NutriStack
Cocaine and Lisdexamfetamine, contraindicated.
Lisdexamfetamine is converted to dextroamphetamine and produces stimulant cardiovascular effects that can overlap with cocaine. Combining them can increase heart rate, blood pressure, myocardial oxygen demand, anxiety, insomnia, overheating, and arrhythmia risk. Controlled cocaine-use studies used careful screening and monitoring, so they should not be treated as proof that real-world co-use is safe.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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At a glance
- Substances
- Cocaine and Lisdexamfetamine
- Pair type
- Contraindicated
- Evidence (highest tier)
- Moderate
- Source citations
- 3 sources
- Stack Score effect
- −25 to your Stack Score (per scored contraindication row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Contraindicated · Moderate evidence
Contraindicated
What is happening. Lisdexamfetamine is converted to dextroamphetamine and produces stimulant cardiovascular effects that can overlap with cocaine. Combining them can increase heart rate, blood pressure, myocardial oxygen demand, anxiety, insomnia, overheating, and arrhythmia risk. Controlled cocaine-use studies used careful screening and monitoring, so they should not be treated as proof that real-world co-use is safe.
Mechanism. Lisdexamfetamine is a prodrug that produces systemic dextroamphetamine exposure. Cocaine blocks monoamine reuptake and has direct cardiac ion-channel effects, while dextroamphetamine increases catecholamine release; together they can amplify adrenergic load.
Recommendation. Do not use cocaine while taking lisdexamfetamine. Do not raise or repeat either substance to overcome a blunted effect. Seek emergency care for chest pain, severe headache, fainting, shortness of breath, confusion, severe agitation, or an irregular heartbeat.
Sources (3)
- Mooney ME, Herin DV, Specker S, Babb D, Levin FR, Grabowski J. Pilot study of the effects of lisdexamfetamine on cocaine use: A randomized, double-blind, placebo-controlled trial. Drug Alcohol Depend. 2015;153:94-103. PMID 26116930
- Dolder PC, Strajhar P, Vizeli P, Hammann F, Odermatt A, Liechti ME. Pharmacokinetics and Pharmacodynamics of Lisdexamfetamine Compared with D-Amphetamine in Healthy Subjects. Front Pharmacol. 2017;8:617. PMID 28936175
- Kim ST, Park T. Acute and Chronic Effects of Cocaine on Cardiovascular Health. Int J Mol Sci. 2019;20(3):584. PMID 30700023
Stack Score
How this pair moves the number.
Effect on the composite score
If both Cocaine and Lisdexamfetamine are in the same stack, this pair applies −25 to your Stack Score (per scored contraindication row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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