DEXTROAMPHETAMINE

(Dexedrine, Dexedrine Spansule, Adderall XR (Mixed Amphetamine Salts))

Standard Prescription

dextroamphetamine IR__mg__(frequency)

dextroamphetamine XR__mg__(frequency)

Dosages

ADHD:
Dextroamphetamine (Dexedrine)

>= 6 years old: 5 mg/24 hr PO QAM; increase by 5 mg/24 hr at weekly intervals to a maximum of 30 mg/24 hr. Some adults may require doses as high as 50 mg/24 hr.

Usual maintenance dose: 0.1-0.5 mg/kg/24 hr

IR: div. BID-TID during waking hours

Spansule: once daily qAM or div. BID during waking hours

Mixed Amphetamine Salts (Adderall XR, other XR)

6-12 years old:
Initial: 5-10 mg PO QAM. May increase in 5-10 mg increments at weekly intervals to maximum of 30 mg/24 hr.

>12 years old:
Initial: 10 mg PO QAM. May increase in 10 mg increments at weekly intervals to usual maximum of 30 mg/24 hr.

Doses up to 50 mg/24 hr have been studied in adults and adolescents.

Mechanism of Action

CNS stimulant. Activates TAAR1 increasing cAMP production via adenylyl cyclase activation and inhibits the function of the dopamine transporter, norepinephrine transporter, and serotonin transporter, preventing re-uptake, as well as inducing the release of these monoamine neurotransmitters

Forms Supplied

Dextroamphetamine
Tablet (Dexedrine): 5 mg (immediate release (IR)).
Capsule (Spansule): 10 mg, 15 mg (sustained release).

Mixed Amphetamine Salts Capsule (Adderall XR, other XR):
5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg
(extended release)

Comments

Adverse effects may include insomnia, restlessness, increased aggression, anorexia, anxiety, dysphoria/sadness, psychosis, headache, vomiting, abdominal cramps, dry mouth, growth suppression, arrhythmias, increased blood pressure, may cause/worsen tics, stereotypic movements Use with caution in patients with cardiovascular disease including structural abnormalities, hypertension, arrhythmias and personal/family history of sudden cardiac death: monitor heart rate and blood pressure. Obtain ECG prior to starting treatment in patients with identified cardiac abnormalities/risk profile.

Dexedrine Spansules and Adderall XR contain 50% immediate release granules and 50% delayed release granules.

Dexedrine Spansules and Adderall XR capsules may be opened and the contents sprinkled on a soft food (e.g. yogurt, pudding) for easier administration.

Amphetamine derivatives are commonly abused, and have a significant street value.

Prescribers must be aware of warnings issued by Health Canada regarding the use of ADHD medications. Refer to the Health Canada website.

References

44, 83, 112, 160, 234

Last Edited

2021-08-02 05:18:47