amphetamine/dextroamphetamine (Rx)

Brand and Other Names:Adderall XR, Mydayis
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

Each tab/cap contains equal portions of the following: amphetamine aspartate, amphetamine sulfate, dextroamphetamine saccharate, and dextroamphetamine sulfate

tablet: Schedule II

  • 5mg (1.25mg/1.25mg/1.25mg/1.25mg)
  • 10mg (2.5mg/2.5mg/2.5mg/2.5mg)
  • 20mg (5mg/5mg/5mg/5mg)
  • 30mg (7.5mg/7.5mg/7.5mg/7.5mg)

capsule, extended-release: Schedule II

  • 5mg (1.25mg/1.25mg/1.25mg/1.25mg) (Adderall XR)
  • 10mg (2.5mg/2.5mg/2.5mg/2.5mg) (Adderall XR)
  • 12.5mg (3.125mg/3.125mg/3.125mg/3.125mg) (Mydayis)
  • 15mg (3.75mg/3.75mg/3.75mg/3.75mg) (Adderall XR)
  • 20mg (5mg/5mg/5mg/5mg) (Adderall XR)
  • 25mg (6.25mg/6.25mg/6.25mg/6.25mg) (Adderall XR, Mydayis)
  • 30mg (7.5mg/7.5mg/7.5mg/7.5mg) (Adderall XR)
  • 37.5mg (9.375mg/9.375mg/9.375mg/9.375mg) (Mydayis)
  • 50mg (12.5mg/12.5mg/12.5mg/12.5mg) (Mydayis)

Attention Deficit Hyperactivity Disorder (ADHD)

Tablet: 5 mg PO qDay initially; may increase by 5-10 mg/day qWeek; administer daily dose in 2-3 doses; not to exceed 40 mg/day

Extended-release capsule

  • Adderall XR
    • 20 mg PO qAM initially or switching from another medication
    • May increase by increments of 5-10 mg/week; not to exceed 60 mg/day
  • Mydayis
    • 18-55 years: 12.5 mg qAM initially
    • May increase by increments of 12.5 mg/week; not to exceed 50 mg/day
    • Note: 25 mg qAM may be considered as an initial dose for some patients

Narcolepsy

Amphetamine/dextroamphetamine

  • 5-60 mg PO qDay; may increase by 10 mg/day qWeek
  • No more than 60 mg given qDay or divided doses with intervals of 4-6 hr between doses

Dosing Modifications

Extended release

  • Severe renal impairment (GFR 15 to <30 mL/min/1.73m²): Reduce recommended dose to 15 mg PO qDay
  • ESRD (GFR < 15 ml/min/1.73m²): Not recommended

Dosage Forms & Strengths

Each tab/cap contains equal portions of the following: amphetamine aspartate, amphetamine sulfate, dextroamphetamine saccharate, and dextroamphetamine sulfate

tablet: Schedule II

  • 5mg (1.25mg/1.25mg/1.25mg/1.25mg)
  • 10mg (2.5mg/2.5mg/2.5mg/2.5mg)
  • 20mg (5mg/5mg/5mg/5mg)
  • 30mg (7.5mg/7.5mg/7.5mg/7.5mg)

capsule, extended-release: Schedule II

  • 5mg (1.25mg/1.25mg/1.25mg/1.25mg) (Adderall XR)
  • 10mg (2.5mg/2.5mg/2.5mg/2.5mg) (Adderall XR)
  • 12.5mg (3.125mg/3.125mg/3.125mg/3.125mg) (Mydayis)
  • 15mg (3.75mg/3.75mg/3.75mg/3.75mg) (Adderall XR)
  • 20mg (5mg/5mg/5mg/5mg) (Adderall XR)
  • 25mg (6.25mg/6.25mg/6.25mg/6.25mg) (Adderall XR, Mydayis)
  • 30mg (7.5mg/7.5mg/7.5mg/7.5mg) (Adderall XR)
  • 37.5mg (9.375mg/9.375mg/9.375mg/9.375mg) (Mydayis)
  • 50mg (12.5mg/12.5mg/12.5mg/12.5mg) (Mydayis)

Attention Deficit Hyperactivity Disorder (ADHD)

Tablet

  • <3 years: Safety and efficacy not established
  • Age 3-6 years: 2.5 mg/day; may increase by 2.5 mg qWeek; not to exceed 40 mg qDay or divided q8hr; use intervals of 4-6 hr between additional doses
  • >6 years: 5 mg PO qDay or q12hr; may increase by 5 mg qWeek; not to exceed 40 mg qDay or divided q8hr; use intervals of 4-6 hr between additional doses

