NutriStack
Lisdexamfetamine and MDMA, contraindicated.
Lisdexamfetamine produces dextroamphetamine exposure, and MDMA adds serotonergic and sympathomimetic stimulation. Co-use can increase risk of hypertension, tachycardia, hyperthermia, dehydration, agitation, panic, arrhythmias, and seizures. The longer duration of lisdexamfetamine can leave stimulant effects present well into the period when MDMA is being used or redosed.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
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What the row says.
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At a glance
- Substances
- Lisdexamfetamine and MDMA
- 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 produces dextroamphetamine exposure, and MDMA adds serotonergic and sympathomimetic stimulation. Co-use can increase risk of hypertension, tachycardia, hyperthermia, dehydration, agitation, panic, arrhythmias, and seizures. The longer duration of lisdexamfetamine can leave stimulant effects present well into the period when MDMA is being used or redosed.
Mechanism. Lisdexamfetamine is converted in blood to dextroamphetamine, which increases catecholamine release. MDMA releases serotonin, norepinephrine, and dopamine through monoamine transporters, producing overlapping cardiovascular stimulation and thermoregulatory stress.
Recommendation. Do not use MDMA while taking lisdexamfetamine. Skipping or delaying a single dose does not reliably remove risk because stimulant effects may persist for much of the day. Seek emergency care for high fever, confusion, severe agitation, chest pain, fainting, seizure, or an irregular heartbeat.
Sources (3)
- 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
- Green AR, Mechan AO, Elliott JM, O'Shea E, Colado MI. The pharmacology and clinical pharmacology of 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy"). Pharmacol Rev. 2003;55(3):463-508. PMID 12869661
- Steinkellner T, Freissmuth M, Sitte HH, Montgomery T. The ugly side of amphetamines: short- and long-term toxicity of 3,4-methylenedioxymethamphetamine (MDMA, 'Ecstasy'), methamphetamine and D-amphetamine. Biol Chem. 2011;392(1-2):103-115. PMID 21194370
Stack Score
How this pair moves the number.
Effect on the composite score
If both Lisdexamfetamine and MDMA 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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