Dextroamphetamine (dexedrine)

Because it stimulates brain activity, Dexedrine can help patients focus much better, improve their listening skills, and help to manage specific behavioral problems.

Overview

Dextroamphetamine (Dexedrine) is a stimulant which has the effect of modifying levels of certain natural substances which are found in the brain, and because it can do this, it can have an impact on all the activities being directed by the brain. The effects the medication has can be very beneficial in managing certain behaviors that require modification. For instance, it can help a person become more organized and enhance their focus and listening skills, and it can help someone concentrate better on tasks they are given.

It is commonly used in the treatment of ADHD because of the way it improves concentration. Since it acts by stimulating the nervous system, dextroamphetamine can also be used to treat narcolepsy in patients who have the uncontrollable desire to fall asleep during the day, often at inopportune times. However, it should be noted that this medication is not intended to be an energy booster for those people who need stimulation to stay awake, or those who need extra energy for the accomplishment of an activity.

Dextroamphetamine (Dexedrine) can be taken with food or by itself, generally between one and three times daily, and always in accordance with the Medication Guide provided by the doctor or pharmacist. Every time you get a refill of this medication, it is advisable to read through this publication carefully, because your dosage may have changed, or the instructions about how it should be administered may have changed.

When you are on a program of treatment which includes this medication, your doctor may ask you to temporarily discontinue taking the drug, so your behavior can be observed, and so that he/she can determine if the medication is actually helping your condition. To obtain the greatest benefit from it, make sure to take each dosage at the prescribed interval, and ideally these times should be the same every day so that you remember to take the medication.

Condition Treated

  • ADHD, Narcolepsy

Type Of Medicine

  • Stimulant for central nervous system

Side Effects

Your doctor has prescribed dextroamphetamine because it is his/her judgment that the benefits imparted by this medication significantly outweigh any risk of side effects that may accrue when you are taking the drug. Still, there are some side effects which should be looked for because they have the potential to become serious medical conditions. It is impossible to predict how individual patients will react to a medication, and it is therefore possible for you to experience severe side effects when very few other patients have those same side effects. On the other hand, many of the side effects experienced by other patients won't appear at all in your case. Since the appearance of side effects cannot be predicted from one patient to another, it will be necessary for you to self-monitor after taking this medication. If any of the side effects listed below do appear in your case, contact your doctor right away, and describe the symptoms as well as their severity:

  • Nausea and/or vomiting
  • Upset stomach
  • Severe cramps
  • Persistent diarrhea
  • Headaches and/or fevers
  • Nervousness or irritability
  • Loss of appetite
  • Difficulty sleeping
  • Disorientation or dizziness
  • Sudden unexplained weight loss
  • Restlessness or agitation
  • Elevated blood pressure
  • Numbness, coldness, pain or skin discoloration in the extremities
  • Unexplained sores which appear on the toes or fingers
  • Behavioral changes or mood changes which you did not have before, for instance aggression, depression, agitation, hallucinations, or suicidal thoughts
  • Uncontrolled muscle movements such as shaking or twitching
  • Inappropriate outbursts of sounds or words
  • Changes in sexual performance or interest
  • Swelling in the feet or around the ankles
  • Severe fatigue or tiredness
  • Requent erections which tend to be prolonged
  • Shortness of breath or other difficulty breathing
  • Pain in the arms, jaw, or chest
  • A sensation that you are about to faint
  • Heartbeat which is either unusually fast, seems to be pounding, or is otherwise irregular
  • Convulsions or seizures
  • Vision which is either blurry or double vision
  • Confusion or disorientation
  • Speech that sounds slurred or confused
  • Pronounced weakness on one or the other sides of the body.

It is also possible that dextroamphetamine can trigger a very serious medical condition known as serotonin syndrome. There is an even greater chance of this kind of toxicity occurring if you are concurrently ingesting other drugs which interact with dextroamphetamine. You should seek medical attention immediately if you experience any of the following symptoms, as they may be associated with serotonin syndrome toxicity:

  • Extreme agitation
  • Unexplained fever
  • Severe dizziness
  • Hallucinations
  • Faster heartbeat than normal
  • Persistent nausea or vomiting
  • Severe diarrhea
  • Muscular twitching

It's also possible that you may find you are allergic to dextroamphetamine, and that you are experiencing some of the classic symptoms of an allergic reaction. These can be severe and can even worsen to the point where they become life-threatening, so you need to seek immediate medical attention if you suspect that you are having an allergic reaction to dextroamphetamine. Here are the side effects you should look for that indicate an allergic reaction:

  • The appearance of rashes or hives
  • Severe itching in various locations around the body
  • Sudden difficulty with breathing
  • Extreme dizziness or disorientation
  • Swelling in the area of the face or on the lips, tongue, or throat.

