dextroamphetamine (Rx)

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Brand and Other Names:Dexedrine, ProCentra, more...Zenzedi

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsule, extended-release (Dexedrine): Schedule II

  • 5mg
  • 10mg
  • 15mg

tablet, immediate-release (Zenzedi): Schedule II

  • 2.5mg
  • 5mg
  • 7.5mg
  • 10mg
  • 15mg
  • 20mg
  • 30mg

oral solution (ProCentra): Schedule II

  • 5mg/5mL
more...

Narcolepsy

10 mg/day PO; may titrate every week until side effects appear

Not to exceed 60 mg/day

Attention Deficit Hyperactivity Disorder

5 mg PO qDay or BID (4-6 hr apart); may increase 5 mg/day qWeek until optimal response

Rarely necessary to exceed 40 mg/day

Dosage Forms & Strengths

capsule, extended-release (Dexedrine): Schedule II

  • 5mg
  • 10mg
  • 15mg

tablet, immediate-release (Zenzedi): Schedule II

  • 2.5mg
  • 5mg
  • 7.5mg
  • 10mg
  • 15mg
  • 20mg
  • 30mg

oral solution (ProCentra): Schedule II

  • 5mg/5mL
more...

Attention Deficit Hyperactivity Disorder

<3 years: Safety and efficacy not established

3-5 years

  • Initial: 2.5 mg PO qDay; may increase by 2.5 mg/day qWeek

≥6 years

  • Initial: 5 mg PO qDay or BID (4-6 hr apart); may increase by 5 mg/day qWeek until optimal response
  • Maintenance: 5-15 mg PO q12hr OR 5-10 mg PO q8hr
  • May substitute with qDay dosing of extended-release capsules
  • Rarely necessary to exceed 40 mg/day

Narcolepsy

>12 years: 10 mg PO qDay initially; may increase by 10 mg qWeek to optimal response

Start at lowest dose

Narcolepsy

5 mg/day PO; may increase the dose by 5 mg/day every week until side effects appear

Not to exceed 60 mg/day

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Interactions

Interaction Checker

and dextroamphetamine

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Appetite loss (21-22%)

            Insomnia (16-20%)

            Abdominal pain (11-15%)

            1-10%

            Vomiting

            Emotional lability

            Nervousness

            Fatigue

            Fever

            Infection

            Nausea

            Diarrhea

            Dyspepsia

            Dizziness

            Weight loss

            Frequency Not Defined

            Hyperactivity

            Hypomania

            Palpitations

            Tachycardia

            Hypertension

            Dry mouth

            Constipation

            Tremor

            Headache

            Postmarketing reports

            Musculoskeletal: Rhabdomyolysis

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            Warnings

            Black Box Warnings

            Dextroamphetamine has a high potential for abuse; particular attention should be paid to the possibility of patients obtaining dextroamphetamine for nontherapeutic use or distribution to others, and the drugs should be prescribed or dispensed sparingly

            Administration of dextroamphetamine for prolonged periods of time may lead to drug dependence and must be avoided

            Misuse of dextroamphetamine may cause sudden death and serious cardiovascular adverse events

            Contraindications

            Hypersensitivity

            Hyperthyroidism

            Glaucoma

            Hypertension, advanced arteriosclerosis, symptomatic CVD

            Agitated states, history of drug abuse

            MAOIs: Risk of severe hypertensive reaction

            Cautions

            Risk of sudden death in children and adolescents with structural cardiac abnormalities; generally avoid

            Risk of adverse psychiatric events; eg, hallucinations and mania

            Caution in mild hypertension

            Associated with peripheral vasculopathy, including Raynaud phenomenon

            Difficulties with accommodation and blurring of vision have been reported with stimulant treatment

            Sudden deaths, stroke, and myocardial infarction reported in adults taking stimulants at usual doses

            Patients who develop symptoms such as exertional chest pain, unexplained syncope, or other symptoms suggestive of cardiac disease during stimulant treatment should undergo a prompt cardiac evaluation

            Particular care should be taken in using stimulants to treat ADHD patients with comorbid bipolar disorder because of concern for possible induction of mixed/manic episode in such patients

            Aggressive behavior or hostility is often observed in children and adolescents with ADHD; monitor for the appearance of or worsening of aggressive behavior or hostility

            Monitor growth of children ages 7 to 10 years during treatment with stimulants; may need to interrupt therapy in patients not growing or gaining weight as expected

            Stimulants may lower convulsive threshold in patients with prior history of seizure, patients with prior EEG abnormalities in absence of seizures, and very rarely, patients without a history of seizures and no prior EEG evidence of seizures; discontinue therapy in the presence of seizures

            Use with caution in patients who use other sympathomimetic drugs

            Amphetamines may exacerbate motor and phonic tics and Tourette’s syndrome; perform clinical evaluation for tics and Tourette’s syndrome in children and their families prior to treating with stimulant medications

            Rare instances of prolonged and sometimes painful erections (priapism), sometimes requiring surgical intervention, reported with methylphenidate products; typically not reported during initiation, but often subsequent to an increase in dose; seek immediate medical attention for abnormally sustained or frequent and painful erections

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            Pregnancy & Lactation

            Pregnancy category: C

            Lactation: Enters breast milk; not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Sympathomimetic amine that promotes release of dopamine and norepinephrine from their storage sites in the presynaptic nerve terminals; may also block reuptake of catecholamines by competitive inhibition.

            Absorption

            Peak plasma time: ~3 hr (immediate release); ~8 hr (sustained release)

            Onset of action: 1-1.5 hr

            Metabolism

            Hepatic via glucuronidation and mono-oxygenase

            Elimination

            Half-life: 7-24 hr, dependent on urinary pH

            Half-life elimination: 10-13 hr (adults)

            Excretion: Urine

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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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