Dextroamphetamine

Introduction

  • Generic Name: Dextroamphetamine
  • Brand Names: Dexedrine, ProCentra, Zenzedi
  • Pharmacological Class: Central nervous system (CNS) stimulant
  • Mechanism of Action: Increases levels of dopamine and norepinephrine in the brain, enhancing attention, focus, and control over impulses.

Indications

  • Primary Use: Treatment of Attention Deficit Hyperactivity Disorder (ADHD) in children and adults.
  • Other Uses: Also used to treat narcolepsy to help stay awake during the day.

Dosage

  • Adults: Starting dose is usually 5 mg once or twice daily, which can be increased based on response and tolerability up to a maximum of 40 mg per day.
  • Elderly: Use with caution due to the potential for more significant side effects.
  • Children: For ADHD, starting at age 3, begin with 2.5 mg daily; may increase gradually. For narcolepsy, starting at age 6, doses begin similarly.

Administration

  • Method: Oral intake.
  • Precautions: Should be taken in the morning to prevent insomnia; avoid late evening doses.

Forms Available

  • Tablets: 5 mg, 10 mg, 15 mg
  • Capsules (Extended-Release): 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg
  • Liquid: 5 mg per 5 mL

Side Effects

  • Common: Loss of appetite, insomnia, weight loss, increased heart rate.
  • Less Common: Dry mouth, headache, jitteriness.
  • Rare but Serious: Cardiac issues, psychiatric disorders like paranoia or mania, long-term growth suppression in children.

Warnings

  • Substance Abuse: High potential for abuse and dependence; classified as a Schedule II controlled substance.
  • Contraindications: Known hypersensitivity to sympathomimetic amines, advanced arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension.

Precautions

  • General: Monitor growth in children and mental health in all patients.
  • Health Conditions: Caution in patients with a history of drug dependence or alcoholism.

Interactions

  • Medications: Avoid concomitant use with MAO inhibitors, certain antidepressants, and antihypertensive medications.
  • Food: Acidic foods can reduce absorption; avoid large amounts of citrus or vitamin C around dose times.

Monitoring Parameters

  • Blood Pressure and Heart Rate: Regular checks are necessary.
  • Growth in Children: Monitor height and weight periodically.
  • Mental Health: Assess for new or worsening psychiatric symptoms.

Use in Children

  • Guidelines: Approved for use in children over 3 years old for ADHD.
  • Monitoring: Essential to monitor side effects, especially growth suppression and mental health changes.

Use in Pregnancy

  • FDA Category: C. Potential risks should be weighed against potential benefits; not recommended unless necessary.

Use in Elderly

  • Recommendations: Typically not recommended due to higher cardiovascular risks and other potential side effects.

Use in Kidney Disease

  • Adjustments: May require lower doses; monitor closely due to potential for decreased clearance.

Use in Liver Disease

  • Caution: Use with caution; may require dose adjustments depending on the extent of liver impairment.

Patient Counselling Points

  • Medication Use: Adherence to prescribed doses is crucial; do not adjust dosage without consulting a healthcare provider.
  • Side Effects: Immediate reporting of cardiac symptoms or signs of psychological changes is essential.
  • Lifestyle: Dietary recommendations to avoid certain foods that may interact with the drug’s effectiveness.

Table of Brand Names, Manufacturer, and Prices in USD

Brand NameManufacturerStrength/Dosage FormPrice (USD)
DexedrineAmedra10 mg Tablet$2.80
ZenzediArbor30 mg Tablet$4.00
ProCentraTakeda5 mg/5 mL Liquid$5.00

15 FAQs with Answers

  1. What is Dextroamphetamine used for? – Primarily to treat ADHD and narcolepsy.
  2. Can Dextroamphetamine cause addiction? – Yes, it has a high potential for abuse and dependence.
  3. How should Dextroamphetamine be taken? – Take orally, in the morning to avoid insomnia; follow the exact prescription.
  4. What are the common side effects of Dextroamphetamine? – Includes insomnia, weight loss, and increased heart rate.
  5. Is Dextroamphetamine safe during pregnancy? – Category C, generally not recommended unless clearly needed.
  6. Can Dextroamphetamine be taken with alcohol? – Alcohol can increase the risk of side effects; it’s best avoided.
  7. What does Dextroamphetamine interact with? – MAO inhibitors and certain antihypertensive drugs can cause dangerous interactions.
  8. What should I avoid while taking Dextroamphetamine? – Avoid acidic foods and beverages which can impact drug absorption.
  9. What are signs of a Dextroamphetamine overdose? – Symptoms may include rapid breathing, confusion, fever, and restlessness.
  10. Is Dextroamphetamine addictive? – Yes, it is classified as a Schedule II controlled substance due to its potential for abuse.
  11. Should I stop taking Dextroamphetamine suddenly? – Discontinuation should be supervised by a healthcare provider to manage withdrawal symptoms.
  12. What are the rare but serious side effects of Dextroamphetamine? – Includes severe cardiac complications and psychiatric disorders.
  13. What other medications interact with Dextroamphetamine? – Certain antidepressants and antihypertensive medications can have significant interactions.
  14. Who should not take Dextroamphetamine? – Individuals with severe cardiovascular disease, hypertension, or a history of substance abuse.
  15. How does Dextroamphetamine work to treat ADHD? – It increases neurotransmitter activity in the brain, improving attention and reducing impulsivity.