Auvelity (dextromethorphan/bupropion) is a brand-name oral tablet that’s prescribed for depression. Auvelity has interactions with alcohol and some other drugs. Examples include escitalopram (Lexapro) and amphetamine/dextroamphetamine (Adderall).

Auvelity is prescribed for major depressive disorder in adults. The drug comes as an extended-release oral tablet.Extended release means the drug is slowly released into your body over a long period of time.

An interaction occurs when one substance causes another substance to have a different effect than expected.

To learn more about Auvelity’s interactions, keep reading. For additional information about Auvelity, including details about its uses, see this article.

In some cases, factors or conditions could prevent your doctor from prescribing Auvelity due to the risk of harm. These are known as contraindications. Auvelity contraindications include:

Having a seizure disorder

Doctors typically will not prescribe Auvelity for people with a disorder that causes seizures, such as epilepsy. This is because Auvelity can raise your risk of having seizures.

If you have a seizure disorder, talk with your doctor before taking Auvelity. They’ll likely prescribe a treatment other than Auvelity for your depression.

Having an eating disorder

Doctors typically will not prescribe Auvelity for people with a history of bulimia or anorexia nervosa. This is because these people may have a raised risk of seizures with Auvelity.

If you’ve ever received a diagnosis of an eating disorder, talk with your doctor before taking Auvelity. They’ll likely prescribe a treatment other than Auvelity for your depression.

Having suddenly stopped drinking alcohol or taking certain drugs

Doctors typically will not prescribe Auvelity for people who have recently suddenly stopped drinking large amounts of alcohol or taking certain drugs. Examples include benzodiazepines such as alprazolam (Xanax), barbiturates such as pentobarbital (Nembutal), and seizure medications such as lamotrigine (Lamictal).

If you’ve been dependent on alcohol or these drugs, suddenly stopping them can raise your risk of seizures. Auvelity can also raise your risk of seizures.

Before you start treatment with Auvelity, it’s important to tell your doctor if you’ve recently stopped drinking alcohol or taking these drugs. You can ask your doctor about alternatives to Auvelity that may be better choices for you.

Taking a monoamine oxidase inhibitor

Doctors typically will not prescribe Auvelity in combination with a type of antidepressant called a monoamine oxidase inhibitor (MAOI).

This is because taking Auvelity with an MAOI can raise your risk of serotonin syndrome. With this syndrome, your body has a high level of a brain chemical called serotonin. This can cause symptoms such as blood pressure changes, excessive sweating, and diarrhea, nausea, or vomiting. Serotonin syndrome can be life threatening for some people.

Below are a few examples of MAOIs that can interact with Auvelity:

  • isocarboxazid (Marplan)
  • linezolid (Zyvox)
  • methylene blue (Provayblue)
  • phenelzine (Nardil)
  • selegiline (Emsam, Zelapar)

Before you start treatment with Auvelity, it’s important to tell your doctor if you take an MAOI. They’ll likely have you stop taking the MAOI and wait at least 2 weeks before starting treatment with Auvelity. Likewise, after you stop taking Auvelity, your doctor will typically have you wait at least 2 weeks before starting treatment with an MAOI.

Having had an allergic reaction to Auvelity or any of its ingredients

If you’ve had an allergic reaction to Auvelity or any of its ingredients, your doctor will likely not prescribe Auvelity. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.

Note: Before you start treatment with Auvelity, it’s important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Auvelity.

Before you start treatment with Auvelity, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Auvelity interacts with supplements, herbs, or vitamins, see the “Auvelity and other interactions” section below.)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a table of drugs that can interact with Auvelity. Keep in mind that this table doesn’t include all drugs that may interact with Auvelity. Some of these interactions are described in detail just below in “Drug interactions in depth.”

