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Dextroamphetamine (D-AMP) is a central nervous system (CNS) stimulant and an amphetamine. This medication is used to treat attention deficit hyperactivity disorder (ADHD). It works by altering the concentration of certain natural substances in the brain. Dextroamphetamine belongs to the class of drugs known as stimulants. It can increase your attention, improve your concentration on an activity, and control behavioral problems. It can also help you organize your tasks and improve your listening comprehension.

Description

Dextroamphetamine (D-AMP) is a central nervous system (CNS) stimulant and an amphetamine enantiomer prescribed for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. It is also used to enhance athletic performance and cognitive abilities, and recreationally as an aphrodisiac and euphoric agent. Dextroamphetamine has also been used historically by the armed forces of some countries to combat fatigue during prolonged combat deployments.

The amphetamine molecule exists in two enantiomers, levoamphetamine and dextroamphetamine. Dextroamphetamine is the dextrorotatory enantiomer and exhibits stronger effects on the central nervous system than levoamphetamine. Pharmaceutical dextroamphetamine sulfate is available under both brand names and generics in various dosage forms. Dextroamphetamine is sometimes prescribed as the inactive prodrug lisdexamfetamine dimesylate, which is converted to dextroamphetamine upon absorption.

Dextroamphetamine is used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy (a sleep disorder), and is sometimes prescribed off-label for previous medical indications such as depression and obesity. Long-term exposure to amphetamines at sufficiently high doses can lead to abnormal development of the dopamine system or nerve damage in some animal species. However, in humans with ADHD, pharmaceutical amphetamines at therapeutic doses appear to improve brain development and nerve growth. Magnetic resonance imaging (MRI) studies suggest that long-term amphetamine treatment reduces abnormalities in brain structure and function observed in patients with ADHD and improves function in several brain regions, such as the right caudate nucleus of the basal ganglia.

Reviews of clinical stimulant research have demonstrated the safety and efficacy of long-term, continuous amphetamine use for the treatment of ADHD. Randomized controlled trials of continuous stimulant therapy for ADHD over a two-year period have demonstrated the efficacy and safety of the treatment. Two reviews have shown that long-term, continuous stimulant therapy for ADHD effectively reduces core symptoms of ADHD (e.g., hyperactivity, inattention, and impulsivity), improves quality of life and academic performance, and results in improvements in a variety of functional outcomes across nine categories related to academic achievement, antisocial behavior, driving, non-medical substance use, obesity, occupation, self-esteem, service use (e.g., academic, vocational, health, financial, and legal services), and social functioning. One study highlighted a nine-month randomized controlled trial of amphetamine treatment for ADHD in children, which found an average improvement of 4.5 points, a sustained increase in attention, and a sustained decrease in disruptive behavior and hyperactivity. Another study, based on the longest follow-up to date, found that lifelong stimulant therapy, starting in childhood, is continuously effective in controlling ADHD symptoms and reduces the risk of developing a substance use disorder in adulthood.

Application:

Read the instructions for use and, if available, the package leaflet from your pharmacist before you start taking dextroamphetamine and each time you receive a new prescription. If you have any questions, ask your doctor or pharmacist.

Take this medicine with or without food, as directed by your doctor, usually 1 to 3 times a day. The first dose is usually taken in the morning after waking up. If you are prescribed multiple doses, take them as directed by your doctor, usually 4-6 hours apart. Taking this medicine late in the day may cause sleep disturbances (insomnia).

If you are taking the liquid form of this medicine, measure the dose carefully using a special measuring spoon. Do not use a household spoon, as you may not get the correct dose.

The dosage depends on your health condition and your response to treatment. Your doctor may adjust the dose to find the optimal dose for you. Follow your doctor’s instructions carefully.

Take this medicine regularly to get the most benefit. To avoid forgetting to take it, take it at the same time every day.

During treatment, your doctor may occasionally recommend that you stop taking the medication for a short time to check if your behavior changes and whether the medication is still needed.

If you suddenly stop taking this medication, withdrawal symptoms may occur (e.g., severe fatigue, sleep disturbances, mood swings such as depression). To prevent withdrawal symptoms, your doctor may gradually reduce your dose. Withdrawal symptoms are more likely if you have taken dextroamphetamine for a long time or in high doses. Inform your doctor or pharmacist immediately if you experience withdrawal symptoms.

Although this medication helps many people, it can sometimes be addictive. This risk may be higher if you have a substance use disorder (such as drug/alcohol abuse or dependence). Do not increase your dose, take the medication more often, or use it for longer than prescribed. Stop taking the medication properly when instructed to do so.

The effectiveness of this medication may decrease with prolonged use. Talk to your doctor if the effect diminishes.

Inform your doctor if your condition does not improve or worsens.

Side effects :

Nausea, upset stomach, cramps, loss of appetite, diarrhea, dry mouth, headache, nervousness, dizziness, sleep disturbances, sweating, weight loss, irritability, and restlessness may occur. If these side effects persist or worsen, inform your doctor or pharmacist immediately.

Remember that your doctor prescribed this medicine because they considered the benefit to you to outweigh the risk of side effects. Many patients using this medicine do not experience serious side effects.

This medicine can increase your blood pressure. Check your blood pressure regularly and inform your doctor if the readings are elevated.

