Drug & supplement interaction

Rauwolscine + Dextroamphetamine (patch)

Dextroamphetamine (patch) brand name: Xelstrym.

Moderate Interaction
The bottom line Moderate

Dextroamphetamine (patch) falls into 2 drug categories that Rauwolscine can interact with; the most serious is rated moderate. Theoretically, rauwolscine might increase levels of drugs metabolized by CYP2D6.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Rauwolscine and Dextroamphetamine (patch)

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Rauwolscine interacts with whole categories of medication. Dextroamphetamine (patch) falls into 2 of those categories, so it can interact with Rauwolscine in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES

1 of 2

Why this applies to Dextroamphetamine (patch)

Dextroamphetamine (patch) falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES — the group Rauwolscine interacts with.

Theoretically, rauwolscine might increase levels of drugs metabolized by CYP2D6.
Rauwolscine is structurally related to yohimbine. In vitro research shows that yohimbine inhibits CYP2D6 enzyme activity.
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

Here's the thing to keep in mind if you're using the Xelstrym patch alongside a rauwolscine-based fat burner or pre-workout. Your body clears dextroamphetamine partly through a liver enzyme called CYP2D6. Rauwolscine is a cousin of yohimbine, and lab (test-tube) studies suggest yohimbine can slow that enzyme down. So in theory, rauwolscine might let dextroamphetamine build up a bit more than usual.

If that happened, you could feel the amphetamine's effects more strongly: a faster or pounding heartbeat, higher blood pressure, jitters, trouble sleeping, or feeling anxious. Rauwolscine itself is a stimulant that already raises heart rate and blood pressure, so the bigger worry is really two stimulants stacking together. This is theoretical and not proven in people, but I'd still run it by your pharmacist or doctor before combining them, especially if you have any heart concerns.

References
  1. VandenBrink, B. M., Foti, R. S., Rock, D. A., Wienkers, L. C., and Wahlstrom, J. L. Prediction of CYP2D6 drug interactions from in vitro data: evidence for substrate-dependent inhibition. Drug Metab Dispos. 2012;40(1):47-53. PubMed
Moderate

STIMULANT DRUGS

2 of 2

Dextroamphetamine (patch) also falls under STIMULANT DRUGS.

Theoretically, taking rauwolscine with stimulant drugs might increase the risk of adverse stimulant effects.
Rauwolscine has demonstrated stimulant effects in animal research.
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

Here's the simple version: your Xelstrym patch delivers dextroamphetamine, a stimulant that revs up your body's fight-or-flight signals. Rauwolscine works through a different door, but it pushes in the same stimulating direction by boosting norepinephrine. Stack the two and you may get more of what amphetamines already do, think a faster or pounding heartbeat, higher blood pressure, jitteriness, trouble sleeping, and more anxiety.

I want to be honest about the evidence, though. This concern comes mostly from animal and lab studies, not solid human trials, so it's more of a cautious flag than a proven danger. Still, since both are stimulants, I'd run this combo by your pharmacist or doctor before mixing them, especially if you have any heart or anxiety issues.

References
  1. Aziz TA, Hussain SA, Mahwi TO, Ahmed ZA, Rahman HS, Rasedee A. The efficacy and safety of Ginkgo biloba extract as an adjuvant in type 2 diabetes mellitus patients ineffectively managed with metformin: a double-blind, randomized, placebo-controlled trial.

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

Rauwolscine Also Interacts With Other Medications

Rauwolscine has 676 moderate known drug interactions in our database — the Dextroamphetamine (patch) one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Rauwolscine

Covers the 2,830 medications we’ve checked against Rauwolscine. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Dextroamphetamine (patch)

This page covers Rauwolscine 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

One more smart check

Taking Rauwolscine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 196 real supplement products containing Rauwolscine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Rauwolscine. Your product may carry other ingredients that interact with Dextroamphetamine (patch) too, on top of Rauwolscine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Rauwolscine 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 Rauwolscine
Top 25%

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

29 days ago today
Medication Dextroamphetamine (patch)
Steady interest

#2,658 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 Rauwolscine

What is Rauwolscine?

  • Fat loss and weight management
  • Bodybuilding and physique support
  • Energy and stimulant effects
  • Athletic performance
  • Libido support

Rauwolscine (alpha-yohimbine) is a stimulant alkaloid closely related to yohimbine that is marketed mainly in fat-burning and pre-workout supplements. Human evidence for its benefits is very limited, and it can raise heart rate and blood pressure and cause anxiety, so it should be used with caution and is not recommended for people with heart conditions, anxiety, or during pregnancy or breastfeeding.

Read the full Rauwolscine monograph & all interactions
Keep checking

Other Drugs & Rauwolscine

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

0Major
676Moderate
0Minor
2,153No known interaction
Moderate

676 interactions

Showing 60 of 676 moderate interactions — see all 676 on the Rauwolscine page.

No interaction 2,153 drugs checked — show the list
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
Pharmacist Counseling Corner

Taking Rauwolscine and Dextroamphetamine (patch) Together: Common Questions

Can you take Rauwolscine 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.
Why are there 2 interactions listed for Rauwolscine and Dextroamphetamine (patch)?
Dextroamphetamine (patch) belongs to more than one drug category, and Rauwolscine interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Rauwolscine 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 Rauwolscine?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.