Learn about Quillivant XR drug interactions including MAOIs, blood pressure meds, antidepressants, supplements, alcohol, and what to tell your doctor.
If you or your child takes Quillivant XR (Methylphenidate extended-release oral suspension) for ADHD, it's important to know which other medications, supplements, and substances can interact with it. Some interactions are dangerous. Others may reduce how well your medications work.
This guide covers the major and moderate drug interactions listed in Quillivant XR's FDA labeling, plus food and supplement interactions you should be aware of.
A drug interaction happens when one substance changes how another substance works in your body. This can happen in several ways:
Quillivant XR (Methylphenidate) can interact with medications in all three of these ways. The severity ranges from mild to life-threatening, depending on the combination.
This is the most dangerous interaction. Do not take Quillivant XR with an MAOI or within 14 days of stopping one. Combining them can cause a hypertensive crisis — a sudden, severe spike in blood pressure that can be life-threatening.
MAOIs include:
If you're switching from an MAOI to Quillivant XR (or vice versa), a 14-day washout period is required.
Quillivant XR can amplify the effects of vasopressors — medications that raise blood pressure. These are typically used in hospital settings (e.g., Epinephrine, Norepinephrine, Dopamine). If you're having surgery or an emergency procedure, tell the medical team that you take Quillivant XR.
If you need surgery with general anesthesia, there's a risk of sudden blood pressure increase when Quillivant XR is combined with halogenated anesthetic agents (like Sevoflurane, Desflurane, or Isoflurane). Your anesthesiologist needs to know you're on this medication. Your doctor may advise stopping Quillivant XR before a scheduled surgery.
Quillivant XR can raise blood pressure and heart rate. If you take blood pressure medications, Quillivant XR may reduce their effectiveness. Common antihypertensives include:
If you take both, your doctor should monitor your blood pressure closely and may need to adjust your antihypertensive dose.
Methylphenidate may slow the breakdown of Coumarin anticoagulants like Warfarin (Coumadin), potentially increasing their effect and raising the risk of bleeding. If you take Warfarin and start Quillivant XR, your doctor should monitor your INR (blood clotting levels) more frequently.
Methylphenidate may inhibit the metabolism of certain anticonvulsants, increasing their blood levels. These include:
If you take a seizure medication with Quillivant XR, your doctor may need to check drug levels and adjust doses.
Methylphenidate may slow the breakdown of tricyclic antidepressants, increasing their levels in the body. TCAs include:
Higher TCA levels can increase the risk of side effects like dry mouth, constipation, drowsiness, and heart rhythm changes.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly prescribed alongside ADHD medications for patients who also have anxiety or depression. While this combination is often used safely, it should be monitored. Examples include:
Your doctor should monitor for increased side effects like anxiety, agitation, or changes in heart rate and blood pressure.
Some over-the-counter products and supplements can also interact with Quillivant XR:
Avoid alcohol while taking Quillivant XR. Alcohol may cause faster release of Methylphenidate from the extended-release formulation, which could result in a sudden dose dump — too much medication released too quickly. This can increase the risk of side effects and potentially dangerous cardiovascular effects.
This warning applies to adults taking Quillivant XR. Even moderate alcohol consumption can be risky with this medication.
While not a formal drug interaction, caffeine (coffee, energy drinks, tea, soda) acts as a stimulant and can amplify Quillivant XR's side effects — especially increased heart rate, anxiety, and trouble sleeping. Limit caffeine intake, particularly in the afternoon and evening.
Some sources suggest that highly acidic foods or drinks (like orange juice or grapefruit juice) could affect the absorption of Methylphenidate, though this is more commonly discussed with amphetamine medications. If you notice the medication seems less effective on days you drink a lot of citrus juice, mention it to your doctor.
Before starting Quillivant XR, give your doctor a complete list of:
Update this list any time a medication changes. Interactions can happen when you add a new drug to an existing regimen — not just when you start Quillivant XR.
For more on what to expect when taking this medication, see our guides on Quillivant XR side effects and what Quillivant XR is.
Quillivant XR is generally safe when taken as prescribed, but drug interactions are real and sometimes serious. The biggest risk is combining it with MAO inhibitors — that combination should always be avoided. For other interactions, the key is communication: make sure every doctor, pharmacist, and surgeon involved in your care knows you take Quillivant XR.
If you're having trouble filling your Quillivant XR prescription, Medfinder can help you find a pharmacy with it in stock.
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