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Nuedexta Drug Interactions
Several products can cause negative drug interactions with Nuedexta, including certain antacids, alcohol, and grapefruit juice. Some of these interactions could increase your risk for serious side effects or decrease the effectiveness of the medications. To ensure a safe treatment process with Nuedexta, tell your healthcare provider about any other medications you are taking, including nonprescription medicines and herbal supplements.
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Nuedexta™ (dextromethorphan and quinidine) may potentially interact with many other medications, far too many to list completely in this article. This article includes some of the more common and dangerous Nuedexta drug interactions.
Some of the drugs that may lead to interactions with Nuedexta include but are not limited to:
- Alcohol
- Alfuzosin (Uroxatral®)
- Alosetron (Lotronex®)
- Amphetamines or amphetamine-like medications, such as:
- Benzphetamine (Didrex®)
- Dextroamphetamine (Dexedrine®)
- Dextroamphetamine and amphetamine (Adderall®)
- Dextroamphetamine-amphetamine extended release (Adderall XR®)
- Lisdexamfetamine (Vyvanse®)
- Methamphetamine (Desoxyn®)
- Phendimetrazine (Bontril®)
- Phentermine (Adipex-P®)
- Antacids
- Atomoxetine (Strattera®)
- Beta blockers, such as:
- Acebutolol (Sectral®)
- Atenolol (Tenormin®)
- Betaxolol (Kerlone®)
- Bisoprolol (Zebeta®)
- Carvedilol (Coreg®, Coreg CR®)
- Esmolol (Brevibloc®)
- Labetalol (Trandate®)
- Metoprolol (Lopressor®, Toprol-XL®)
- Nadolol (Corgard®)
- Nebivolol (Bystolic®)
- Penbutolol (Levatol®)
- Propranolol (Inderal®, Inderal® LA, InnoPran XL™)
- Sotalol (Betapace®)
- Timolol
- Calcium channel blockers, such as:
- Amlodipine (Norvasc®)
- Diltiazem (Cardizem®, Cardizem CD®, Cardizem LA®, Cartia XT®, Dilacor XR®, Dilt-CD®, Diltia XT®, Dilt-XR®, Taztia XT®, Tiazac®)
- Felodipine (Plendil®)
- Isradipine (Dynacirc®, Dynacirc CR®)
- Nisoldipine (Sular®)
- Nicardipine (Cardene®, Cardene SR®)
- Nifedipine (Adalat CC®, Afeditab CR®, Nifediac CC®, Nifedical XL®, Procardia®, Procardia XL®)
- Nimodipine (Nimotop®)
- Verapamil (Calan®, Calan SR®, Covera-HS®, Isoptin SR®, Verelan®, Verelan PM®)
- Carbonic anhydrase inhibitors, such as:
- Acetazolamide (Diamox®)
- Dichlorphenamide (Daranide®)
- Methazolamide
- Certain statin medications, such as:
- Atorvastatin (Lipitor®) or combination medications that contain atorvastatin (Caduet®)
- Lovastatin (Altoprev®, Mevacor®) or combination medications that contain lovastatin (Advicor®)
- Simvastatin (Zocor®) or combination medications that contain simvastatin (Juvisync®, Simcor®, Vytorin®)
- Codeine
- Colchicine (Colcrys®)
- CYP 2D6 inhibitor medications, such as:
- Bupropion (Aplenzin™, Budeprion SR®, Budeprion XL®, Buproban®, Wellbutrin®, Wellbutrin SR®, Wellbutrin XL®, Zyban®)
- Chlorpromazine
- Cinacalcet (Sensipar®)
- Cocaine