Drug class or drug nameDrug examplesInteraction result with Auvelity
monoamine oxidase inhibitors (MAOIs)*• intravenous methylene blue (ProvayBlue)
• linezolid (Zyvox)
• phenelzine (Nardil)
• selegiline (Emsam, Zelapar)
can increase the risk of serious side effects of Auvelity and MAOIs
selective serotonin reuptake inhibitors (SSRIs)• escitalopram (Lexapro)
• fluoxetine (Prozac)
• paroxetine (Paxil)
can increase the risk of side effects of Auvelity and SSRIs
serotonin-norepinephrine reuptake inhibitors (SNRIs)• desvenlafaxine (Pristiq)
• duloxetine (Cymbalta)
• venlafaxine (Effexor XR)
can increase the risk of side effects of Auvelity and SNRIs
tricyclic antidepressantsamitriptyline
• clomipramine (Anafranil)
• nortriptyline (Pamelor)
can increase the risk of side effects of Auvelity and tricyclics
stimulants• amphetamine/dextroamphetamine (Adderall)
• methylphenidate (Ritalin, others)
• modafinil (Provigil)
can increase the risk of seizures with Auvelity
antipsychotics• aripiprazole (Abilify)
• chlorpromazine
• clozapine (Clozaril)
can increase the risk of side effects of Auvelity and antipsychotics
dopamine agonists• amantadine (Gocovri)
• levodopa
can increase the risk of side effects of Auvelity and dopamine agonists
digoxin (Lanoxin)can make digoxin less effective
carbamazepine (Tegretol, others)can make Auvelity less effective
metoclopramide (Reglan)can increase the risk of side effects of metoclopramide

Auvelity and alcohol can interact. Your doctor will likely recommend that you avoid or limit drinking alcohol while taking Auvelity.

While taking Auvelity, your body can be more sensitive to the effects of alcohol. Drinking alcohol with Auvelity can also cause changes in your mental health. And drinking large amounts of alcohol can also raise your risk of seizures with Auvelity.

Also, drinking alcohol can worsen symptoms of depression, which Auvelity is used to treat.

If you have concerns about avoiding alcohol while you’re taking Auvelity, talk with your doctor before starting treatment.

Note that if you’ve recently stopped drinking heavily, you may have a raised risk of seizures with Auvelity. For more information about this, see the section above called “When to avoid Auvelity.”

Here’s a closer look at certain drug interactions of Auvelity.

Selective serotonin reuptake inhibitors (SSRIs) such as Lexapro

Auvelity can interact with SSRIs, which are a class of antidepressants used to treat depression and anxiety disorders.

Interaction result: Taking Auvelity with an SSRI can raise your risk of side effects* of both drugs. Examples include serotonin syndrome (a serious condition caused by high levels of serotonin in your body).

Interaction explained: Auvelity and SSRIs can both cause serotonin syndrome. So taking these drugs together can raise your risk of this side effect.

Some SSRIs can also slow the action of an enzyme that helps clear dextromethorphan (one of the active drugs in Auvelity) from your body. Taking one of these SSRIs with Auvelity can make dextromethorphan build up in your body. This can raise your risk of dextromethorphan side effects, such as dizziness and sleepiness.

Examples of SSRI drugs: Here are some SSRIs that may interact with Auvelity:

  • citalopram (Celexa)
  • escitalopram (Lexapro)
  • fluoxetine (Prozac)
  • paroxetine (Paxil)

Steps you or your doctor may take: If your doctor prescribes Auvelity with certain SSRIs, they may prescribe a dosage of Auvelity that’s lower than usual.

If you take Auvelity with an SSRI such as Lexapro, tell your doctor if you have bothersome side effects. In particular, see your doctor right away if you have symptoms of serotonin syndrome. These can include diarrhea, fast heartbeat, sweating, tremor, and feeling anxious or agitated.

If you have questions about taking Auvelity and an SSRI together, talk with your doctor or pharmacist.

* For details about Auvelity’s side effects, see this article.

Stimulants such as Adderall

Auvelity can interact with stimulants, which are used to treat attention deficit hyperactivity disorder (ADHD) and sleep disorders such as narcolepsy.

Interaction result: Taking Auvelity with stimulants can raise your risk of seizures.

Interaction explained: Auvelity and stimulants can both raise your risk of seizures. So taking these drugs together can raise your risk of this side effect* even more.

Examples of stimulant drugs: Here are some stimulants that may interact with Auvelity:

  • amphetamine/dextroamphetamine (Adderall)
  • armodafinil (Nuvigil)
  • methylphenidate (Ritalin, others)
  • modafinil (Provigil)

Steps you or your doctor may take: If you take Auvelity with a stimulant such as Adderall, your doctor may prescribe a lower than usual dose of one or both drugs.

