Yes

Stimulant

Treatment of narcolepsy; attention deficit/hyperactivity disorder (ADHD); exogenous obesity

C-II

C

Known hypersensitivity or idiosyncrasy to amphetamine or other sympathomimetic amines. Patients with advanced arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension (stage II or III), hyperthyroidism, glaucoma, diabetes mellitus, agitated states, patients with a history of drug abuse, and during or within 14 days following MAO inhibitor therapy. Stimulant medications are contraindicated for use in children with attention deficit/hyperactivity disorders and concomitant Tourette's syndrome or tics.

Use with caution in patients with bipolar disorder, cardiovascular disease, seizure disorders, insomnia, porphyria, or mild hypertension (stage I). May exacerbate symptoms of behavior and thought disorder in psychotic patients. Potential for drug dependency exists - avoid abrupt discontinuation in patients who have received for prolonged periods. Stimulant use in children has been associated with growth suppression.

Cardiovascular: Arrhythmia (high dose), palpitations, elevation in blood pressure, tachycardia, chest pain

Central nervous system: Overstimulation, restlessness, insomnia, dizziness, euphoria, dyskinesia, dysphoria, headache, exacerbation of motor incoordination, tics, Tourette's syndrome; may rarely see psychosis

Dermatologic: Urticaria

Endocrine & metabolic: Changes in libido

Gastrointestinal: Xerostomia, unpleasant taste, diarrhea, constipation; anorexia and weight loss may occur as undesirable effects when amphetamines aroused for other than anorectic effect

Genitourinary: Impotence

Neuromuscular & skeletal: Tremor

Miscellaneous: Delayed bone growth

There is no specific antidote for amphetamine intoxication and the bulk of the treatment is supportive

CYP2D6 enzyme substrate

Amphetamines may induce a hypertensive episode in patients receiving furazolidone and enhance the pressor response to norepinephrine. Amphetamines inhibit the antihypotensive response to guanethidine, and probably guanadrel. Severe hypertensive episodes have occurred with amphetamine when used in patients receiving MAOIs; avoid this combination.

The amphetamines are noncatecholamine sympathomimetic amines with CNS stimulant activity. They require breakdown by monoamine oxidase for inactivation; produce central nervous system and respiratory stimulation, a pressor response, mydriasis, bronchodilation, and contraction of the urinary sphincter; thought to have a direct effect on both alpha- and beta-receptor sites in the peripheral system, as well as release stores of norepinephrine in adrenergic nerve terminals. The central nervous system action is thought to occur in the cerebral cortex and reticular activating system. The anorexigenic effect is probably secondary to the CNS-stimulating effect; the site of action is probably the hypothalamic feeding center.

Onset of action: 1 hour

Duration: 4-24 hours

Oral:

Children:

6-12 years: 5 mg/day, increase by 5 mg at weekly intervals

>12 years: 10 mg/day, increase by 10 mg at weekly intervals

Adults: 5-60 mg/day in 2-3 divided doses

Attention deficit/hyperactivity disorder: Children:

3-5 years: 2.5 mg/day, increase by 2.5 mg at weekly intervals for maximum dose of 40 mg/day

>6 years: 5 mg/day, increase by 5 mg at weekly intervals not to exceed 40 mg/day

Short-term adjunct to exogenous obesity: Children >12 years and Adults: 10 mg or 15 mg long-acting capsule daily, up to 30 mg/day; or 5-30 mg/day in divided doses (immediate release tablets only)

Therapeutic: 20-30 ng/mL; Toxic: >200 ng/mL

Use vasoconstriction with caution in patients taking amphetamine sulfate. Amphetamines enhance the sympathomimetic response of epinephrine and norepinephrine leading to potential hypertension and cardiotoxicity.

No effects or complications reported

Take during day to avoid insomnia; do not discontinue abruptly, may cause physical and psychological dependence with prolonged use

Monitor CNS, dose should not be given in evening or at bedtime

Tablet, as sulfate: 5 mg, 10 mg