Inform your doctor immediately if you experience any serious side effects, including: signs of circulatory problems in your fingers or toes (such as feeling cold, numb, pain, or changes in skin color), unusual sores on your fingers or toes, changes in mental state/mood/behavior (such as restlessness, aggression, mood swings, depression, hallucinations, abnormal thoughts/behaviors, suicidal thoughts), uncontrolled movements, muscle twitching/trembling, sudden outbursts of words/sounds, changes in sexual performance/sexual interest, swollen ankles/feet, extreme tiredness, significant unexplained weight loss, frequent/prolonged erections (in men).

Seek immediate medical attention if you experience very serious side effects, including: shortness of breath, pain in the chest, jaw or left arm, severe headache, fainting, rapid/pounding/irregular heartbeat, seizures, weakness on one side of the body, slurred speech, confusion, blurred vision.

This medicine can increase serotonin levels and, in rare cases, cause a very serious condition called serotonin syndrome/serotonin toxicity. The risk increases if you are also taking other medicines that increase serotonin levels. Therefore, tell your doctor or pharmacist about all medicines you are taking (see section “Interactions with other medicines”). Seek immediate medical attention if you experience any of the following symptoms: rapid heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, muscle twitching, unexplained fever, unusual agitation/restlessness.

Warnings and precautions:

Inform your doctor or pharmacist before taking this medicine 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 that could cause allergic reactions or other problems. Ask your pharmacist for more information.

Before using this medicine, inform your doctor or pharmacist about your medical history, especially about: circulatory disorders (such as Raynaud’s syndrome), certain mental disorders/mood disorders (such as severe restlessness, psychosis), a personal or family history of mental disorders/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), a family history of heart problems (such as sudden cardiac death/irregular heartbeat/rhythm), stroke, high blood pressure, overactive thyroid (hyperthyroidism), certain eye problems (glaucoma), seizures, a personal or family history of substance-related disorders (such as drug/alcohol abuse or dependence), or a personal or family history of uncontrolled muscle movements. (such as Tourette syndrome).

This medicine can cause dizziness. Alcohol or marijuana (cannabis) can make dizziness worse. Do not drive, operate machinery, or do anything that requires your full attention until you can do so safely. Limit your alcohol consumption. Talk to your doctor if you use marijuana (cannabis).

Before any surgery, inform your doctor or dentist about all products you are taking (including prescription and non-prescription drugs, as well as herbal products).

Children may be more sensitive to the side effects of this medication, especially weight loss. This medication can slow a child’s growth. Your doctor may recommend temporarily stopping the medication from time to time to reduce this risk. Monitor your child’s weight and height. Ask your doctor or pharmacist for more information.

Older adults may be more sensitive to the side effects of this medication, particularly chest pain, sleep disturbances, or weight loss.

This medication should only be used during pregnancy if absolutely necessary. Discuss the risks and benefits with your doctor. Infants of mothers who are dependent on this medication may be born prematurely and with low birth weight. They may also experience withdrawal symptoms. Inform your doctor immediately if you notice mood swings, restlessness, or unusual tiredness in your newborn.

This medicine passes into breast milk and may have adverse effects on the infant. Therefore, breastfeeding is not recommended while using this medicine. Consult your doctor before breastfeeding.

storage

Store at room temperature, away from light and moisture. Do not store in the bathroom. Keep all medications out of the reach of children and pets.

Do not pour medication down the toilet or drain unless instructed to do so. Dispose of this product properly when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Interactions with other medications

Drug interactions can alter the way your medications work or increase the risk of serious side effects. This document does not list all possible interactions. Keep a list of all products you take (including prescription and nonprescription drugs, as well as herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medication without consulting your doctor.

Taking MAOIs with this medication can cause a serious (potentially fatal) interaction. Avoid taking MAOIs (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) while taking this medication. Most MAOIs should also not be taken for two weeks before starting treatment with this medication. Ask your doctor when to start or stop taking this medication.

Some products contain ingredients that can increase your heart rate or blood pressure. Inform your pharmacist about the products you are using and ask about their safe use (especially cough and cold remedies or diet aids).

The risk of serotonin syndrome/serotonin toxicity increases if you are also taking other medications that raise serotonin levels. Examples include street drugs such as MDMA/ecstasy, St. John’s wort, and certain antidepressants (including SSRIs such as fluoxetine/paroxetine and SNRIs such as duloxetine/venlafaxine). The risk of serotonin syndrome/serotonin toxicity may be higher at the start of treatment or when the dose of these medications is increased.

Dextroamphetamine is very similar to amphetamine or lisdexamfetamine. Do not take any medications containing amphetamine or lisdexamfetamine while taking dextroamphetamine.

This medication can interfere with certain medical/laboratory tests (including steroid levels in blood and urine, brain scans for Parkinson’s disease screening) and may lead to false test results. Make sure that laboratory personnel and all your doctors are aware that you are taking this medication.

Overdose:

In case of severe symptoms such as fainting or difficulty breathing, call 911. Otherwise, contact a Poison Control Center immediately. U.S. residents can call their local Poison Control Center at 1-800-222-1222. Canadian residents can call their provincial Poison Control Center. Symptoms of an overdose may include: severe mood swings, seizures, severe/persistent headaches, severe restlessness, and rapid breathing.

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