Lisdexamfetamine and Naltrexone and bupropion interaction

If serotonin syndrome occurs, discontinue lisdexamfetamine dimesylate and the CYP2D6 inhibitor [see Warnings and Precautions (5.7) and Overdosage (10) ] .

The co-administration with cytochrome P450 2D6 (CYP2D6) inhibitors may also increase the risk with increased exposure to the active metabolite of lisdexamfetamine dimesylate (dextroamphetamine).

In these situations, consider an alternative non-serotonergic drug or an alternative drug that does not inhibit CYP2D6 [see Drug Interactions (7.1) ] .

If concomitant use of lisdexamfetamine dimesylate with other serotonergic drugs or CYP2D6 inhibitors is clinically warranted, initiate lisdexamfetamine dimesylate with lower doses, monitor patients for the emergence of serotonin syndrome during drug initiation or titration, and inform patients of the increased risk for serotonin syndrome.

CYP2D6 Inhibitors Clinical Impact The concomitant use of lisdexamfetamine dimesylate and CYP2D6 inhibitors may increase the exposure of dextroamphetamine, the active metabolite of lisdexamfetamine dimesylate compared to the use of the drug alone and increase the risk of serotonin syndrome.

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Drug-Laboratory Test Interactions: CONTRAVE can cause false- positive urine test results for amphetamines.

Drug-Laboratory Test Interactions False-positive urine immunoassay screening tests for amphetamines have been reported in patients taking bupropion.

Confirmatory tests, such as gas chromatography/mass spectrometry, will distinguish bupropion from amphetamines.