Capsule, extended-release

  • (Adderall XR)
    • <6 years: Safety and efficacy not established
    • ≥6 years to <13 years: 5-10 mg PO qAM initially; may increase by 5-10 mg/day qWeek; not to exceed 30 mg/day
    • 13-17 years: 10 mg PO qAM initially; may increase to 20 mg/day after 1 week if symptoms not controlled; doses up to 60 mg/day have been used, but there is no evidence that higher doses increase effectiveness
  • Mydayis
    • <13 years: Safety and efficacy not established; younger children experienced higher plasma exposure than those aged ≥13 yr at the same dose, and experienced higher rates of adverse reactions, mainly insomnia and decreased appetite
    • ≥13-17 years: 12.5 mg qAM initially
    • May increase by increments of 12.5 mg/week; not to exceed 50 mg/day

Narcolepsy

<6 years: Safety and efficacy not established

6-12 years: 5mg/day PO initially in divided doses; may increase by 5 mg/day qWeek; not to exceed 60 mg qDay or divided doses with intervals of 4-6 hr between doses

>12 years: 10 mg/day PO initially; may increase by 10 mg/day qWeek; not to exceed 60 mg given qDay or divided doses with intervals of 4-6 hr between doses

Dosing Modifications

Severe renal impairment

  • <6 years: Not established
  • 6-17 years: 5 mg once daily recommended; not to exceed 20 mg once daily for children 6 to 12 years of age
  • End stage renal disease (GFR < 15 mL/min/1.73m²): Not recommended

End stage renal disease

  • < 15 mL/min/1.73m²
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Interactions

Interaction Checker

and amphetamine/dextroamphetamine

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            Contraindicated (10)

            • iobenguane I 123

              dextroamphetamine decreases effects of iobenguane I 123 by receptor binding competition. Contraindicated. If clinically appropriate, discontinue drugs that compete for NE receptor sites for at least 5 half-lives; may cause false-negative imaging results.

            • isocarboxazid

              isocarboxazid increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • linezolid

              linezolid increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • phenelzine

              phenelzine increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • procarbazine

              procarbazine increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • rasagiline

              rasagiline increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Coadministration is contraindicated during or within 14 days following the administration of MAOIs.

            • safinamide

              dextroamphetamine, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.

            • selegiline

              selegiline and dextroamphetamine both increase serotonin levels. Contraindicated. Amphetamines should not be administered during or within 14 days following the use of most MAOIs or drugs with MAO-inhibiting activity

              selegiline increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Coadministration is contraindicated during or within 14 days following the administration of MAOIs.

            • selegiline transdermal

              selegiline transdermal increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • tranylcypromine

              tranylcypromine increases effects of dextroamphetamine by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            Serious - Use Alternative (18)

            • amitriptyline

              amitriptyline, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • amoxapine

              amoxapine, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • cabergoline

              cabergoline, dextroamphetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • clomipramine

              clomipramine, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • desflurane

              desflurane increases toxicity of dextroamphetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

            • desipramine

              desipramine, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • desvenlafaxine

              dextroamphetamine and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.

            • dihydroergotamine

              dihydroergotamine, dextroamphetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • dihydroergotamine intranasal

              dihydroergotamine intranasal, dextroamphetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • doxapram

              doxapram increases effects of dextroamphetamine by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.

            • doxepin

              doxepin, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • ergoloid mesylates

              ergoloid mesylates, dextroamphetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • ergotamine

              ergotamine, dextroamphetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • ether

              ether increases toxicity of dextroamphetamine by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

            • imipramine

              imipramine, dextroamphetamine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • iobenguane I 131

              amphetamine will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.

              dextroamphetamine will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.

            • isocarboxazid

              isocarboxazid and dextroamphetamine both increase serotonin levels. Avoid or Use Alternate Drug.

            • ozanimod

              ozanimod increases toxicity of amphetamine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

            Monitor Closely (223)

            • 5-HTP

              5-HTP and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.

            • acetazolamide

              acetazolamide will increase the level or effect of dextroamphetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

            • albuterol

              albuterol and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              albuterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • alfentanil

              alfentanil increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • almotriptan

              almotriptan and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.

            • alprazolam

              alprazolam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • aluminum hydroxide

              aluminum hydroxide will increase the level or effect of dextroamphetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

            • amitriptyline

              amitriptyline increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              amitriptyline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              amitriptyline increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • ammonium chloride

              ammonium chloride decreases levels of dextroamphetamine by increasing renal clearance. Use Caution/Monitor.

