dextroamphetamine (Rx)

Brand and Other Names:Dexedrine, ProCentra, more...Zenzedi
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsule, extended-release (Dexedrine): Schedule II

  • 5mg
  • 10mg
  • 15mg

tablet, immediate-release (Zenzedi): Schedule II

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

oral solution (ProCentra): Schedule II

  • 5mg/5mL

Narcolepsy

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

Not to exceed 60 mg/day

Attention Deficit Hyperactivity Disorder

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

Rarely necessary to exceed 40 mg/day

Dosage Forms & Strengths

capsule, extended-release (Dexedrine): Schedule II

  • 5mg
  • 10mg
  • 15mg

tablet, immediate-release (Zenzedi): Schedule II

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

oral solution (ProCentra): Schedule II

  • 5mg/5mL

Attention Deficit Hyperactivity Disorder

<3 years

  • Safety and efficacy not established

3-5 years

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

≥6 years

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

Narcolepsy

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

Dosing considerations

  • Narcolepsy seldom occurs in children <12 years; however, when it does, dextroamphetamine may be used; suggested initial dose for patients aged 6 - 12 is 5 mg daily; daily dose may be raised in increments of 5 mg at weekly intervals until an optimal response obtained
  • Capsules may be used for once-a-day dosage wherever appropriate

Start at lowest dose

Narcolepsy

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

Not to exceed 60 mg/day

Next:

Interactions

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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 (37)

            • 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

              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.

            • isoflurane

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

            • linezolid

              linezolid and dextroamphetamine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.

            • lofepramine

              lofepramine, 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.

            • lorcaserin

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

            • maprotiline

              maprotiline, 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.

            • methoxyflurane

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

            • methylene blue

              methylene blue and dextroamphetamine both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.

            • methylergonovine

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

            • nortriptyline

              nortriptyline, 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.

            • ozanimod

              ozanimod increases toxicity of dextroamphetamine 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.

            • phenelzine

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

            • procarbazine

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

            • protriptyline

              protriptyline, 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.

            • sevoflurane

              sevoflurane increases toxicity of dextroamphetamine by Mechanism: unknown. Avoid or Use Alternate Drug.

            • tedizolid

              tedizolid, dextroamphetamine. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.

            • tranylcypromine

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

            • trazodone

              trazodone, 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.

            • trimipramine

              trimipramine, 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.

            • vilazodone

              dextroamphetamine, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .

            • yohimbe

              yohimbe, dextroamphetamine. Mechanism: pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            Monitor Closely (220)

            • 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, 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.

            • 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.

            • 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.

            • 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, 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.

            • 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, 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%

            Appetite loss (21-22%)

            Insomnia (16-20%)

            Abdominal pain (11-15%)

            1-10%

            Vomiting

            Emotional lability

            Nervousness

            Fatigue

            Fever

            Infection

            Nausea

            Diarrhea

            Dyspepsia

            Dizziness

            Weight loss

            Frequency Not Defined

            Hyperactivity

            Hypomania

            Palpitations

            Tachycardia

            Hypertension

            Dry mouth

            Constipation

            Tremor

            Headache

            Postmarketing reports

            Musculoskeletal: Rhabdomyolysis

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            Warnings

            Black Box Warnings

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

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

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

            Contraindications

            Hypersensitivity to drug or components

            Hyperthyroidism

            Glaucoma

            Hypertension, advanced arteriosclerosis, symptomatic CVD

            Agitated states, history of drug abuse

            Within 14 days of administering MAOIs

            Cautions

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

            Risk of adverse psychiatric events; eg, hallucinations and mania

            Caution in mild hypertension

            Associated with peripheral vasculopathy, including Raynaud phenomenon

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

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

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

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

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

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

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

            Use with caution in patients who use other sympathomimetic drugs

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

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

            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 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; 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 category: C

