Drug & supplement interaction

1,4-butanediol + Dextroamphetamine (patch)

Dextroamphetamine (patch) brand name: Xelstrym.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

1,4-butanediol has a moderate interaction with Dextroamphetamine (patch). Theoretically, amphetamines may increase or decrease the therapeutic and adverse effects of 1,4-butanediol.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

1,4-butanediol and Dextroamphetamine (patch)

Here is the interaction we found between these two, with the evidence behind it.

Moderate

AMPHETAMINES

Why this applies to Dextroamphetamine (patch)

Dextroamphetamine (patch) falls under AMPHETAMINES — the group 1,4-butanediol interacts with.

Theoretically, amphetamines may increase or decrease the therapeutic and adverse effects of 1,4-butanediol.
1,4-Butanediol is metabolized to gamma-hydroxybutyrate (GHB). Although some researchers have suggested that amphetamines may antagonize the effects of GHB, this has not been well studied. Also, some case reports suggest that concomitant use might increase the risk of severe side effects, including CNS and respiratory depression.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

First, a straight-up safety note: 1,4-butanediol isn't a real supplement. Your body turns it into GHB, a strong sedative that can slow your breathing, knock you unconscious, and even be fatal. So the biggest concern here isn't a subtle drug interaction, it's the chemical itself.

As for your Xelstrym patch (dextroamphetamine), it's a stimulant that speeds you up, raising heart rate, blood pressure, and alertness. On paper these two pull in opposite directions, but that's misleading. A stimulant can mask how sedated you actually are, so you may not realize the GHB is dangerously slowing your breathing. Some case reports also link the combo to serious central nervous system and breathing problems. This is weak, anecdotal evidence, but please don't combine them. Talk with your doctor or pharmacist.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Anon. Multistate outbreak of poisonings associated with illicit use of gamma hydroxy butyrate. JAMA 1991;265:447-8. DOI

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

1,4-butanediol Also Interacts With Other Medications

1,4-butanediol has 250 major, 20 moderate known drug interactions in our database — the Dextroamphetamine (patch) one above is one of them. If you take anything else, check it against the full list below.

Major 250 Moderate 20 No known interaction 2,560 (incl. Dextroamphetamine (patch))
Taking anything else?

Check Another of Your Medications Against 1,4-butanediol

Covers the 2,830 medications we’ve checked against 1,4-butanediol. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Dextroamphetamine (patch)

This page covers 1,4-butanediol only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Dextroamphetamine (patch) page lists 112 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Ephedra (major), Lithium (major), Peyote (major), Rauvolfia Vomitoria (major) and Sida Cordifolia (major).

By severity: 5 major · 93 moderate · 14 minor.

From our pharmacist’s overview on the Dextroamphetamine (patch) page

“Ephedra sits at the very top of the concerns for anyone using the dextroamphetamine patch (Xelstrym). The herb is a stimulant in its own right, and stacking two stimulants can push blood pressure and heart strain into dangerous territory.”

Reviewed by 2 · Jul 18, 2026

Open the Dextroamphetamine (patch) interaction page

How much people look this up

Where 1,4-butanediol and Dextroamphetamine (patch) Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement 1,4-butanediol
Steady interest

#735 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Dextroamphetamine (patch)
Top half

#1,332 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About 1,4-butanediol

What is 1,4-butanediol?

  • Marketed illegally as a 'recreational' or party substance
  • Falsely sold as a sleep aid
  • Falsely promoted for bodybuilding or muscle growth
  • Industrial solvent and chemical manufacturing

1,4-butanediol is a toxic industrial chemical, not a safe dietary supplement. Once swallowed, the body converts it into GHB, a powerful central nervous system depressant that can cause coma, dangerous breathing problems, addiction, and death. It should never be taken as a supplement or recreational substance.

Read the full 1,4-butanediol monograph & all interactions
Keep checking

Other Drugs & 1,4-butanediol

Browse every other medication we’ve checked against 1,4-butanediol — both the ones with a known interaction and the ones without. Select any drug for the full detail.

250Major
20Moderate
0Minor
2,559No known interaction
250 Major 20 Moderate 2,559 No interaction
Major

250 interactions

Showing 60 of 250 major interactions — see all 250 on the 1,4-butanediol page.

Moderate

20 interactions

No interaction 2,559 drugs checked — show the list

We also checked 1,4-butanediol against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,559 medications checked with no known interaction — see the full 1,4-butanediol list.

See the full 1,4-butanediol interactions page
See every supplement checked against Dextroamphetamine (patch), ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
1,4-butanediol monograph › Uses, safety, and every drug interaction in one place Dextroamphetamine (patch) supplement interactions › Every supplement checked against Dextroamphetamine (patch), ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking 1,4-butanediol and Dextroamphetamine (patch) Together: Common Questions

Can you take 1,4-butanediol with Dextroamphetamine (patch)?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the 1,4-butanediol and Dextroamphetamine (patch) interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Dextroamphetamine (patch) and 1,4-butanediol?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.