            • amobarbital

              amobarbital increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • amoxapine

              amoxapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              amoxapine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              amoxapine increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • arformoterol

              arformoterol and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              arformoterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • aripiprazole

              aripiprazole increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • armodafinil

              armodafinil and dextroamphetamine both decrease sedation. Use Caution/Monitor.

            • artemether/lumefantrine

              artemether/lumefantrine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • azelastine

              azelastine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • belladonna and opium

              belladonna and opium increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • benazepril

              dextroamphetamine decreases effects of benazepril by pharmacodynamic antagonism. Use Caution/Monitor.

            • benperidol

              benperidol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • benzhydrocodone/acetaminophen

              benzhydrocodone/acetaminophen, amphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

              benzhydrocodone/acetaminophen, dextroamphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

            • benzphetamine

              dextroamphetamine and benzphetamine both decrease sedation. Use Caution/Monitor.

              benzphetamine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • buprenorphine, long-acting injection

              amphetamine, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

            • bromocriptine

              bromocriptine, dextroamphetamine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Hypertension, V tach.

            • brompheniramine

              brompheniramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • buprenorphine buccal

              buprenorphine buccal increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • buprenorphine subdermal implant

              dextroamphetamine, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

            • buprenorphine, long-acting injection

              dextroamphetamine, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

            • bupropion

              bupropion will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              dextroamphetamine increases toxicity of bupropion by unspecified interaction mechanism. Use Caution/Monitor. May lower seizure threshold; keep bupropion dose as low as possible.

            • buspirone

              buspirone and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • butabarbital

              butabarbital increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • butalbital

              butalbital increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • butorphanol

              butorphanol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • caffeine

              caffeine and dextroamphetamine both decrease sedation. Use Caution/Monitor.

            • calcium carbonate

              calcium carbonate will increase the level or effect of dextroamphetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

            • captopril

              dextroamphetamine decreases effects of captopril by pharmacodynamic antagonism. Use Caution/Monitor. Dextroamphetamine may decrease the antihypertensive effects of ACE Inhibitors.

            • carbinoxamine

              carbinoxamine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cenobamate

              cenobamate will decrease the level or effect of dextroamphetamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.

            • chloral hydrate

              chloral hydrate increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlordiazepoxide

              chlordiazepoxide increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlorpheniramine

              chlorpheniramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlorpromazine

              chlorpromazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              chlorpromazine, dextroamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • cinnarizine

              cinnarizine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • citalopram

              citalopram and dextroamphetamine both increase serotonin levels. Use Caution/Monitor. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.

            • clemastine

              clemastine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clomipramine

              clomipramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              clomipramine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              clomipramine increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • clonazepam

              clonazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clorazepate

              clorazepate increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clozapine

              clozapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cocaine

              cocaine and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.

            • codeine

              codeine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cyclizine

              cyclizine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cyproheptadine

              cyproheptadine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • desipramine

              desipramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              desipramine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              desipramine increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • desvenlafaxine

              desvenlafaxine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Desvenlafaxine inhibits CYP2D6; with higher desvenlafaxine doses (ie, 400 mg) decrease the CYP2D6 substrate dose by up to 50%; no dosage adjustment needed with desvenlafaxine doses <100 mg

            • dexchlorpheniramine

              dexchlorpheniramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dexfenfluramine

              dextroamphetamine and dexfenfluramine both decrease sedation. Use Caution/Monitor.

              dexfenfluramine and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.

              dexfenfluramine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dexlansoprazole

              dexlansoprazole, dextroamphetamine. Other (see comment). Use Caution/Monitor. Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .

            • dexmedetomidine

              dexmedetomidine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dexmethylphenidate

              dexmethylphenidate and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dextromethorphan

              dextroamphetamine and dextromethorphan both increase serotonin levels. Modify Therapy/Monitor Closely.

            • dextromoramide

              dextromoramide increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diamorphine

              diamorphine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diethylpropion

              dextroamphetamine and diethylpropion both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and diethylpropion both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • difenoxin hcl

              difenoxin hcl increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dihydroergotamine

              dextroamphetamine and dihydroergotamine both increase serotonin levels. Use Caution/Monitor.

            • dihydroergotamine intranasal

              dextroamphetamine and dihydroergotamine intranasal both increase serotonin levels. Use Caution/Monitor.

            • dimenhydrinate

              dimenhydrinate increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diphenhydramine

              diphenhydramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diphenoxylate hcl

              diphenoxylate hcl increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dipipanone

              dipipanone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dobutamine

              dobutamine and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              dobutamine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dopamine

              dextroamphetamine and dopamine both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and dopamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dopexamine

              dopexamine and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              dopexamine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • doxepin

              doxepin increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              doxepin and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              doxepin increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • droperidol

              droperidol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • droxidopa

              dextroamphetamine and droxidopa both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. May increase risk for supine hypertension

            • duloxetine

              duloxetine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely.

              duloxetine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • eletriptan

              eletriptan and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.

