How does this medication work? What will it do for me?

Dextroamphetamine belongs to the family of medications known as stimulants. This medication is used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy (falling asleep at inappropriate times without any control). It works for treating narcolepsy by acting as a stimulant to the brain. The way that it helps people with ADHD has not been established.

Other measures (e.g., psychological, educational, and social therapies) are used along with dextroamphetamine as part of an overall treatment program for ADHD.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Spansules (sustained-release capsules)

10 mg
Each brown-capped, natural-coloured body taper-end capsule, with 2 shades of orange pellets, monogrammed "3513" on the cap with "10 mg" and "SB" on the body in white ink, contains dextroamphetamine sulfate 10 mg, and releases a therapeutic dose promptly with the remaining dose being delivered gradually and without interruption to sustain the effects for 10 to 12 hours. Nonmedicinal ingredients: cetyl alcohol, D&C Yellow No. 10, dibutyl sebacate, ethylcellulose, FD&C Blue No. 1, FD&C Blue No. 1 Aluminum Lake, FD&C Red No. 40, FD&C Yellow No. 6, gelatin, hydroxypropyl methylcellulose, propylene glycol, povidone, silicon dioxide, sodium lauryl sulfate, sugar spheres, and trace amounts of other inactive ingredients.

15 mg
Each brown-capped, natural-coloured body taper-end capsule, with 2 shades of orange pellets, monogrammed "3514" on the cap with "15 mg" and "SB" on the body in white ink, contains 15 mg of dextroamphetamine sulfate, and releases a therapeutic dose promptly with the remaining dose being delivered gradually and without interruption to sustain the effect for 10 to 12 hours. Nonmedicinal ingredients: cetyl alcohol, D&C Yellow No. 10, dibutyl sebacate, ethylcellulose, FD&C Blue No. 1, FD&C Blue No. 1 Aluminum Lake, FD&C Red No. 40, FD&C Yellow No. 6, gelatin, hydroxypropyl methylcellulose, propylene glycol, povidone, silicon dioxide, sodium lauryl sulfate, sugar spheres, and trace amounts of other inactive ingredients.

Tablets

5 mg
Each orange, round-cornered, equilaterally triangular shaped, scored, compressed tablet engraved with the Paladin shield logo contains 5 mg of dextroamphetamine sulfate. Nonmedicinal ingredients: calcium sulfate, gelatin, lactose, FD&C Yellow No. 6, FD&C Yellow No. 5, starch, stearic acid, sucrose, and talc.

How should I use this medication?

This medication should be started at the lowest possible dose and increased slowly.

For narcolepsy, the daily dosage may range from 5 mg to 60 mg daily depending on individual response.

For attention deficit hyperactivity disorder, the daily dosage may range from 2.5 mg to 40 mg daily for best response.

Dextroamphetamine is not recommended for children under 6 years of age.

The timing of this medication is very important. Generally, a long-acting form of the medication would not be taken in the evening, as it may interfere with sleep.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by the doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take dextroamphetamine if you:

  • are allergic to dextroamphetamine or any ingredients of the medication
  • are allergic to other medications of the same class
  • are in an agitated state
  • are experiencing anxiety or tension
  • have a history of drug abuse
  • have an overactive thyroid gland (hyperthyroidism)
  • have advanced hardening of the arteries
  • have glaucoma (increased pressure in the eye)
  • have heart disease
  • have moderate-to-severe high blood pressure
  • have motor tics
  • have a history or family history of Tourette’s syndrome

This medication should not be used at the same time as, or within 14 days after taking, MAO inhibitors such as phenelzine or tranylcypromine.

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • dizziness
  • dry mouth, unpleasant taste
  • headache
  • irritability or mood swings
  • loss of appetite
  • stomach upset
  • tremor
  • trouble sleeping

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • abnormal thoughts or behaviour, hallucinations, or delusions
  • anxiety
  • behavior changes
  • increased blood pressure
  • leg swelling accompanied by breathlessness
  • palpitations (feeling your heart beat quickly or irregularly)
  • slowed growth
  • symptoms of depression (e.g., losing interest in your usual activities, feeling sad, having thoughts of suicide)
  • symptoms of Raynaud’s syndrome (e.g., discolouration, coldness or numbness of fingers or toes)
  • vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • seizures
  • symptoms of a serious allergic reaction (e.g., hives, swelling of the face and throat, difficulty breathing)
  • thoughts of hurting or killing yourself

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

HEALTH CANADA ADVISORY

March 30, 2015

Health Canada has issued new restrictions concerning the use of drugs used in the management of Attention Deficit Hyperactivity Disorder (ADHD). To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

Allergies: Dextroamphetamine products contain atrazine, which can cause allergic-type reactions (including bronchial asthma). People who are allergic to salicylates are often allergic to tartrazine. Speak to your doctor about the risks and benefits of using this medication.

Drowsiness/reduced alertness: This medication may disguise extreme fatigue, which can impair the ability to perform potentially hazardous activities such as driving or operating machinery. Do not drive or engage in other activities requiring alertness if the medication affects you in this way.