Dosage

Like most medications, dextroamphetamine is always prescribed at the lowest possible dosage which will still be effective in managing the medical condition the patient's being treated for. Regardless of what condition you're being treated for, you should avoid taking dextroamphetamine anywhere near bedtime, because it is very likely to inhibit your sleeping patterns.

For adult patients being treated for attention deficit disorder with hyperactivity (ADHD), a standard dosage would be to start with 5 mg either once a day or twice a day. Depending on the patient's reaction, it may be necessary to increase the dosage by 5 mg increments each week until the desired response is obtained. Although the daily dosage can be incremented weekly in this fashion until positive effects are observed in the patient, it is rarely necessary to prescribe a dosage as high as 40 mg daily or higher.

For most patients with ADHD, there will be positive results obtained with a dosage of 30 mg daily or less. Many doctors will interrupt an ongoing treatment program periodically to determine if sufficiently positive effects have been obtained. They will then decide if the treatment can be discontinued, or if the dosage can be lowered.

It is rare for any ADHD patient below the age of six years old to be prescribed a program of treatment which includes dextroamphetamine, so there is no standardized dosage for this age group. For children aged seven and above, the 5 mg initial dosage will generally be a good starting point, and your doctor will be very careful about incrementing that initial dosage as the treatment program continues.

Adults being treated for narcolepsy will generally start out with a 10 mg per day dosage, with a maximum daily dosage of 60 mg indicated, although these will be in divided doses, administered two or three times throughout the day. Narcolepsy only rarely afflicts children under the age of 12, but dextroamphetamine can be used relatively safely in these cases.

Children at this young age however, will be kept as close to the 5 mg dosage as possible while the medical condition can still be treated. When it is necessary to increase the dosage for children up to age 18, increments are generally in the 5 mg area, while for adult patients being treated for narcolepsy, 10 mg increments are more likely. When any kind of troublesome or uncomfortable side effects begin to appear for adults or children, your doctor will probably recommend a decrement in the daily dosage.

Interactions

There are a number of possible interactions with other medications and other medical conditions for patients being treated with dextroamphetamine. This makes it very important that you compile a list of all other medications you are currently taking, so that your doctor has the opportunity to review this list and spot any potential interactions beforehand.

When preparing this list, make sure to include all your other prescription medications, herbal supplements, vitamins, and over-the-counter drugs, as well as the dosages of each one. This will also be essential if you need to visit the emergency room or some health care clinic for unscheduled treatment of a medical condition. Any doctor at a facility like this will be able to safely prescribe treatment for your emergency medical condition if he/she has an understanding of all your other medications and dosages.

Some of the drugs which are known to interact with dextroamphetamine are the following:

  • Safinamide, sibutramine, tranylcypromine, methylene blue, rasagiline, selegiline, moclobemide, linezolid, isocarboxazid, furazolidone, iproniazid, phenelzine, procarbazine, donepezil.

Warnings

There are a number of precautions or warnings associated with taking dextroamphetamine. First among these is the potential for an allergic reaction, so if you know you are allergic to dextroamphetamine or any of the ingredients used in its manufacture, make sure to tell your doctor beforehand, since the consequences can be fairly severe.

In addition, if you know that you are allergic to any other kinds of medication, or to pets, fabrics, preservatives or foods, make sure to point this out to your doctor as well. It is possible for some of the inactive ingredients in dextroamphetamine to react with your other allergic tendencies.

No extensive studies have been conducted to determine the relationship between dextroamphetamine tablets and the treatment of children at a very young age, for instance three years and younger. Since no safety factor has been established, it is considered inadvisable to treat younger ADHD patients with this medication.

Likewise, there is no information available which suggests that there are any safety issues related to prescribing dextroamphetamine to geriatric patients. While it is unlikely that there would be a safety issue with prescribing this medication to older patients, it should still be based on a doctor's recommendation in individual cases.

With regard to women who are pregnant, or think they may become pregnant while being treated with dextroamphetamine, a full discussion should be had with your doctor. The limited information available from studies shows that there can be harmful effects on unborn infants while the mother is being treated with dextroamphetamine.

By the same token, studies conducted on women who are breastfeeding have also shown harmful effects can be imparted to the infant, since dextroamphetamine traces are passed on through breast milk. For this reason, women should not be breastfeeding while being treated with dextroamphetamine, or an alternative medication should be found which is not passed on through breast milk.