            • ephedrine

              ephedrine and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              ephedrine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • epinephrine

              epinephrine and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              epinephrine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • epinephrine inhaled

              dextroamphetamine, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

              amphetamine, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • epinephrine racemic

              epinephrine racemic and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • esketamine intranasal

              esketamine intranasal, amphetamine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .

            • ergotamine

              dextroamphetamine and ergotamine both increase serotonin levels. Use Caution/Monitor.

            • escitalopram

              escitalopram and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • esketamine intranasal

              esketamine intranasal, dextroamphetamine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .

            • esomeprazole

              esomeprazole, dextroamphetamine. Other (see comment). Use Caution/Monitor. Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .

            • estazolam

              estazolam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ethanol

              ethanol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fenfluramine

              dextroamphetamine and fenfluramine both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and fenfluramine both increase serotonin levels. Use Caution/Monitor.

              dextroamphetamine and fenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • fluoxetine

              fluoxetine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              fluoxetine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • fluphenazine

              fluphenazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              fluphenazine, dextroamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • flurazepam

              flurazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fluvoxamine

              fluvoxamine and dextroamphetamine both decrease serotonin levels. Modify Therapy/Monitor Closely.

            • formoterol

              formoterol and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              formoterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • frovatriptan

              frovatriptan and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.

            • green tea

              green tea, dextroamphetamine. Other (see comment). Use Caution/Monitor. Comment: Green tea may include caffeine. Caffeine is a CNS-stimulant and additive effects may be seen when coadministered with other CNS stimulants. Caffeine should be avoided or used cautiously.

            • haloperidol

              haloperidol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • hydralazine

              hydralazine, dextroamphetamine. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Sympathomimetics can antagonize the activity of some antihypertensive agents.

            • hydrocodone

              hydrocodone, amphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

              hydrocodone, dextroamphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

            • hydromorphone

              hydromorphone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sodium zirconium cyclosilicate

              sodium zirconium cyclosilicate will increase the level or effect of amphetamine by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate. Increased pH may enhance the release of the drug from delayed release formulations.

            • hydroxyzine

              hydroxyzine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • iloperidone

              iloperidone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • imipramine

              imipramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              imipramine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              imipramine increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • ioflupane I 123

              dextroamphetamine decreases effects of ioflupane I 123 by receptor binding competition. Use Caution/Monitor. Drugs that bind to dopamine transporter receptor with high affinity may interfere with the image following ioflupane I 123 administration.

            • isoniazid

              dextroamphetamine and isoniazid both increase serotonin levels. Use Caution/Monitor.

            • isoproterenol

              isoproterenol and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              isoproterenol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • ketotifen, ophthalmic

              ketotifen, ophthalmic increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • L-tryptophan

              dextroamphetamine and L-tryptophan both increase serotonin levels. Use Caution/Monitor.

            • lansoprazole

              lansoprazole, dextroamphetamine. Other (see comment). Use Caution/Monitor. Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .

            • levalbuterol

              levalbuterol and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              levalbuterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • levomilnacipran

              levomilnacipran and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • levorphanol

              levorphanol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lisdexamfetamine

              dextroamphetamine and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • lithium

              dextroamphetamine and lithium both increase serotonin levels. Use Caution/Monitor.

            • lofepramine

              lofepramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              lofepramine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              lofepramine increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • lofexidine

              lofexidine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • loprazolam

              loprazolam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lorazepam

              lorazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lormetazepam

              lormetazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • loxapine

              loxapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • loxapine inhaled

              loxapine inhaled increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lsd

              dextroamphetamine and lsd both increase serotonin levels. Use Caution/Monitor.

            • lumefantrine

              lumefantrine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • maprotiline

              maprotiline increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              maprotiline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              maprotiline increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • marijuana

              marijuana increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • melatonin

              melatonin increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • meperidine

              meperidine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              dextroamphetamine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • meprobamate

              meprobamate increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • metaproterenol

              metaproterenol and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              metaproterenol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • methadone

              methadone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • methamphetamine

              dextroamphetamine and methamphetamine both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and methamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • methyldopa

              methyldopa increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • methylenedioxymethamphetamine

              dextroamphetamine and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and methylenedioxymethamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • methylphenidate

              dextroamphetamine increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.