- Delavirdine (Rescriptor®)
- Fluoxetine (Prozac®, Sarafem®, Selfemra™)
- Lopinavir and ritonavir (Kaletra®)
- Paroxetine (Paxil®, Paxil CR®, Pexeva®)
- Quinidine
- Ritonavir (Norvir®)
- Terbinafine (Lamisil®)
- CYP 3A4 inducer medications, such as:
- Aminoglutethimide (Cytadren®)
- Bosentan (Tracleer®)
- Carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®)
- Dexamethasone (Decadron®, Dexpak®, Maxidex®)
- Efavirenz (Sustiva®)
- Efavirenz, emtricitabine, and tenofovir (Atripla®)
- Etravirine (Intelence™)
- Fosphenytoin (Cerebyx®)
- Nafcillin
- Nevirapine (Viramune®)
- Oxcarbazepine (Trileptal®)
- Pentobarbital (Nembutal®)
- Phenobarbital (Luminal®)
- Phenytoin (Dilantin®, Phenytek®)
- Primidone (Mysoline®)
- Rifabutin (Mycobutin®)
- Rifampin (Rifadin®)
- Rifapentine (Priftin®)
- St. John's wort
- CYP 3A4 inhibitor medications, such as:
- Amprenavir (Agenerase®)
- Atazanavir (Reyataz®)
- Clarithromycin (Biaxin®)
- Conivaptan (Vaprisol®)
- Darunavir (Prezista®)
- Delavirdine (Rescriptor®)
- Erythromycin
- Fosamprenavir (Lexiva®)
- Imatinib (Gleevec®)
- Indinavir (Crixivan®)
- Isoniazid
- Itraconazole (Sporanox®)
- Ketoconazole (Nizoral®)
- Lopinavir and ritonavir (Kaletra®)
- Miconazole
- Nefazodone (Serzone®)
- Nelfinavir (Viracept®)
- Nicardipine (Cardene®)
- Posaconazole (Noxafil®)
- Quinidine
- Ritonavir (Norvir®)
- Saquinavir (Fortovase®, Invirase®)
- Telithromycin (Ketek®)
- Voriconazole (VFEND®)
- Dabigatran (Pradaxa®)
- Dienogest/estradiol valerate (Natazia™)
- Digoxin (Lanoxin®)
- Dutasteride (Avodart®) and dutasteride/tamsulosin (Jalyn™)
- Eplerenone (Inspra®)
- Ergot medications, such as:
- Bromocriptine (Parlodel®)
- Dihydroergotamine (Migranal®)
- Ergonovine
- Ergotamine (Cafergot®, Ergomar®)
- Methylergonovine (Methergine®)
- Pergolide (Permax®)
- Everolimus (Afinitor®, Zortress®)
- Fentanyl (Abstral®, Actiq®, Duragesic®, Fentora®, Lazanda®, Onsolis®, Subsys®)
- Fesoterodine (Toviaz™)
- Guanfacine (Tenex®) and guanfacine ER (Intuniv™)
- Hydrocodone (used in combination with acetaminophen or other medicines, and available as Lorcet®, Lortab®, Tussionex®, Pennkinetic®, Vicodin®, and many others)
- Linezolid (Zyvox®)
- Lurasidone (Latuda®)
- Malaria medications, such as:
- Artemether-lumefantrine (Coartem®)
- Chloroquine (Aralen®)
- Halofantrine
- Mefloquine (Lariam®)
- Quinidine
- Quinine sulfate (Qualaquin®)
- Maraviroc (Selzentry™)
- Medications that cause a certain change in the heart rhythm known as QT prolongation (see QT-Prolonging Medications for a list of such medications)
- Methylprednisolone (Depo-Medrol®, Medrol®)
- Mometasone inhaler (Asmanex®) and mometasone/formoterol (Dulera®)
- Monoamine oxidase inhibitors (MAOIs), such as:
- Isocarboxazid (Marplan®)
- Phenelzine (Nardil®)
- Rasagiline (Azilect®)
- Selegiline (Eldepryl®, Emsam®, Zelapar®)
- Tranylcypromine (Parnate®)
- Neuromuscular-blocking medications, such as:
- Atracurium
- Cisatracurium (Nimbex®)
- Pancuronium
- Rocuronium (Zemuron®)
