From the Guidelines
When taking omeprazole and Adderall XR together, you can take them at the same time without concern about reduced effectiveness of either medication. The interaction between these medications means that omeprazole reaches its peak concentration in the blood more quickly (reduced Tmax), but the total amount absorbed (AUC) and the maximum concentration reached (Cmax) remain unchanged. Practically speaking, this means the omeprazole may start working slightly faster, but its overall effectiveness and duration of action are not affected. The acid-reducing effects of omeprazole will still work normally, and the stimulant effects of Adderall XR should also remain consistent. This interaction occurs because Adderall XR may temporarily increase gastric emptying, allowing omeprazole to reach the small intestine (where it's absorbed) more quickly. No dosage adjustments are needed for either medication when taken together, and you can continue your normal dosing schedule as prescribed by your healthcare provider. Some studies have investigated the effects of concomitant administration of medications, such as the COGENT study 1, which found that concomitant administration of clopidogrel and a proton pump inhibitor (PPI) like omeprazole reduced the rate of GI bleeding and associated complications. However, this study does not directly address the interaction between omeprazole and Adderall XR, and its findings should not be applied to this specific situation. In the context of attention-deficit/hyperactivity disorder (ADHD) treatment, a study published in the American Journal of Obstetrics and Gynecology 1 discussed the use of amphetamine mixed salts (Adderall XR) in pregnancy, but did not provide information on its interaction with omeprazole. Given the available evidence, it is reasonable to conclude that the interaction between omeprazole and Adderall XR does not require dosage adjustments or special precautions, and patients can take these medications together as prescribed by their healthcare provider. Key points to consider include:
- The reduced Tmax of omeprazole when taken with Adderall XR
- The unchanged AUC and Cmax of omeprazole
- The potential for increased gastric emptying with Adderall XR
- The lack of need for dosage adjustments or special precautions when taking these medications together.
From the Research
Pharmacokinetics of Omeprazole
- The absorption of omeprazole is rapid, with peak plasma concentrations within 0.5 hours after a single oral dose of buffered suspension 2
- The bioavailability of omeprazole after a single dose is 35% and increases during repeated once-daily dosing to 60% 2
Effect of Combining Omeprazole and Adderall XR
- Combining omeprazole and Adderall XR causes the tmax of omeprazole to be reduced, but the auc and cmax remain unchanged
- This means that the time it takes for omeprazole to reach its peak concentration is shorter, but the overall amount of omeprazole absorbed and its peak concentration remain the same
Practical Implications
- The reduction in tmax may not have a significant impact on the efficacy of omeprazole, as the auc and cmax remain unchanged
- However, the interaction between omeprazole and Adderall XR may affect the timing of omeprazole's peak effect, which could be important for patients who take both medications 2, 3
- It is essential to monitor patients who take omeprazole and Adderall XR concomitantly, especially those with heart disorders or who are taking antiplatelet agents, to avoid potential adverse reactions 4
Omeprazole's Clinical Use
- Omeprazole is used to treat various conditions, including gastric ulcer, duodenal ulcer, gastroesophageal reflux, and hypersecretory states 3, 5
- The efficacy of omeprazole in treating these conditions is well established, but its use may be associated with adverse events, such as cardiac problems, Steven-Johnson syndrome, and proliferative changes 4