Drug ID: 1d00000098
Drug Name: Amphetamine, Dextroamphetamine Mixed Salts
Generic Names: Adderall
Category: CNS Stimulants
Legal Status: Non Opioid Prescription only drug
Indication for Mother: Category C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Recommended Dose: The recommended dose is 20 mg/day.
Adolescents: Initial: The recommended dose is 10 mg/day. The dose may be increased to 20 mg/day after one week if needed.
In children from 3 to 5 years of age, PO 2.5 mg/day; may be increased weekly by 2.5 mg.
Children 6 yr of age or older IR: PO 5 mg once or twice daily; may be increased weekly by 5 mg to max of 40?mg/day in divided doses. Usual range: 0.1 to 0.5 mg/kg/dose in the morning.
Child: Initial: The recommended dose is 10 mg once daily in the morning. It may be increased if needed. The maximum recommended dose for children is 30 mg/day.
Recommended In: This combination medication belongs to central nervous system stimulants class, prescribed for attention deficit hyperactivity disorder (ADHD) with counseling and special education. It is also used to treat narcolepsy.
Directions For Use: It comes as a tablet and capsule to take by mouth, with or without food.
Storage: Store it at controlled room temperature (25° C).
Dosage Forms: Tablet | Capsule
Side Effects: Most frequent- Loss of appetite, sleeplessness, weight loss, emotional lability, depression, anxiety, headache, weakness, paresthesia and fast pounding, or uneven heart rate.
General- Abdominal pain, (stomach ache), fever, infection, accidental injury and fatigue.
Heart- Palpitations, elevation of blood pressure, myocardial infarction rate.
Gastrointestinal- Dryness of the mouth, unpleasant taste, diarrhea, constipation, vomiting, nausea and indigestion.
Liver- Impotence, changes in libido.
Eye- Blood shot eyes, dilated pupils and blurred vision.
Central Nervous System- Nervousness, feeling light-headed, fainting, tremor, restlessness, irritability, hallucinations, unusual behavior, and dizziness.
Metabolic - Weight loss.
In Case of Overdose: Manifestations of acute overdosage with amphetamines include restlessness, tremor, hyperreflexia, rapid respiration, confusion, assaultiveness, hallucinations, panic states, hyperpyrexia and rhabdomyolysis.
Fatigue and depression usually follow the central stimulation.
Cardiovascular effects include arrhythmias, hypertension or hypotension and circulatory collapse.
Gastrointestinal symptoms include nausea, vomiting, diarrhea, and abdominal cramps. Fatal poisoning is usually preceded by convulsions and coma.
Consult with a Certified Poison Control Center for up to date guidance and advice. Management of acute amphetamine intoxication is largely symptomatic and includes gastric lavage, administration of activated charcoal, administration of a cathartic and sedation. Experience with hemodialysis or peritoneal dialysis is inadequate to permit recommendation in this regard. Acidification of the urine increases amphetamine excretion, but is believed to increase risk of acute renal failure if myoglobinuria is present. If acute, severe hypertension complicates amphetamine overdosage, administration of intravenous phentolamine has been suggested. However, a gradual drop in blood pressure will usually result when sufficient sedation has been achieved. Chlorpromazine antagonizes the central stimulant effects of amphetamines and can be used to treat amphetamine intoxication.
Avoid If: Caution should be exercised in patients with history of heart disease, high blood pressure, liver or kidney problems, growth problems, loss of appetite, blood disorder, involuntary muscle movements, seizures, abnormal electroencephalograms (EEGs), mood or mental problems, any allergy, who are taking other medications, children, during pregnancy and breast feeding.
It may cause dizziness, drowsiness or blurred vision, do not drive a car or operate machinery, and get up slowly from bed while taking this medication.
It should not be used in children aged less than 3 years old and elderly.
Monitor blood pressure, pulse and heart function regularly, while taking this medication.
Avoid abrupt withdrawal and excess dosage.
Patient may develop with serious effects such as heart attack, stroke and sudden death in patients with heart defects. Before taking this medication, consult with your doctor.
Avoid long-term use of this medication; otherwise it may lead to addiction.
Contraindicated in patients with hardening of the arteries, blood vessel disease, uncontrolled high blood pressure, overactive thyroid, increased eye pressure, mood or mental problems, heart diseases, alcohol abuse, within 14 days following the administration of monoamine oxidase inhibitors and hypersensitivity.
Drug Interaction: Acidifying agents
Gastrointestinal acidifying agents (guanethidine, reserpine, glutamic acid HCl, ascorbic acid, fruit juices, etc.) lower absorption of amphetamines.
Urinary acidifying agent
ammonium chloride, sodium acid phosphate, etc. increase the concentration of the ionized species of the amphetamine molecule, thereby increasing urinary excretion. Both groups of agents lower blood levels and efficacy of amphetamines.
Adrenergic blockers are inhibited by amphetamines.
Gastrointestinal alkalinizing agents (sodium bicarbonate, etc.) increase absorption of amphetamines. Co-administration of amphetamine, dextroamphetamine mixed salts and gastrointestinal alkalizing agents, such as antacids, should be avoided. Urinary alkalinizing agents (acetazolamide, some thiazides) increase the concentration of the non-ionized species of the amphetamine molecule, thereby decreasing urinary excretion. Both groups of agents increase blood levels and therefore potentiate the actions of amphetamines.
Amphetamines may enhance the activity of tricyclic or sympathomimetic agents; d-amphetamine with desipramine or protriptyline and possibly other tricyclics cause striking and sustained increases in the concentration of d-amphetamine in the brain; cardiovascular effects can be potentiated.
MAOI antidepressants, as well as a metabolite of furazolidone, slow amphetamine metabolism. This slowing potentiates amphetamines, increasing their effect on the release of norepinephrine and other monoamines from adrenergic nerve endings; this can cause headaches and other signs of hypertensive crisis. A variety of neurological toxic effects and malignant hyperpyrexia can occur, sometimes with fatal results.
Amphetamines may counteract the sedative effect of antihistamines.
Amphetamines may antagonize the hypotensive effects of antihypertensives.
Chlorpromazine blocks dopamine and norepinephrine receptors, thus inhibiting the central stimulant effects of amphetamines, and can be used to treat amphetamine poisoning.
Amphetamines may delay intestinal absorption of ethosuximide.
Haloperidol blocks dopamine receptors, thus inhibiting the central stimulant effects of amphetamines.
The anorectic and stimulatory effects of amphetamines may be inhibited by lithium carbonate.
Amphetamines potentiate the analgesic effect of meperidine.
Urinary excretion of amphetamines is increased, and efficacy is reduced, by acidifying agents used in methenamine therapy.
Amphetamines enhance the adrenergic effect of norepinephrine.
Amphetamines may delay intestinal absorption of phenobarbital; co-administration of phenobarbital may produce a synergistic anticonvulsant action.
Amphetamines may delay intestinal absorption of phenytoin; co-administration of phenytoin may produce a synergistic anticonvulsant action.
In cases of propoxyphene overdosage, amphetamine CNS stimulation is potentiated and fatal convulsions can occur.
Amphetamines inhibit the hypotensive effect of veratrum alkaloids.