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Pharmacy and Medications

Adderall and Lisinopril Interactions

01/11/2010

Question:

Thank you for taking the time to read my question.

I am very concerned about my Hypertension (which runs on average 145/95). I am male, 28 y/o, 5`7, 155 lbs, pretty active and walk on average 5 miles a day at work. I have currently been prescribed Lisinopril 20 mg daily and have been taking meds for about a week now. I have not noticed a reduction in blood pressure yet.

I am also in my 2nd semester of nursing school and I`m concerned about my ability to concentrate and productivity in my study habits. After alot of scrutiny from family and friends, they have suggested I may have a mild form of ADHD. While addressing my blood pressure at the Dr`s visit, I inquired about ADHD. The doctor suggested Adderall 20 mg, which he prescribed me. I have a follow up appt in about 45 days.

I have done alot of research on the internet and have read alot about hypertension and Adderall. I am kinda curious as to why my doc did not mention this at my visit and I am very concerned.

My questions are:

1) Is it okay to take Adderall with my blood pressure, if I am taking these Ace inhibitors to control my hypertension?

2) If so, What concerns should I have with the combination of these medications?

3) If these 2 meds are concerning, What two drug combinations should be taken to address both my hypertension and my ability to concentrate in school?

4) What other information would be helpful to me when I go back for my follow up appt.?

I have been in the medical field for the past 8 years and I want to be a nurse with all my heart but not at the risk of a heart attack of stroke.

Thank you again. I hope to read your expertise on this matter.

Answer:

Firstly, I highly encourage you to discuss this with the physician who prescribed dextroamphetamine/amphetamine (Adderall). The physician my not have considered the effect on your blood pressure.

Secondly, I would be curious to know if your physician really has any expertise in the area of ADHD or if you should seek a referral to a physician who may be better able to properly diagnose and treat adult ADHD.

There is no direct drug interaction between the Adderall and your lisinopril. However, as you mentioned, the Adderall may raise blood pressure. If your blood pressure is well-controlled on the lisinopril, and you are able to maintain that control while taking the Adderall, then you should not have any problems. There is a newer medication that has been approved for adult ADHD. Atomoxetine (Strattera) may be more expensive, but it does seem to have a lower incidence of hypertension. You can check with your prescription insurance plan for copayment information or call your local pharmacy to check pricing.

Finally, you should pay close attention to whether you notice a difference on the Adderall or not. From your question, it almost seems that you had a brief discussion with your physician about inability to concentrate, then walked out of the office with a prescription for a controlled-substance. If you truly think that you are having problems with ADHD and you are not comfortable with the medications prescribed by your physician, you should consider seeing a specialist in this area.

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Response by:

Michael  Ganio, PharmD Michael Ganio, PharmD
Clinical Applications Pharmacist
Wexner Medical Center
The Ohio State University