Class: CNS Stimulant. C-II
Dosage Forms. Tablet: 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, 30 mg; Capsule, Extended Release: 5 mg, 10 mg, 15 mg, 20 mg, 25mg, 30 mg
Common FDA Label Indication, Dosing, and Titration.
1. Attention deficit hyperactivity disorder: Adults, extended release, 20 mg po daily; Children, immediate release (age 3-5 y), initial 2.5 mg po daily in am; extended release (6 y and older), initial 10 mg po daily in am
2. Narcolepsy: Adults, immediate release, 5-60 mg/d po in divided doses; Children, immediate release (age 6-12 y) initial, 5 mg po daily, immediate release (age 12 y and older) initial, 10 mg po once daily
Off-Label Uses. None
MOA. Amphetamines are non-catecholamine sympathomimetic amines with CNS stimulant activity. Amphetamines are thought to block the reuptake of norepinephrine and dopamine into the presynaptic neuron and increase the release of these monoamines into the extraneuronal space.
Drug Characteristics: Amphetamine
Medication Safety Issues: Amphetamine
Drug Interactions: Amphetamine
Adverse Reactions: Amphetamine
Efficacy Monitoring Parameters. Resolution of signs of ADHD; patients should have improved attention span and reduced impulsivity.
Toxicity Monitoring Parameters. BP, heart rate, and weight. Chest pain, seizures, heart palpitations, changes in behavior or personality, hostility.
Key Patient Counseling Points. Avoid late evening doses due to resulting insomnia. Extended-release capsules may be swallowed whole with or without food. The entire capsule contents may be sprinkled on applesauce and consumed immediately; the applesauce with sprinkled beads should be consumed in its entirety without chewing. Do not divide the dose of a single capsule.
Clinical Pearls. Amphetamines have a high potential for abuse, and administration for prolonged periods of time may lead to drug dependence and must be avoided. Misuse of amphetamines may cause sudden death and serious cardiovascular adverse events. Not recommended for weight loss.