            • midazolam

              midazolam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • midodrine

              dextroamphetamine and midodrine both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and midodrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • milnacipran

              milnacipran and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • mirtazapine

              mirtazapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              dextroamphetamine and mirtazapine both increase serotonin levels. Use Caution/Monitor.

            • modafinil

              dextroamphetamine and modafinil both decrease sedation. Use Caution/Monitor.

            • morphine

              morphine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              dextroamphetamine and morphine both increase serotonin levels. Use Caution/Monitor.

            • motherwort

              motherwort increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • moxonidine

              moxonidine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nabilone

              nabilone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nalbuphine

              nalbuphine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • naratriptan

              naratriptan and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.

            • nefazodone

              nefazodone and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • norepinephrine

              norepinephrine and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              norepinephrine and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • nortriptyline

              nortriptyline increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              nortriptyline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              nortriptyline increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • olanzapine

              olanzapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • omeprazole

              omeprazole, dextroamphetamine. Other (see comment). Use Caution/Monitor. Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .

            • opium tincture

              opium tincture increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxazepam

              oxazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxycodone

              oxycodone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxymorphone

              oxymorphone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxytocin

              oxytocin increases effects of dextroamphetamine by pharmacodynamic synergism. Use Caution/Monitor.

            • paliperidone

              paliperidone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pantoprazole

              pantoprazole, dextroamphetamine. Other (see comment). Use Caution/Monitor. Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .

            • papaveretum

              papaveretum increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • paroxetine

              paroxetine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              paroxetine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • pentazocine

              pentazocine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              dextroamphetamine and pentazocine both increase serotonin levels. Use Caution/Monitor.

            • pentobarbital

              pentobarbital increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • perphenazine

              perphenazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              perphenazine, dextroamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • phendimetrazine

              dextroamphetamine and phendimetrazine both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and phendimetrazine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • phenobarbital

              phenobarbital increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phentermine

              dextroamphetamine and phentermine both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • phenylephrine

              dextroamphetamine and phenylephrine both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and phenylephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • phenylephrine PO

              dextroamphetamine and phenylephrine PO both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and phenylephrine PO both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • pholcodine

              pholcodine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pimozide

              pimozide increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pirbuterol

              pirbuterol and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              pirbuterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • primidone

              primidone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • prochlorperazine

              prochlorperazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              prochlorperazine, dextroamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • promazine

              promazine, dextroamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • promethazine

              promethazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              promethazine, dextroamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • propylhexedrine

              dextroamphetamine and propylhexedrine both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • protriptyline

              protriptyline increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              protriptyline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              protriptyline increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • pseudoephedrine

              dextroamphetamine and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • quazepam

              quazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • quetiapine

              quetiapine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • quinidine

              quinidine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • rabeprazole

              rabeprazole, dextroamphetamine. Other (see comment). Use Caution/Monitor. Comment: Reduced gastric acidity caused by proton pump inhibitors decreases time to Tmax for amphetamine and dextroamphetamine. AUC was unaffected. .

            • risperidone

              risperidone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • rizatriptan

              rizatriptan and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.

            • salmeterol

              salmeterol and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              salmeterol and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • SAMe

              dextroamphetamine and SAMe both increase serotonin levels. Use Caution/Monitor.

            • scullcap

              scullcap increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • secobarbital

              secobarbital increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • selegiline transdermal

              selegiline transdermal and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • sertraline

              sertraline will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              sertraline and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • shepherd's purse

              shepherd's purse increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sodium acid phosphate

              sodium acid phosphate decreases levels of dextroamphetamine by increasing renal clearance. Use Caution/Monitor.

            • sodium bicarbonate

              sodium bicarbonate will increase the level or effect of dextroamphetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

            • sodium citrate/citric acid

              sodium citrate/citric acid will increase the level or effect of dextroamphetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

            • sodium lactate

              sodium lactate will increase the level or effect of dextroamphetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.

            • sodium zirconium cyclosilicate

              sodium zirconium cyclosilicate will increase the level or effect of dextroamphetamine by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate. Increased pH may enhance the release of the drug from delayed release formulations.

            • solriamfetol

              dextroamphetamine and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • St John's Wort

              dextroamphetamine and St John's Wort both increase serotonin levels. Modify Therapy/Monitor Closely.

            • sufentanil

              sufentanil increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sufentanil SL

              sufentanil SL, amphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

              sufentanil SL, dextroamphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.

            • sumatriptan

              sumatriptan and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.

            • sumatriptan intranasal

              sumatriptan intranasal and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.

