious condition caused by a buildup of serotonin in your system.

Examples of these supplements include tryptophan and 5-HTP (5-hydroxytryptophan).

Adderall interactions with herbs

An herb called St. John’s wort can increase the level of serotonin in your body. Taking Adderall with St. John’s wort can increase your risk of serotonin syndrome.

Adderall interactions with vitamins

Taking Adderall with vitamin C can reduce the absorption of Adderall into your body. This could make Adderall less effective than usual. You should take vitamin C and Adderall at least 1 hour apart.

Adderall interactions with food

Adderall has stimulant effects. If you consume caffeine with Adderall, this may increase the stimulant effects of the drug. This could cause or worsen Adderall side effects such as trouble sleeping, anxiety, and increased heart rate.

You should avoid consuming large amounts of caffeine with Adderall. Caffeine is found in several foods and drinks, such as:

  • tea, including green tea
  • coffee
  • chocolate
  • cola drinks
Adderall and cannabis or CBD

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

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

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

  • High blood pressure. Adderall can increase your blood pressure. If you have mildly high blood pressure, Adderall could make it worse. If you have moderately or severely high blood pressure, your doctor will likely not prescribe Adderall. To learn more, see “When to avoid Adderall” above.
  • Heart conditions. Adderall can increase your heart rate and blood pressure. If you have a heart condition, Adderall could make it worse. Your doctor may check your heart function before prescribing Adderall to make sure the drug is safe for you. If you have a serious heart condition, your doctor will likely not prescribe Adderall. To learn more, see “When to avoid Adderall” above.
  • Circulation problems. Adderall can decrease blood flow to your fingers and toes. If you have a circulation problem such as Raynaud’s disease, taking Adderall could worsen your symptoms.
  • Mental health conditions. If you have a mental health condition such as bipolar disorder, anxiety, psychosis, or schizophrenia, taking Adderall could worsen your symptoms.
  • Tourette’s syndrome or tics. If you haveTourette’s syndrome or tics affecting movements or speech, taking Adderall could worsen your symptoms.
  • Seizures. If you have a seizure disorder, taking Adderall could increase your risk of having a seizure.
  • Allergic reaction. If you’ve had an allergic reaction to Adderall or any of its ingredients, taking the drug could cause such a reaction. You could also have an allergic reaction with Adderall if you’ve had such a reaction to other drugs called amphetamines. (Adderall is a type of amphetamine.)
  • Hyperthyroidism. Taking Adderall can increase your heart rate and blood pressure. Hyperthyroidism can also cause these symptoms. If you have hyperthyroidism, Adderall could worsen your symptoms.
  • Glaucoma. Adderall can increase the pressure in your eyes. If you have glaucoma, taking Adderall could worsen your condition.
  • Agitation. If you’re in an agitated state, taking Adderall could worsen it. Agitation refers to feeling restless, nervous, or annoyed. Sometimes it can be due to a mental health condition.
  • Past drug misuse or dependence. Adderall has a risk of misuse and dependence. If you’ve misused or been dependent on drugs in the past, you may have an increased risk of these problems with Adderall. In fact, the drug has a boxed warning about this risk. This is a serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warning: Risk of misuse and dependence” at the top of this article.
  • Pregnancy. It’s not known if Adderall is safe to take during pregnancy.
  • Breastfeeding. You should not take Adderall if you’re breastfeeding. The drug can pass into breast milk and cause side effects in a child who is breastfed.

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

Does Adderall interact with antihistamines?

Adderall is not known to interact with antihistamines (medications that treat allergies). However, some antihistamines can make you feel drowsy. Examples include chlorpheniramine and diphenhydramine (Benadryl). Adderall tends to make you more alert than usual. So if you take it with one of these antihistamines, Adderall may reduce drowsiness from the antihistamine.

It’s generally considered safe to take Adderall with antihistamines. If you have additional questions about taking these medications together, talk with your doctor or pharmacist.

Can you take gabapentin and Adderall together?

Adderall is not known to interact with gabapentin (Neurontin, Gralise, Horizant). Gabapentinis a seizure medication that’s also prescribed for nerve pain.

However, if you take gabapentin to help prevent seizures, it’s important to note that Adderall can increase your risk of having a seizure. This means that gabapentin may not work as well as usual to help prevent seizures if you take it with Adderall.

Your doctor and pharmacist can help answer other questions you have about Adderall and gabapentin.

Are there interactions between Adderall and Ativan or Klonopin?

There are no known interactions between Adderall and lorazepam (Ativan) or clonazepam (Klonopin). They can be used together safely if you take them as your doctor prescribes.

Ativan and Klonopin are a type of drug called benzodiazepines and are used to relieve anxiety. Adderall is sometimes prescribed with these drugs for people who have both anxiety and attention deficit hyperactivity disorder (ADHD).

Klonopin is sometimes also used to help prevent certain types of seizures. It’s important to note that Adderall can increase your risk of having a seizure. This means Klonopin may not work as well as usual to help prevent seizures if you take it with Adderall.

If you’re interested in taking Adderall with Ativan or Klonopin, talk with your doctor. They can advise you on the right treatment plan for you.

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

  • Let them know if you drink alcohol or take 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.
  • Check with your doctor or pharmacist before taking any new medications, supplements, herbs, or vitamins while you’re taking Adderall.

It’s also important to read the label of Adderall and other paperwork that comes with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the prescribing information, may contain details about interactions. If this information is difficult to understand, ask your doctor or pharmacist to help explain it.

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

Besides learning about interactions, you may want to find out more about Adderall. These resources might help:

  • Overview of Adderall. For a general overview of Adderall, you can see this article.
  • Side effects. If you’re interested in the side effects of Adderall, see this article. Another option is to refer to the prescribing information for Adderall and Adderall XR.
  • Drug comparison. For information abouthow Adderall compares with other drugs such as modafinil, Strattera, and methylphenidate, see this article. You can also find information about how Adderall compares with the following medications:
    • Dexedrine
    • Vyvanse
    • Ritalin
    • Concerta
    • guanfacine
  • Facts about your condition. To learn more about attention deficit hyperactivity disorder (ADHD), see our list of related articles. For more information about narcolepsy, you can visit our science of sleep hub and list of sleep articles.

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.

Does high blood pressure affect Adderall?

Effects on the heart Some people may observe larger increases in their blood pressure and heart rate. People who already have high blood pressure or a fast heart rate should exercise caution when taking Adderall.

What ADHD medication can I take with high blood pressure?

Reduces blood pressure: If you have ADHD and high blood pressure, clonidine may be a good choice for you because it will also help reduce your blood pressure. Can treat tic disorders: If you have both Tourette syndrome or another tic disorder and ADHD, clonidine can help the symptoms of both.

What should you not combine with Adderall?

Combining Adderall with medications such as serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants and St. John's wort may trigger it.

Can you take stimulants with high blood pressure?

Stimulants. Stimulants, such as methylphenidate (Ritalin, Concerta, others), can cause your heart to beat faster or irregularly, raising your blood pressure. Have your blood pressure checked regularly if you take a stimulant.