- Succinylcholine (Anectine®, Quelicin®)
- Vecuronium (Norcuron®)
- P-glycoprotein inducers, such as:
- Carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®)
- Dexamethasone (Decadron®)
- Doxorubicin (Adriamycin®, Doxil®)
- Nefazodone (Serzone®)
- Prazosin (Minipress®)
- Rifampin (Rifadin®)
- St. John's wort
- Tipranavir (Aptivus®)
- Trazodone (Desyrel®) and trazodone ER (Oleptro™)
- Vinblastine
- P-glycoprotein inhibitors, such as:
- Amiodarone (Cordarone®, Pacerone®)
- Atorvastatin (Lipitor®, also found in Caduet®)
- Carvedilol (Coreg®, Coreg CR®)
- Clarithromycin (Biaxin®)
- Cyclosporine (Gengraf®, Neoral®, Sandimmune®)
- Darunavir (Prezista®)
- Dipyridamole (Persantine®, also found in Aggrenox®)
- Dronedarone (Multaq®)
- Erythromycin
- Grapefruit juice
- Itraconazole (Sporanox®)
- Ketoconazole (Nizoral®)
- Lapatinib (Tykerb®)
- Lopinavir and ritonavir (Kaletra®)
- Mefloquine (Lariam®)
- Nelfinavir (Viracept®)
- Nicardipine (Cardene®)
- Nilotinib (Tasigna®)
- Progesterone
- Propranolol (Inderal®, Inderal LA®, InnoPran XL®, also found in Inderide®)
- Quinidine
- Ranolazine (Ranexa®)
- Reserpine
- Ritonavir (Norvir®, also found in Kaletra®)
- Saquinavir (Invirase®)
- Sunitinib (Sutent®)
- Tacrolimus (Prograf®, Protopic®)
- Tamoxifen (Nolvadex®)
- Verapamil (Calan®, Calan SR®, Covera-HS®, Isoptin SR®, Verelan®, Verelan PM®)
- Paricalcitol (Zemplar®)
- Pazopanib (Votrient™)
- Quinidine
- Selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) medications, such as:
- Citalopram (Celexa®)
- Duloxetine (Cymbalta®)
- Desvenlafaxine (Pristiq®)
- Escitalopram (Lexapro®)
- Fluoxetine (Prozac®, Sarafem®, Selfemra™)
- Fluvoxamine (Luvox®, Luvox® CR)
- Milnacipran (Savella™)
- Paroxetine (Paxil®, Paxil CR®, Pexeva®)
- Sertraline (Zoloft®)
- Venlafaxine (Effexor®, Effexor XR®)
- Salmeterol (Serevent®)
- Saxagliptin (Onglyza™) and saxagliptin/metformin ER (Kombiglyze™ XR)
- Sibutramine (Meridia®)
- Silodosin (Rapaflo™)
- St. John's Wort
- Sucralfate (Carafate®)
- Tadalafil (Cialis®)
- Tamsulosin hydrochloride (Flomax®)
- Theophylline (Uniphyl®, Theochron®, TheoCap®, Theo-24®, Elixophyllin®)
- Tolvaptan (Samsca™)
- Topotecan (Hycamtin®)
- Tramadol (Ultram®), tramadol ER (Ultram® ER, Ryzolt™), or products that contain tramadol (Ultracet®)
- Triptans, such as:
- Almotriptan (Axert®)
- Eletriptan (Relpax®)
- Frovatriptan (Frova®)
- Naratriptan (Amerge®)
- Rizatriptan (Maxalt®)
- Sumatriptan (Alsuma™, Imitrex®, Sumavel®, Zecuity™) or sumatriptan/naproxen sodium (Treximet®)
- Zolmitriptan (Zomig®)
- Tricyclic antidepressants, such as:
- Amitriptyline (Elavil®)
- Amoxapine (Asendin®)
- Clomipramine (Anafranil®)
- Desipramine (Norpramin®)
- Doxepin (Sinequan®, Silenor®)
- Imipramine (Tofranil®, Tofranil PM®)
- Maprotiline (Ludiomil®)
- Nortriptyline (Pamelor®)
- Protriptyline (Vivactil®)
- Trimipramine (Surmontil®)
Written by/reviewed by: Susan Lakey, PharmD, MPH
Last reviewed by: Kristi Monson, PharmD