            • tapentadol

              tapentadol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • tazemetostat

              tazemetostat will decrease the level or effect of dextroamphetamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • temazepam

              temazepam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • terbutaline

              terbutaline and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              terbutaline and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • thioridazine

              thioridazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              thioridazine, dextroamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • thiothixene

              thiothixene increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • topiramate

              topiramate increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • tramadol

              tramadol increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              dextroamphetamine and tramadol both increase serotonin levels. Use Caution/Monitor.

            • trazodone

              trazodone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trazodone and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              trazodone increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • triazolam

              triazolam increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • triclofos

              triclofos increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • trifluoperazine

              trifluoperazine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, dextroamphetamine. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • trimipramine

              trimipramine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trimipramine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

              trimipramine increases effects of dextroamphetamine by unknown mechanism. Use Caution/Monitor.

            • triprolidine

              triprolidine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • venlafaxine

              venlafaxine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Modify Therapy/Monitor Closely.

              venlafaxine and dextroamphetamine both increase serotonin levels. Modify Therapy/Monitor Closely.

            • xylometazoline

              dextroamphetamine and xylometazoline both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and xylometazoline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • yohimbine

              dextroamphetamine and yohimbine both decrease sedation. Use Caution/Monitor.

              dextroamphetamine and yohimbine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • ziconotide

              ziconotide increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ziprasidone

              ziprasidone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • zolmitriptan

              zolmitriptan and dextroamphetamine both increase serotonin levels. Use Caution/Monitor.

            Minor (56)

            • acetazolamide

              acetazolamide increases levels of dextroamphetamine by passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown.

            • alfentanil

              dextroamphetamine increases effects of alfentanil by unspecified interaction mechanism. Minor/Significance Unknown.

            • amantadine

              amantadine, dextroamphetamine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Potential for additive CNS stimulation.

            • American ginseng

              American ginseng increases effects of dextroamphetamine by pharmacodynamic synergism. Minor/Significance Unknown.

            • amiodarone

              amiodarone will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • asenapine

              asenapine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • ashwagandha

              ashwagandha increases effects of dextroamphetamine by unspecified interaction mechanism. Minor/Significance Unknown.

            • belladonna and opium

              dextroamphetamine increases effects of belladonna and opium by unspecified interaction mechanism. Minor/Significance Unknown.

            • buprenorphine

              dextroamphetamine increases effects of buprenorphine by unspecified interaction mechanism. Minor/Significance Unknown.

            • buprenorphine buccal

              dextroamphetamine increases effects of buprenorphine buccal by unspecified interaction mechanism. Minor/Significance Unknown.

            • butorphanol

              dextroamphetamine increases effects of butorphanol by unspecified interaction mechanism. Minor/Significance Unknown.

            • celandine

              celandine increases effects of dextroamphetamine by unspecified interaction mechanism. Minor/Significance Unknown. Based on animal studies.

            • celecoxib

              celecoxib will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • chloroquine

              chloroquine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • cimetidine

              cimetidine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • codeine

              dextroamphetamine increases effects of codeine by unspecified interaction mechanism. Minor/Significance Unknown.

            • darifenacin

              darifenacin will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • desmopressin

              desmopressin increases effects of dextroamphetamine by pharmacodynamic synergism. Minor/Significance Unknown.

            • dextromoramide

              dextroamphetamine increases effects of dextromoramide by unspecified interaction mechanism. Minor/Significance Unknown.

            • diamorphine

              dextroamphetamine increases effects of diamorphine by unspecified interaction mechanism. Minor/Significance Unknown.

            • difenoxin hcl

              dextroamphetamine increases effects of difenoxin hcl by unspecified interaction mechanism. Minor/Significance Unknown.

            • diphenhydramine

              diphenhydramine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • diphenoxylate hcl

              dextroamphetamine increases effects of diphenoxylate hcl by unspecified interaction mechanism. Minor/Significance Unknown.

            • dipipanone

              dextroamphetamine increases effects of dipipanone by unspecified interaction mechanism. Minor/Significance Unknown.

            • dronedarone

              dronedarone will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • ethosuximide

              dextroamphetamine decreases levels of ethosuximide by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

            • eucalyptus

              eucalyptus increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

            • guarana

              guarana increases effects of dextroamphetamine by pharmacodynamic synergism. Minor/Significance Unknown.

            • haloperidol

              haloperidol will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • hydromorphone

              dextroamphetamine increases effects of hydromorphone by unspecified interaction mechanism. Minor/Significance Unknown.

            • imatinib

              imatinib will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • levorphanol

              dextroamphetamine increases effects of levorphanol by unspecified interaction mechanism. Minor/Significance Unknown.

            • maraviroc

              maraviroc will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • marijuana

              marijuana will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • meperidine

              dextroamphetamine increases effects of meperidine by unspecified interaction mechanism. Minor/Significance Unknown.

