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Standing risks

  • High dependence, taper carefullyconfidence high
    Physical dependence
    low
    Psychological dependence
    high
    View in article

Lethal interactions

Specific substances

  • Tramadollethal

By drug class

  • Ibogainelethal3 mechanismsconfidence medium
  • MAOIslethal6 mechanismsconfidence high

Dangerous interactions

33 dangerous interactions recorded for this substance.

See the full interactions table

Contraindications

Cardiovascular

  • symptomatic cardiovascular diseaseabsolute

    Contraindicated in advanced arteriosclerosis, symptomatic cardiovascular disease, and structural cardiac abnormalities. FDA black box warning notes risk of sudden cardiac death.

  • moderate-to-severe hypertensionabsolute

    Contraindicated in moderate-to-severe hypertension. Cochrane review confirms chronic blood pressure elevation with amphetamine use.

Psychiatric

  • psychotic disordersrelative

    Personal or family history of psychosis represents elevated risk. Amphetamine can trigger first psychotic episodes or destabilize controlled schizophrenia.

  • bipolar disorderrelative

    Risk of mania induction in predisposed individuals. Requires careful risk-benefit assessment and mood stabilizer co-prescription if used.

Metabolic

  • hyperthyroidismabsolute

    Contraindicated in hyperthyroidism due to synergistic sympathomimetic overload.

Pregnancy & Breastfeeding

  • pregnancyrelative

    Associated with adverse pregnancy outcomes. Amphetamines excreted in breast milk at 3-7x maternal plasma levels — breastfeeding is contraindicated.

Other

  • MAOI use within 14 daysabsolute

    Concurrent or recent MAOI use is absolutely contraindicated. Minimum 14-day washout required. Applies to phenelzine, tranylcypromine, selegiline, linezolid, methylene blue.

  • glaucomaabsolute

    Contraindicated in narrow-angle glaucoma. Pupil dilation from noradrenergic activation can precipitate acute glaucoma attack.

If this is going wrong

Reducing or stopping