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Drugdad, Pharmacist
Category: Pharmacy
Satisfied Customers: 1727
Experience:  I have a doctor of pharmacy degree with experience in both retail and hospital. I will be happy to share this knowledge with you
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I am taking dexamphetamine, clonidine, pristiq ( currently

Customer Question

Hello, i am taking dexamphetamine, clonidine, pristiq ( currently changing to valdoxen) and also occasionally stilnox or tempazepam. I feel that the clonidine's effect on CYP2D6 may be stopping the dexamphetamine from working as i feel like it has stopped having an effect.
Submitted: 1 year ago.
Category: Pharmacy
Customer: replied 1 year ago.
the current daily meds are dexamphetamine (which i feel isn't working due to some sort of polypharmacy drug interaction, possibly with the clonidine?)
stilnox (ambien)
pristiq (desvenlafexine)
Expert:  Drugdad replied 1 year ago.

Hi, thanks for the question. As for drug interactions, there is no interaction between the clonidine and dexamphetamine. Also, clonidine is not known to be a powerful CYP inducer. It is metabolize by CYP2D6.

Depending on the dose you are taking, your doctor might have to increase your dexamphetamine dose or add another ADD/ADHD drug.

Expert:  Drugdad replied 1 year ago.

If you have additional question, feel free to ask.

Customer: replied 1 year ago.
Hello, yes they are both cyp2d6 metabolisers.. Perhaps that may be affecting the Dex
Expert:  Drugdad replied 1 year ago.

No, it does not mean that. To affect CYP2D6, it has to be either an inducer or inhibitor. An inducer will increase metabolism of dexamphetamine in the long run thereby decreasing its efficacy. That is not the case with clonidine.

Expert:  Dr. Bridget replied 1 year ago.

Hi! Just a different point of view to offer on possible reasons for the reduced effectiveness of Dexamphetamine: Stilnox and Temazepam both have opposing mechanisms to Dexamphetamine, thereby possibly reducing its effectiveness. Another thing to consider when evaluating why Dexamphetamine may not work as well for you is diet changes: acidic foods reduce its efficacy. If you want to discuss it further, please address your replies on the post to me (to reduce the confusion as multiple experts are replying).



Customer: replied 1 year ago.
What I meant was they are both cyp2d6 substrates. Would that not affect anything?I also eat a lot of raw fruits with veg and nuts, not sure if that's impacting.
Expert:  Dr. Bridget replied 1 year ago.

As noted by Drugdad, there are no concerns with the med list you provided regarding CYP enzymes and lower drug levels. As far as diet goes, acidic foods would reduce the effects of dextroamphetamine. These foods acidify the urine and increase the clearance of dextroamphetamine by the kidneys. Here are some examples of foods with high acidity:

  • nuts (cashew, peanut, walnuts)
  • grains
  • dairy products
  • fish
  • corned beef and turkey
  • seeds (pumpkin, sunflower)
  • most legumes
  • fruits (blueberry, cranberry, plum)
  • corn oil
  • sweeteners (sugars, molasses, maple syrup, processed honey, aspartame)
  • salt
  • condiments (mayonnaise, soy sauce, vinegar)
  • tobacco

If my answer helped you get your problem solved, please take a moment to provide a rating!



Expert:  Drugdad replied 1 year ago.

If both drugs are substrates cyp, it wouldn't change anything. The only things that affect CYP enzymes are the inducers and inhibitors. If you eat or drink grapefruit juice, it will affect it.