            Lactation: Enters breast milk; not recommended

            Pregnancy Categories

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

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

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

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

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

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

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

            Absorption

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

            Onset of action: 1-1.5 hr

            Metabolism

            Hepatic via glucuronidation and mono-oxygenase

            Elimination

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

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

            Excretion: Urine

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            Administration

            Administer amphetamines at lowest effective dosage and adjust dosage individually

            Administer initial dose upon awakening; avoid late evening doses because of resulting insomnia

            Do not crush or chew extended-release formulations

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            Zenzedi oral
            -
            2.5 mg tablet
            Zenzedi oral
            -
            10 mg tablet
            Zenzedi oral
            -
            7.5 mg tablet
            Zenzedi oral
            -
            5 mg tablet
            Zenzedi oral
            -
            15 mg tablet
            Zenzedi oral
            -
            30 mg tablet
            Zenzedi oral
            -
            20 mg tablet
            dextroamphetamine oral
            -
            15 mg capsule
            dextroamphetamine oral
            -
            5 mg capsule
            dextroamphetamine oral
            -
            10 mg capsule
            dextroamphetamine oral
            -
            5 mg tablet
            dextroamphetamine oral
            -
            10 mg tablet
            dextroamphetamine oral
            -
            5 mg/5 mL solution
            dextroamphetamine oral
            -
            15 mg capsule
            dextroamphetamine oral
            -
            10 mg tablet
            dextroamphetamine oral
            -
            5 mg tablet
            dextroamphetamine oral
            -
            10 mg capsule
            dextroamphetamine oral
            -
            5 mg capsule
            dextroamphetamine oral
            -
            5 mg capsule
            dextroamphetamine oral
            -
            10 mg capsule
            dextroamphetamine oral
            -
            15 mg capsule
            dextroamphetamine oral
            -
            10 mg tablet
            dextroamphetamine oral
            -
            5 mg tablet
            dextroamphetamine oral
            -
            10 mg capsule
            dextroamphetamine oral
            -
            5 mg capsule
            dextroamphetamine oral
            -
            10 mg capsule
            dextroamphetamine oral
            -
            5 mg tablet
            dextroamphetamine oral
            -
            5 mg capsule
            dextroamphetamine oral
            -
            10 mg tablet
            dextroamphetamine oral
            -
            15 mg capsule
            dextroamphetamine oral
            -
            30 mg tablet
            dextroamphetamine oral
            -
            20 mg tablet
            dextroamphetamine oral
            -
            15 mg tablet
            Dexedrine Spansule oral
            -
            15 mg capsule
            Dexedrine Spansule oral
            -
            10 mg capsule
            Dexedrine Spansule oral
            -
            5 mg capsule
            Dexedrine Spansule oral
            -
            10 mg capsule
            Dexedrine Spansule oral
            -
            10 mg capsule

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            dextroamphetamine oral

            DEXTROAMPHETAMINE SUSTAINED-ACTION CAPSULE - ORAL

            (DEX-troe-am-FET-a-meen)

            COMMON BRAND NAME(S): Dexedrine

            WARNING: Misuse or abuse of amphetamines may cause serious (possibly fatal) heart and blood pressure problems. Amphetamine-type medications can be habit-forming. Use only as directed. If you use this drug for a long time, you may become dependent on it and may have withdrawal symptoms after stopping the drug. Consult your doctor or pharmacist for more details. (See also How to Use section).

            USES: This medication is used to treat attention deficit hyperactivity disorder - ADHD. It works by changing the amounts of certain natural substances in the brain. Dextroamphetamine belongs to a class of drugs known as stimulants. It can help increase your ability to pay attention, stay focused on an activity, and control behavior problems. It may also help you to organize your tasks and improve listening skills.This drug is also used to treat a certain sleeping disorder (narcolepsy) to help you stay awake during the day. It should not be used to treat tiredness or to hold off sleep in people who do not have a sleep disorder.

