Select therapeutic use:
  • ADHD
  • Sleep-wake disorders

ADHD:

Indications for Dextroamp Saccharate/Amp Aspartate/Dextroamp Sulfate/Amp Sulfate:

Attention deficit hyperactivity disorder.

Adults and Children:

Avoid late evening doses; give upon awakening and 4–6hrs apart. <3yrs: not recommended. 3–5yrs: initially 2.5mg once daily, may increase by 2.5mg/day weekly. ≥6yrs: initially 5mg 1–2 times daily, may increase by 5mg/day weekly; usual max 40mg/day in 2–3 divided doses.

Contraindications:

Advanced arteriosclerosis. Symptomatic cardiovascular disease. Moderate to severe hypertension. Hyperthyroidism. Glaucoma. History of drug abuse. Agitation. During or within 14 days of MAOIs. Hypersensitivity to sympathomimetics.

Boxed Warning:

Abuse and dependence.

Warnings/Precautions:

High potential for abuse and dependence (monitor). Increased risk of sudden death, stroke, and MI; assess for presence of cardiac disease before initiating (eg, family history, physical exam). Avoid in known structural cardiac abnormalities, cardiomyopathy, serious arrhythmias, coronary artery disease, and other cardiac problems. Pre-existing psychotic disorder. Bipolar disorder; screen for risk before initiation. Consider discontinuing if new psychotic/manic symptoms occur. Monitor for new or worsening aggressive behavior or hostility. Seizure disorder. Monitor for serotonin syndrome; discontinue if occurs. Evaluate for tics or Tourette's syndrome prior to therapy. Peripheral vasculopathy, including Raynaud's phenomenon; monitor for digital changes. Monitor growth (esp. children), BP, HR. Renal impairment. Write ℞ for smallest practical amount. Reevaluate periodically. Pregnancy. Nursing mothers: not recommended.

See Also:

Pharmacologic Class:

CNS stimulant.

Interactions:

See Contraindications. Hypertensive crisis with MAOIs (including linezolid, IV methylene blue). Increased risk of serotonin syndrome with serotonergic drugs (eg, SSRIs, SNRIs, TCAs, triptans, fentanyl, lithium, tramadol, tryptophan, busprione, St. John's wort), CYP2D6 inhibitors (eg, paroxetine, fluoxetine, quinidine, ritonavir); consider alternatives; if needed, initiate with lower doses and monitor. Potentiated by urinary alkalinizers (eg, sodium bicarbonate, acetazolamide); avoid. Antagonized by acidifiers (eg, ascorbic acid). May potentiate TCAs, sympathomimetics, norepinephrine, meperidine; adjust dose or use alternatives. May antagonize adrenergic blockers, antihistamines, antihypertensives, phenobarbital, phenytoin, veratrum alkaloids, ethosuximide. Monitor effects with concomitant PPIs.

Adverse Reactions:

Anorexia, insomnia, abdominal pain, emotional lability, vomiting, nervousness, nausea, fever, weight loss; also Adults: dry mouth, headache, anxiety, agitation, dizziness, tachycardia, diarrhea, asthenia, UTIs, prolonged erections; hypertension, visual disturbances.

Note:

Formerly known under the brand name Adderall.

How Supplied:

Caps—100; Tabs—contact supplier.

Sleep-wake disorders:

Indications for Dextroamp Saccharate/Amp Aspartate/Dextroamp Sulfate/Amp Sulfate:

Narcolepsy.

Adults and Children:

Avoid late evening doses; give upon awakening and 4–6hrs apart. <12yrs: use dextroamphetamine sulfate; ≥12yrs: usual range 5–60mg/day in divided doses.

Contraindications:

Advanced arteriosclerosis. Symptomatic cardiovascular disease. Moderate to severe hypertension. Hyperthyroidism. Glaucoma. History of drug abuse. Agitation. During or within 14 days of MAOIs. Hypersensitivity to sympathomimetics.

Boxed Warning:

Abuse and dependence.

Warnings/Precautions:

High potential for abuse and dependence (monitor). Increased risk of sudden death, stroke, and MI; assess for presence of cardiac disease before initiating (eg, family history, physical exam). Avoid in known structural cardiac abnormalities, cardiomyopathy, serious arrhythmias, coronary artery disease, and other cardiac problems. Pre-existing psychotic disorder. Bipolar disorder; screen for risk before initiation. Consider discontinuing if new psychotic/manic symptoms occur. Monitor for new or worsening aggressive behavior or hostility. Seizure disorder. Monitor for serotonin syndrome; discontinue if occurs. Evaluate for tics or Tourette's syndrome prior to therapy. Peripheral vasculopathy, including Raynaud's phenomenon; monitor for digital changes. Monitor growth (esp. children), BP, HR. Renal impairment. Write ℞ for smallest practical amount. Reevaluate periodically. Pregnancy. Nursing mothers: not recommended.

Pharmacologic Class:

CNS stimulant.

Interactions:

See Contraindications. Hypertensive crisis with MAOIs (including linezolid, IV methylene blue). Increased risk of serotonin syndrome with serotonergic drugs (eg, SSRIs, SNRIs, TCAs, triptans, fentanyl, lithium, tramadol, tryptophan, busprione, St. John's wort), CYP2D6 inhibitors (eg, paroxetine, fluoxetine, quinidine, ritonavir); consider alternatives; if needed, initiate with lower doses and monitor. Potentiated by urinary alkalinizers (eg, sodium bicarbonate, acetazolamide); avoid. Antagonized by acidifiers (eg, ascorbic acid). May potentiate TCAs, sympathomimetics, norepinephrine, meperidine; adjust dose or use alternatives. May antagonize adrenergic blockers, antihistamines, antihypertensives, phenobarbital, phenytoin, veratrum alkaloids, ethosuximide. Monitor effects with concomitant PPIs.

Adverse Reactions:

Anorexia, insomnia, abdominal pain, emotional lability, vomiting, nervousness, nausea, fever, weight loss; also Adults: dry mouth, headache, anxiety, agitation, dizziness, tachycardia, diarrhea, asthenia, UTIs, prolonged erections; hypertension, visual disturbances.

Note:

Formerly known under the brand name Adderall.

How Supplied:

Caps—100; Tabs—contact supplier.