Simtriyo (centanafadine) is used for attention deficit hyperactivity disorder (ADHD) and can be an effective treatment. But it is important to note that it can interact with other medicines and substances.
An interaction occurs when a substance changes how a medicine works or affects the body. Understanding these interactions can help lower the risk of side effects and avoid unsafe combinations.
This article does not include all possible Simtriyo interactions. Always tell your health care provider and pharmacist about all prescription drugs, over-the-counter medicines, and any vitamins, herbs, or other supplements you use.
Understanding Simtriyo Interactions
Simtriyo seems to work by increasing levels of natural brain chemicals, such as norepinephrine, dopamine, and serotonin. Some other medicines also can affect these brain chemicals, which may increase the risk of side effects.
Other interactions can happen because Simtriyo blocks the effects of an enzyme called CYP1A2, which helps break down certain medicines and supplements. By blocking this enzyme, Simtriyo could slow how quickly certain medicines are broken down, which may increase the risk of side effects of these other medicines.
Below are more details about some Simtriyo interactions.
1. Other medicines that increase serotonin levels
Simtriyo can increase serotonin levels, and so can many other medicines.
Examples include:
- A triptan, such as eletriptan, rizatriptan, or sumatriptan
- A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline
- A selective serotonin reuptake inhibitor (SSRI), such as fluoxetine, paroxetine, or sertraline
- A serotonin and norepinephrine reuptake inhibitor (SNRI), such as duloxetine or venlafaxine
- An opioid, such as codeine, fentanyl, meperidine, methadone, morphine, oxycodone, or tramadol
Taking Simtriyo with any of these medicines that work similarly can increase your risk of side effects, and some of these side effects can be serious.
If you must take both of these medications, your health care provider may monitor you more closely or adjust your dosage of either medicine. If you take any of these medicines, tell your health care provider before you start taking Simtriyo.
2. Monoamine oxidase inhibitors
Simtriyo can increase serotonin, dopamine, and norepinephrine levels, and so can monoamine oxidase inhibitors (MAOIs).
MAOIs are a group of medicines used to treat depression, Parkinson’s disease, and certain other conditions. Examples include:
- Linezolid
- Phenelzine
- Tranylcypromine
- Selegiline
Since all of these medicines can increase serotonin, dopamine, and norepinephrine levels, taking any of them with Simtriyo may increase your risk for side effects of either medicine, some of which can be serious.
Do not take these medicines together or within two weeks of one another. If you take any of these medicines or recently stopped it, tell your health care provider before you start taking Simtriyo.
3. Central nervous system (CNS) stimulants
Simtriyo is a CNS stimulant, and so are many other medicines.
A CNS stimulant is a medicine that increases activity in the CNS, including the brain. While stimulants such as Simtriyo can help improve ADHD symptoms related to alertness and attention, too much stimulation can increase the risk of side effects such as a fast heart rate, anxiety, or trouble sleeping.
Examples of other CNS stimulants include:
- Amphetamine
- Lisdexamfetamine
- Methylphenidate
Taking Simtriyo with other stimulants can increase your risk of side effects, and some of these side effects can be serious.
If you must take any of these medicines, your health care provider may monitor you more closely or adjust your dosage of either medicine. If you take any of these medicines, tell your health care provider before you start taking Simtriyo.
4. Tizanidine
Tizanidine is used as a muscle relaxant. Taking Simtriyo with tizanidine may lead to higher levels of tizanidine in your body.
Simtriyo can slow the breakdown of tizanidine in your body, increasing its levels and your risk for side effects from it.
If these medicines need to be taken together, your health care provider may monitor you more closely or change your dose.
5. Certain sleep medicines or supplements
Medicines or supplements for sleep are used to help you fall asleep faster or stay asleep longer. Taking Simtriyo with certain sleep aids may increase the amount of these medicines in your body. Examples include melatonin and ramelteon.
Simtriyo can slow their breakdown, increasing their levels in your body and the risk of side effects. If these need to be taken together, your health care provider may monitor you more closely or change your dose.
Other Simtriyo Interactions
Simtriyo and alcohol
Do not consume alcohol with or within two hours after taking Simtriyo. Taking them together may raise Simtriyo levels in your blood, increasing the risk of side effects.
Supplement interactions
Some supplements may interact with Simtriyo. One example is St. John’s wort.
St. John’s wort can affect serotonin and dopamine levels or their activity. Taking it with Simtriyo, which increases the levels of these chemicals, may increase your risk for side effects of St. John’s wort and Simtriyo. It’s best to avoid herbal supplements that contain St. John’s wort while taking Simtriyo.
Other herbal and dietary supplements may also cause interactions, even if they are not listed here. Tell your health care team about all supplements you take.
How to Avoid Simtriyo Interactions
The following steps can help lower your risk of drug interactions while taking Simtriyo:
- Take it exactly as prescribed.
- Keep an updated list of all medicines and supplements you use.
- Share your medication list with your health care team and pharmacist.
- Ask your health care provider before you start or stop any medicine, vitamin, or supplement.
- Properly dispose of unused or expired medicines to help prevent accidental use.
Your health care provider can help decide whether Simtriyo is safe for you and if your treatment plan needs any changes to help avoid or manage interactions.