            • methadone

              dextroamphetamine increases effects of methadone by unspecified interaction mechanism. Minor/Significance Unknown.

            • morphine

              dextroamphetamine increases effects of morphine by unspecified interaction mechanism. Minor/Significance Unknown.

            • nalbuphine

              dextroamphetamine increases effects of nalbuphine by unspecified interaction mechanism. Minor/Significance Unknown.

            • opium tincture

              dextroamphetamine increases effects of opium tincture by unspecified interaction mechanism. Minor/Significance Unknown.

            • oxycodone

              dextroamphetamine increases effects of oxycodone by unspecified interaction mechanism. Minor/Significance Unknown.

            • oxymorphone

              dextroamphetamine increases effects of oxymorphone by unspecified interaction mechanism. Minor/Significance Unknown.

            • papaveretum

              dextroamphetamine increases effects of papaveretum by unspecified interaction mechanism. Minor/Significance Unknown.

            • parecoxib

              parecoxib will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • pentazocine

              dextroamphetamine increases effects of pentazocine by unspecified interaction mechanism. Minor/Significance Unknown.

            • perphenazine

              perphenazine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • propafenone

              propafenone will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • quinacrine

              quinacrine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • ranolazine

              ranolazine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • ritonavir

              ritonavir will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • sage

              sage increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

            • sufentanil

              dextroamphetamine increases effects of sufentanil by unspecified interaction mechanism. Minor/Significance Unknown.

            • tapentadol

              dextroamphetamine increases effects of tapentadol by unspecified interaction mechanism. Minor/Significance Unknown.

            • thioridazine

              thioridazine will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • tipranavir

              tipranavir will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • tramadol

              dextroamphetamine increases effects of tramadol by unspecified interaction mechanism. Minor/Significance Unknown.

            • yerba mate

              yerba mate increases effects of dextroamphetamine by pharmacodynamic synergism. Minor/Significance Unknown.

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            Adverse Effects

            >10% (Extended Release)

            Loss of appetite (22-36%)

            Headache (<26%)

            Insomnia (12-27%)

            Abdominal pain (11-14%)

            Weight loss (4-11%)

            1-10% (Extended Release)

            Anxiety (8%)

            Vomiting (7%)

            Nervousness (6%)

            Tachycardia (6%)

            Fever (5%)

            Nausea (5-8%)

            Infection (4%)

            Emotional lability (2-9%)

            Dizziness (2-7%)

            Diarrhea (2-6%)

            Fatigue (2-4%)

            Dry mouth (2-4%)

            Dyspepsia (2-4%)

            Postmarketing Reports

            Cardiovascular: Palpitations; isolated reports of cardiomyopathy associated with chronic amphetamine use

            CNS: Psychotic episodes at recommended doses, overstimulation, restlessness, irritability, euphoria, dyskinesia, dysphoria, depression, tremor, tics, aggression, anger, logorrhea, dermatillomania, paresthesia (including formication), bruxism

            Eye disorders: Blurred vision, mydriasis

            Gastrointestinal: Unpleasant taste, constipation, other gastrointestinal disturbances

            Allergic: Urticaria, rash, hypersensitivity reactions (including angioedema and anaphylaxis); serious skin rashes (including Stevens-Johnson syndrome and toxic epidermal necrolysis)

            Endocrine: Impotence, changes in libido, frequent/prolonged erections

            Skin: Alopecia

            Vascular disorders: Raynaud phenomenon

            Musculoskeletal: Rhabdomyolysis

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            Warnings

            Black Box Warnings

            Amphetamines have a high potential for abuse and dependence

            Administration for prolonged periods may lead to dependence and must be avoided

            Assess the possibility of persons obtaining amphetamines for nontherapeutic use or distribution to others

            Prescribed or dispensed sparingly

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

            Contraindications

            Hypersensitivity

            Hyperthryroidism

            Glaucoma

            Hypertension, advanced arteriosclerosis, symptomatic CVD

            Symptomatic cardiovascular disease

            Moderate-to-severe hypertension

            Agitated states, history of drug abuse

            MAO inhibitors given within 14 days (risk of severe hypertensive reaction)

            Cautions

            Preexisting cardiac structural abnormalities associated with risk of sudden death (if abused)

            Time to maximum concentration decreased when coadministered with acid-suppressing drugs (eg, proton pump inhibitors)

            Associated with peripheral vasculopathy, including Raynaud phenomenon

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

            May impair ability to engage in potentially hazardouse activities due to CNS effects

            Potential exists for drug dependency

            Use caution in hypertension, history of psychosis, seizure disorders, elderly, or Tourette's syndrome (may unmask tics)

