From the Guidelines
Combining dexamphetamine and alcohol is strongly discouraged due to significant health risks, and it is recommended to avoid alcohol completely or strictly limit consumption to occasional small amounts with significant time separation between the substances. When considering the management of substances that may cause elevated blood pressure, the 2018 guideline for the prevention, detection, evaluation, and management of high blood pressure in adults suggests limiting alcohol to #1 drink daily for women and #2 drinks for men [ 1 ]. Additionally, for amphetamines, such as dextroamphetamine, the guideline recommends discontinuing or decreasing the dose [ 1 ]. The combination of dexamphetamine and alcohol can lead to dangerous interactions, including increased risk of cardiovascular problems, dehydration, impaired judgment, and unpredictable behavior.
- Key considerations for patients taking dexamphetamine include:
- Avoiding alcohol completely or strictly limiting consumption to occasional small amounts
- Significant time separation between the substances to minimize interactions
- Monitoring blood pressure and cardiovascular health
- Being aware of the potential for increased risk of dehydration, impaired judgment, and unpredictable behavior
- Considering alternative therapies for ADHD, such as behavioral therapies, as recommended in the guideline [ 1 ]
It is essential to consult with a healthcare provider to discuss safe alcohol use guidelines and to monitor potential interactions between dexamphetamine and alcohol. The healthcare provider can provide personalized recommendations based on individual health needs and medical history.
From the Research
Combining Dexamphetamine and Alcohol: Effects and Risks
- The combination of dexamphetamine and alcohol can have significant effects on driving skills and cognitive performance, as shown in a study published in 2012 2.
- This study found that the use of alcohol or dexamphetamine + alcohol was associated with a higher frequency of red light running and collisions than the dexamphetamine or placebo conditions.
- The stimulatory effects of co-administration of dexamphetamine were not sufficient to overcome the impairing effects of alcohol on skills related to driving.
- Another study published in 2025 found that daily oral amphetamines increase blood pressure, heart rate, and withdrawals due to adverse effects 3.
- The use of amphetamines, including dexamphetamine, has also been linked to an increased risk of cardiomyopathy and heart failure, particularly in young patients 4, 5.
- A review of prescription stimulants, including dextroamphetamine, found that misuse can lead to serious consequences, including psychosis, myocardial infarction, cardiomyopathy, and sudden death 5.
- However, a study published in 1992 found that the cardiovascular changes induced by psychostimulant medication, including dextroamphetamine, were modest in comparison with changes in cardiovascular functioning associated with normal daily activities 6.
Key Findings
- Combining dexamphetamine and alcohol can impair driving skills and increase the risk of accidents.
- Daily oral amphetamines can increase blood pressure, heart rate, and withdrawals due to adverse effects.
- The use of amphetamines, including dexamphetamine, can increase the risk of cardiomyopathy and heart failure.
- Misuse of prescription stimulants can lead to serious consequences, including psychosis, myocardial infarction, cardiomyopathy, and sudden death.
Cardiovascular Risks
- The use of amphetamines, including dexamphetamine, can increase blood pressure and heart rate, which can lead to cardiovascular problems.
- Cardiomyopathy and heart failure have been linked to the use of amphetamines, particularly in young patients.
- The risk of cardiovascular problems can be increased when combining dexamphetamine with other substances, such as alcohol.