Drug dependence: Abuse of dextroamphetamine is possible by certain individuals. Tolerance, extreme psychological dependence, and severe social disability can occur with abuse of this medication. If you have a history of drug or alcohol dependence, your doctor should carefully monitor your condition while you are using this medication.

Exercise: If you participate in strenuous exercise or activities, consult your doctor before taking dextroamphetamine.

Heart problems: This medication can increase heart rate and blood pressure. It may also increase the risk of sudden death for people with heart problems. If you have a heart problem, including an irregular heartbeat, or a family history of sudden death related to heart disease, your doctor should carefully evaluate you before you start taking this medication, and should closely monitor your condition if you take the medication. This medication should generally not be used by people with known structural heart abnormalities (such as abnormal size, missing or poorly functioning heart valves, or problems with blood vessels connected to the heart).

High blood pressure: Dextroamphetamine may increase blood pressure. If you have high blood pressure or heart problems, talk to your doctor before taking this medication.

Long-term use: If you use this medication for a long period of time, you will need regular heart check-ups by your doctor.

Psychiatric problems: Tell your doctor about any mental health problems you or your child have, or about any family history of bipolar disorder, depression, or suicide. This medication may increase the risk of mental health (psychiatric) problems. Problems include new or worse behaviour and thought problems, bipolar disease, depression, aggressive behaviour, and hostility. Children and adolescents may also experience new psychotic symptoms (e.g., paranoia or hallucinations) or new mania symptoms (e.g., delusions, hyperactivity). If you experience these types of symptoms while taking dextroamphetamine, contact your doctor immediately.

Seizure: Dextroamphetamine may increase the risk of having seizures, particularly if you have had seizures in the past. If you have a history of seizures or a seizure disorder, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Stopping the medication: People who abruptly stop taking this medication sometimes experience difficulty sleeping, extreme tiredness, and depression. Check with your doctor before stopping this medication.

Suicidal or agitated behaviour: People taking this medication may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur at any time during treatment with this medication, although it is seen most commonly at the beginning of treatment or when the dose is increased. If you experience these side effects or notice them in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.

Suppression of growth: Growth suppression (less increase in height or weight than expected) has been reported for children using stimulants such as dextroamphetamine for long periods of time. It is not known if the medication causes the growth suppression. However, children who need long-term therapy should be carefully monitored for growth. Their doctor may also recommend a "drug holiday," where the medication is not given on weekends or during school holidays.

Vision: Rarely, people taking dextroamphetamine have experienced vision changes. If you notice any changes in your vision, contact your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: Dextroamphetamine passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding. Women taking this medication should not breast-feed.

Children: The safety and effectiveness of using this medication have not been established for children less than 6 years of age.

What other drugs could interact with this medication?

There may be an interaction between dextroamphetamine and any of the following:

  • acetazolamide
  • other medications for ADHD (e.g., atomoxetine, methylphenidate, lisdexamphetamine)
  • antacids (e.g., aluminum hydroxide, calcium carbonate, magnesium hydroxide)
  • antihistamines (e.g,. cetirizine, doxylamine, diphenhydramine, hydroxyzine, loratadine)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  • atomoxetine
  • barbiturates (e.g., phenobarbital)
  • beta-blockers (e.g., propranolol)
  • bromocriptine
  • fast acting bronchodilators (e.g., salbutamol, terbutaline)
  • long acting bronchodilators (e.g., formoterol, salmeterol)
  • buspirone
  • cabergoline
  • caffeine
  • cyclobenzaprine
  • decongestant cold medications (e.g., phenylephrine, pseudoephedrine)
  • decongestant eye drops and nose sprays (e.g., naphazoline, oxymetazoline, xylometazoline)
  • desvenlafaxine
  • dextromethorphan
  • dipivefrin
  • dronabinol
  • epinephrine
  • ergot alkaloids (e.g., ergotamine, dihydroergotamine)
  • ethosuximide
  • hydrochlorothiazide
  • linezolid
  • lithium
  • MAO inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
  • medications that treat high blood pressure
  • methadone
  • methenamine
  • multivitamin and mineral supplements
  • nabilone
  • narcotic pain relievers (e.g., codeine, fentanyl, morphine, oxycodone)
  • nefazodone
  • phenytoin
  • proton pump inhibitors (e.g., lansoprazole, omeprazole)
  • serotonin antagonists (anti-emetic medications; e.g., granisetron, ondansetron)
  • serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
  • selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, duloxetine, fluoxetine, paroxetine, sertraline)
  • sodium bicarbonate
  • St. John's wort
  • tapentadol
  • topiramate
  • tramadol
  • trazodone
  • tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
  • "triptan" migraine medications (e.g., eletriptan, sumatriptan)
  • tryptophan
  • urinary tract acidifiers (e.g., ammonium chloride) and alkalinizers (e.g., potassium citrate)
  • venlafaxine
  • vitamin C

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2017. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Dexedrine