Tell your doctor right away if you have symptoms of seizures while taking Auvelity with a stimulant. These can include staring into space, having changes in smell or taste, twitching, jerking, or shaking movements, and losing consciousness.

If you have questions about taking Auvelity with a stimulant, talk with your doctor or pharmacist.

* For details about Auvelity’s side effects, see this article.

Antipsychotics

Auvelity can interact with antipsychotic drugs, which are used to treat mental health conditions such as schizophrenia and bipolar disorder.

Interaction result: Taking Auvelity with an antipsychotic can raise your risk of side effects* of both drugs, such as seizures.

Interaction explained: Auvelity and antipsychotics can both raise your risk of seizures. So taking these drugs together can raise your risk of this side effect even more.

Auvelity can also slow the action of an enzyme that helps clear certain antipsychotics from your body. Taking Auvelity with one of these antipsychotics can make the antipsychotic build up in your body. This can raise your risk of side effects from the antipsychotic, such as sleepiness or irregular heartbeats.

Examples of antipsychotic drugs: Here are some antipsychotic drugs that may interact with Auvelity:

  • aripiprazole
  • chlorpromazine
  • clozapine (Clozaril)

Steps you or your doctor may take: If your doctor prescribes Auvelity with an antipsychotic, they may prescribe a lower than usual dose of the antipsychotic.

If you take Auvelity with an antipsychotic, tell your doctor if you have bothersome side effects. In particular, see your doctor right away if you have symptoms of seizures. These can include staring into space, having changes in smell or taste, twitching, jerking, or shaking movements, and losing consciousness.

If you have questions about taking Auvelity with an antipsychotic, talk with your doctor or pharmacist.

* For details about Auvelity’s side effects, see this article.

Here are some frequently asked questions about Auvelity and possible interactions.

Can I take Auvelity and Xanax together?

Yes, you can usually take Auvelity and alprazolam (Xanax) together. These drugs have not been reported to interact.

Auvelity is used to treat depression, and Xanax is used to treat anxiety disorders. These conditions can often coexist. It’s not unusual for doctors to prescribe these drugs together.

If you have questions about taking Auvelity and Xanax together, talk with your doctor or pharmacist.

Can I take Auvelity with lamotrigine (Lamictal) or gabapentin (Neurontin)?

In some cases, yes. There’s no known interaction between Auvelity and lamotrigine or gabapentin. However, whether you can take these drugs together depends on the reason for taking lamotrigine or gabapentin.

Lamotrigine and gabapentin are both prescribed to treat certain types of seizures. You should not take Auvelity if you’re taking lamotrigine or gabapentin for a seizure disorder. This is because Auvelity can raise your risk of having seizures.

However, lamotrigine and gabapentin also have other uses. For example, gabapentin is used to treat restless legs syndrome and certain types of nerve pain. And lamotrigine may be prescribed off-label for bipolar disorder. If you take gabapentin or lamotrigine for these uses, it may be safe to take Auvelity as well.

Note that if you have bipolar disorder, taking Auvelity can raise your risk of having a manic episode. Talk with your doctor about whether it’s safe for you to take Auvelity with lamotrigine.

If you have questions about taking Auvelity with lamotrigine or gabapentin, talk with your doctor or pharmacist.

Can you take Auvelity with Wellbutrin?

Doctors typically will not prescribe Auvelity with Wellbutrin. This is because both medications contain the active drug bupropion. (Auvelity also contains the active drug dextromethorphan.)

Bupropion can raise your risk of seizures. Taking two medications that contain bupropion together can increase this risk even further.

Auvelity may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Auvelity.

Auvelity interactions with supplements

Before you start treatment with Auvelity, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Auvelity interactions with herbs

Doctors will typically recommend you avoid taking St. John’s wort with Auvelity. St. John’s wort is an herbal supplement that may be used to treat depression and other conditions.

Taking St. John’s wort with Auvelity can raise your risk of serotonin syndrome (a serious condition caused by high levels of serotonin in your body).

Your doctor may be able to suggest a treatment option other than St. John’s wort.

