NutriStack
Cocaine and Methylphenidate, contraindicated.
Methylphenidate and cocaine both act as stimulant monoamine transporter blockers. A small controlled study did not find clinically significant physiologic toxicity at the tested doses, but cocaine still has well-established risks of acute hypertension, coronary spasm, arrhythmias, and myocardial infarction. Real-world cocaine dose, purity, route, and redosing make this combination unsafe.
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 Methylphenidate
- 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. Methylphenidate and cocaine both act as stimulant monoamine transporter blockers. A small controlled study did not find clinically significant physiologic toxicity at the tested doses, but cocaine still has well-established risks of acute hypertension, coronary spasm, arrhythmias, and myocardial infarction. Real-world cocaine dose, purity, route, and redosing make this combination unsafe.
Mechanism. Methylphenidate blocks DAT and NET, increasing dopamine and norepinephrine signaling. Cocaine also blocks DAT, NET, and SERT and can impair cardiac conduction through sodium-channel blockade, creating additive stimulant and cardiovascular toxicity potential.
Recommendation. Do not use cocaine while taking methylphenidate. Do not take extra methylphenidate to counter cocaine withdrawal or fatigue. Seek emergency care for chest pain, severe headache, fainting, severe anxiety or agitation, shortness of breath, or a racing or irregular heartbeat.
Sources (3)
- Winhusen T, Somoza E, Singal BM, et al. Methylphenidate and cocaine: a placebo-controlled drug interaction study. Pharmacol Biochem Behav. 2006;85(1):29-38. PMID 16916538
- Volkow ND, Wang GJ, Fowler JS, et al. Cardiovascular effects of methylphenidate in humans are associated with increases of dopamine in brain and of epinephrine in plasma. Psychopharmacology (Berl). 2003;166(3):264-270. PMID 12589522
- 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 Methylphenidate 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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