It is also inadvisable to be eating food, or to consume alcohol or tobacco when taking dextroamphetamine, since there are various interactions possible which could cause discomfort to the consumer.

Dextroamphetamine is very similar in composition to amphetamine and lisdexamfetamine, so neither of these two medications should be taken in conjunction with Dexedrine, because it could have the effect of compounding the impact of your medicine and triggering some unwanted side effects. In that same vein, if you should ingest any street drugs which include serotonin, such as 'Ecstasy', fluoxetine, paroxetine, duloxetine, venlafaxine, or St. John's wort, it can significantly increase the possibility of serotonin toxicity.

There is a risk that dextroamphetamine can interfere with certain laboratory results, so if you are asked to have bloodwork drawn at any time while you are being treated with this medication, the results may be skewed somewhat. In particular, the levels of steroids in the blood and urine may be a little off-kilter, as well as any brain scans which might be taken for Parkinson's disease or for other reasons. When you go in for tests like these, make sure the laboratory personnel are aware that you're taking dextroamphetamine.

Some patients have been known to ingest more dextroamphetamine than a doctor has recommended, or they may have doubled up on their medication in an effort to 'catch up' after missing a dose or two. If you suspect that you or someone you know has overdosed on this medication, call the Poison Control Center nearest to you immediately, and ask for instructions. Be prepared to tell them how much of the drug has been ingested, and what the time interval is since the last dosage.

Patients who have certain existing medical conditions may not be good candidates for treatment with dextroamphetamine because of adverse reactions which may occur with the medication. Before being prescribed a program of treatment with dextroamphetamine, your doctor will undertake a review of your medical history with you, and at this time, you should point out to him/her any past history you've had with any of these medical conditions:

  • Seizures or convulsions
  • Thyroid problems
  • Drug abuse
  • Glaucoma
  • Anxiety or agitation
  • Arteriosclerosis
  • Heart attack or heart failure
  • Any kind of blood vessel disease such as cardiomyopathy
  • High blood pressure, either moderate or severe
  • Hyperthyroidism
  • Strokes
  • Severe tension
  • Coronary artery disease
  • Psychosis or mania
  • Depression
  • Raynaud's disease
  • Tourette's syndrome
  • Bipolar disorder or any kind of manic depressive symptoms.

Taking dextroamphetamine when you have a medical history that includes any of these conditions, can cause them to return and to become much worse than they were originally.

Storage

It's very important that dextroamphetamine be kept out of the reach of small children and/or pets to avoid the possibility of accidental ingestion. The safest location is one which will be so high up that it's out of the reach of a small child, even if he/she were to climb up on furniture to try and access it. This medication should also not be kept in a weekly pill reminder, because there are seldom any safety features on these containers to prevent or inhibit access.

The room where your medication is stored should be free of temperature extremes, and there should be no excessive humidity in the room. For that reason, bathrooms are not good places to store dextroamphetamine, since they routinely get hot and humid during showering and bathing sessions. Make sure your medication is never allowed to freeze either.

You should not take expired medication, and once it has expired you should discard of it properly ' not by flushing it down the sink or toilet. Your doctor or pharmacist can advise you on proper disposal methods, and if that isn't convenient, you can contact your local medication take-back program to surrender your unused dextroamphetamine. There is also a website maintained by the FDA for the safe disposal of medicines, and you can consult this for proper disposal methods.

Summary

Dextroamphetamine (Dexedrine) is a prescription medication commonly used in the treatment of narcolepsy and attention deficit disorder with hyperactivity (ADHD). The drug works by altering the levels of certain substances in the brain, and this alteration facilitates greater concentration and focus in the user, so that normal tasks and activities can be addressed more easily.

Because it is basically a stimulant which acts on the nervous system, it can also be very effective in treating narcolepsy, wherein a patient frequently falls asleep during the daytime and is unable to stave off the sleeping sessions. For that same reason, it should not be taken close to bedtime, because the stimulant component of the medication is likely to prevent the consumer from falling asleep as normal.

There are some risks of several different kinds of side effects developing during treatment with this medication, some of which can be fairly severe. This makes it important to constantly monitor a patient for any kind of reaction to the drug, and to identify side effects as soon as possible, so adjustments can be made in dosage or to an alternative medication. Dextroamphetamine is also known to interact with a fairly large number of other drugs, so it becomes very important for the patient to review both their medical history and a list of other medications being taken with their doctor.