Auvelity and vitamins

There are no specific reports of vitamins interacting with Auvelity. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Auvelity.

Auvelity interactions with food

Auvelity may interact with caffeine. Consuming too much caffeine while taking Auvelity can increase the risk of seizures. Examples of foods and beverages that contain caffeine include:

Because of this interaction, your doctor will likely recommend limiting how much caffeine you consume during Auvelity treatment.

If you’d like to learn more about eating certain foods during treatment with Auvelity, talk with your doctor.

Auvelity and vaccines

There aren’t any known interactions between Auvelity and vaccines. Talk with your doctor or pharmacist to see whether you’re due for any vaccines.

Auvelity interactions with lab tests

Auvelity may interfere with the results of certain lab tests. Taking the medication may cause a false-positive result on a urine drug screening test that checks for the presence of amphetamines. This means the test could show that you have amphetamines in your urine even if you do not. Such urine tests may be required by an employer or for other reasons.

Because of this, it’s important to tell the person giving you the test that you’re taking Auvelity.

For additional information, talk with your doctor or pharmacist.

AUVELITY INTERACTION WITH CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Auvelity.

Cannabis and CBD can affect the level of bupropion (one of the active drugs in Auvelity) in your body. Using cannabis or CBD while taking Auvelity could either raise your risk of Auvelity side effects or make Auvelity less effective.

Before you start treatment with Auvelity, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Auvelity. Before you take this drug, be sure to talk with your doctor about your health history. Auvelity may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Auvelity include:

  • Seizure disorders: If you have a seizure disorder such as epilepsy, your doctor will likely not prescribe Auvelity.*
  • Eating disorders: If you’ve ever had bulimia or anorexia nervosa, your doctor will likely not prescribe Auvelity.*
  • Suddenly stopping drinking alcohol or taking certain drugs: If you’ve recently suddenly stopped drinking alcohol or taking certain drugs, your doctor will likely not prescribe Auvelity.*
  • Allergic reaction: If you’ve had an allergic reaction to Auvelity or any of its ingredients, your doctor will likely not prescribe Auvelity.*
  • Bipolar disorder: If you have a history of mania or bipolar disorder, taking Auvelity could trigger a manic episode. Before taking Auvelity, talk with your doctor about any mental health problems you or family members have had in the past. This can help your doctor determine whether Auvelity is right for you.
  • High blood pressure: If you have high blood pressure, taking Auvelity can make this worse. Your doctor will likely monitor your blood pressure more often during your Auvelity treatment.
  • Brain tumor, head injury, or stroke: If you’ve had a brain tumor, head injury, or stroke, you may have a raised risk of seizures with Auvelity. Talk with your doctor about whether this medication is safe for you.
  • Kidney or liver problems: If you have kidney or liver problems, Auvelity can build up in your body. This can raise your risk of side effects, so your doctor may prescribe a lower dosage of Auvelity for you. If you have a severe kidney or liver problem, your doctor will likely not prescribe Auvelity.
  • Narrow-angle glaucoma: Auvelity can trigger narrow-angle glaucoma in certain people. If you’ve ever been told you have an increased risk of this eye condition, talk with your doctor about whether Auvelity is right for you.
  • Breastfeeding: It’s not known whether it’s safe to take Auvelity while breastfeeding. The drug passes into breast milk, but it’s not known what effects it may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before taking Auvelity. They can talk with you about treatment options and ways to feed your child.
  • Pregnancy: Auvelity is not usually considered safe to take while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects) or pregnancy loss. However, it’s important to note that animal studies don’t always indicate what may happen in humans. If you’re pregnant or planning to become pregnant, tell your doctor before starting Auvelity. They can advise you on the right treatment plan for you.
  • Risk of suicidal thoughts and actions: Auvelity has a boxed warning about the risk of suicidal thoughts and actions in certain people. This is a serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous. For details, see the boxed warning at the top of this article.

* For more information, see the “When to avoid Auvelity” section above.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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You can take certain steps to help prevent interactions with Auvelity. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

  • Let them know if you drink alcohol or use cannabis.
  • Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
  • Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the Auvelity label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Auvelity doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Auvelity by taking it exactly as your doctor prescribes.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.