            Abrupt discontinuation may result in symptoms for withdrawal

            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

            Drug interaction overview

            • Serotonin syndrome, a potentially life-threatening reaction, may occur when amphetamines are used in combination with other drugs that affect the serotonergic neurotransmitter systems such as monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John’s Wort
            • Amphetamines and amphetamine derivatives are known to be metabolized, to some degree, by cytochrome P450 2D6 (CYP2D6) and display minor inhibition of CYP2D6 metabolism; potential for a pharmacokinetic interaction exists with coadministration of CYP2D6 inhibitors which may increase risk with increased exposure to amphetamines and derivatives; in these situations, consider alternative non-serotonergic drug or alternative drug that does not inhibit CYP2D6
            • If concomitant use with other serotonergic drugs or CYP2D6 inhibitors is clinically warranted, initiate therapy with lower doses, monitor patients for emergence of serotonin syndrome during drug initiation or titration, and inform patients of increased risk for serotonin syndrome
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            Pregnancy & Lactation

            Pregnancy

            Pregnancy exposure registry is available that monitors pregnancy outcomes in women exposed during pregnancy; healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for Psychostimulants at 1-866-961-2388 or visiting online at https://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/othermedications/

            Available data from published epidemiologic studies and postmarketing reports on use of prescription amphetamine in pregnant women have not identified drug-associated risk of major birth defects and miscarriage; adverse pregnancy outcomes, including premature delivery and low birth weight, reported in infants born to mothers taking amphetamines during pregnancy

            Amphetamines cause vasoconstriction and thereby may decrease placental perfusion; in addition, amphetamines can stimulate uterine contractions, increasing the risk of premature delivery; infants born to mothers taking amphetamines during pregnancy have increased risk of premature delivery and low birth weight

            Monitor infants born to mothers taking amphetamines for symptoms of withdrawal such as feeding difficulties, irritability, agitation, and excessive drowsiness

            Animal data

            • No apparent effects on morphological development reported in embryo-fetal development studies, with oral administration of amphetamine to rats and rabbits during organogenesis at doses 2 and 12 times, respectively, the maximum recommended human dose (MRHD) of 20 mg/day given to adolescents, on a mg/m² basis
            • However, in a pre- and post-natal development study, amphetamine (d-to l- ratio of 3:1) administered orally to pregnant rats during gestation and lactation caused a decrease in pup survival and a decrease in pup body weight that correlated with a delay in developmental landmarks at clinically relevant doses of amphetamine
            • Adverse effects on reproductive performance observed in pups whose mothers were treated with amphetamine; long-term neurochemical and behavioral effects reported in animal developmental studies using clinically relevant doses of amphetamine

            Lactation

            Based on limited case reports in published literature, amphetamine is present in human milk; there are no reports of adverse effects on breastfed infant

            Long-term neurodevelopmental effects on infants from amphetamine exposure are unknown; large dosages of amphetamine might interfere with milk production, especially in women whose lactation is not well established

            Because of potential for serious adverse reactions in nursing infants, advise patients that breastfeeding is not recommended during therapy

            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

            Well absorbed

            Onset of action: 30-60 min

            Duration: 4-6 hr

            Vd: 3.5-4.6 L/kg (distributes into CNS; mean CSF concentrations are 80% of plasma)

            Peak plasma time: 3 hr (Adderall); 7 hr (Adderall XR)

            Metabolism

            Hepatic via glucuronidation and CYP450 mono-oxygenase

            Elimination

            Half-life elimination (children)

            • 6-12 years: 9 hr (d-amphetamine); 11 hr (l-amphetamine)
            • 12-18 years: 11 hr (d-amphetamine); 13-14 hr (l-amphetamine)

            Half-life elimination (adults)

            • d-amphetamine: 10 hr
            • l-amphetamine: 13 hr

            Excretion

            • Urine; dependent on urinary pH
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            Administration

            Oral Administration

            Tablet

            • May take with or without food
            • Give first dose on awakening; give additional doses (1 or 2) at intervals of 4-6 hr
            • Avoid late evening doses owing to potential insomnia

            Extended-release capsule

            • May take with or without food
            • Take in morning upon awakening; avoid afternoon doses owing to potential insomnia
            • Swallow capsule whole, OR
            • Open capsule and sprinkle the entire content over a spoonful of applesauce and consume immediately without chewing (do not store)
            • Do not divide content of a single capsule
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            Images

            No images available for this drug.
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            Patient Handout

            A Patient Handout is not currently available for this monograph.
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            Formulary

            FormularyPatient Discounts

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            • 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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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.