            HOW TO USE: Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking dextroamphetamine and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with or without food as directed by your doctor, usually 1-3 times a day. The first dose is usually taken when you wake up in the morning. If more doses are prescribed, take them as directed by your doctor, usually 4-6 hours apart. Taking this medication late in the day may cause trouble sleeping (insomnia).The dosage is based on your medical condition and response to treatment. Your doctor may adjust your dose to find the dose that is best for you. Follow your doctor's instructions carefully.Swallow the capsules whole. Do not crush or chew the capsules. Doing so can release all of the drug at once, increasing the risk of side effects.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.During treatment, your doctor may occasionally recommend stopping the medication for a short time to see whether there are any changes in your behavior and whether the medication is still needed.If you suddenly stop using this medication, you may have withdrawal symptoms (such as severe tiredness, sleep problems, mental/mood changes such as depression). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used dextroamphetamine for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Do not increase your dose, take it more often, or use it for a longer time than prescribed. Properly stop the medication when so directed.When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well.Tell your doctor if your condition does not improve or if it worsens.

            SIDE EFFECTS: Nausea, stomach upset, cramps, loss of appetite, diarrhea, dry mouth, headache, nervousness, dizziness, trouble sleeping, sweating, weight loss, irritability, and restlessness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: signs of blood flow problems in the fingers or toes (such as coldness, numbness, pain, or skin color changes), unusual wounds on the fingers or toes, mental/mood/behavior changes (such as agitation, aggression, mood swings, depression, hallucinations, abnormal thoughts/behavior, thoughts of suicide), uncontrolled movements, muscle twitching/shaking, outbursts of words/sounds, change in sexual ability/interest, swelling ankles/feet, extreme tiredness, significant unexplained weight loss, frequent/prolonged erections (in males).Get medical help right away if you have any very serious side effects, including: shortness of breath, chest/jaw/left arm pain, severe headache, fast/pounding/irregular heartbeat, seizures, weakness on one side of the body, trouble speaking, confusion, fainting, blurred vision.This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or to other sympathomimetic drugs (such as amphetamine or lisdexamfetamine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood circulation problems (such as Raynaud's disease), certain mental/mood conditions (such as severe agitation, psychosis), personal/family history of mental/mood disorders (such as bipolar disorder, depression, psychotic disorder, suicidal thoughts), heart problems (including irregular heartbeat/rhythm, coronary artery disease, heart failure, cardiomyopathy, problems with the heart structure such as valve problems), family history of heart problems (such as sudden death/irregular heartbeat/rhythm), history of stroke, high blood pressure, overactive thyroid (hyperthyroidism), history of heart attack or stroke, a certain eye problem (glaucoma), seizures, personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol), personal or family history of uncontrolled muscle movements (such as Tourette's syndrome).This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Children may be more sensitive to the side effects of this drug, especially weight loss. This medication may slow down a child's growth. The doctor may recommend temporarily stopping the medication from time to time to reduce this risk. Monitor your child's weight and height. Consult your doctor or pharmacist for more details.Older adults may be more sensitive to the side effects of this drug, especially chest pain, trouble sleeping, or weight loss.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. Infants born to mothers who are dependent on this medication may be born too soon (premature) and have low birth weight. They may also have withdrawal symptoms. Tell your doctor right away if you notice possible mood changes, agitation, or unusual tiredness in your newborn.This medication passes into breast milk and may have undesirable effects on a nursing infant. Breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products or diet aids).The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/ "ecstasy," St. John's wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.Dextroamphetamine is very similar to amphetamine or lisdexamfetamine. Do not use medications containing amphetamine or lisdexamfetamine while using dextroamphetamine.This medication may interfere with certain medical/laboratory tests (including blood and urine steroid levels, brain scan for Parkinson's disease), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe mental/mood changes, seizures, severe/persistent headache, severe restlessness, fast breathing.

            NOTES: Do not share this medication with others. Sharing it is against the law.Laboratory and/or medical tests (such as blood pressure, heart rate, growth monitoring in children) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

            MISSED DOSE: If you miss a dose, take it as soon as you remember in the morning hours. If it is late in the afternoon or near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

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

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

            Adding plans allows you to:

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

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

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