Amphetamine:
Mixed Amphetamine Salts/Dextroamphetamine/Lisdexamfetamine
Brand
names:
Adderall® (mixed amphetamine salts) – immediate release
-
Tablets: 5 mg, 7.5 mg,
10 mg, 12.5 mg, 15 mg, 20 mg, 30 mg
Adderall
XR® (mixed amphetamine salts) – extended release
-
Capsules: 5 mg, 10 mg,
15 mg, 20 mg, 25 mg, 30 mg
Dexedrine® (dextroamphetamine) – immediate release
-
Tablets: 5 mg
-
Elixir: 1 mg/mL
Dexedrine
Spansules® (dextroamphetamine) – sustained release
Vyvanse® (lisdexamfetamine)
-
Capsules: 20 mg, 30 mg,
40 mg, 50 mg, 60 mg, 70 mg
Generic
name: amphetamine (am
FET a meen)
Medication
class: Amphetamine, central nervous system (CNS) stimulant
All FDA black box
warnings are at the end of this fact sheet. Please review before
taking this medication.
What
are Adderall®,
Dexedrine®,
Vyvanse® and what do they treat?
Amphetamine,
mixed amphetamine salts, dextroamphetamine, and lisdexamfetamine are
prescription medications that are used to treat individuals with
attention-deficit hyperactivity disorder (ADHD). These medications
are also known as stimulants.
Symptoms
of ADHD interfere with an individual’s ability to function at
school or work or in social settings and include:
-
Inattention
(e.g., making careless mistakes, losing things necessary for tasks)
-
Hyperactivity
(e.g., inability to sit still)
-
Impulsivity
(e.g., interrupting or intruding on others)
Hyperactivity
is less common in adults. A person may have severe inattention
without hyperactivity or impulsivity.
Stimulants
are used in addition to non-medication treatments to manage ADHD
symptoms.
What
is the most important information I should know about Adderall®,
Dexedrine®,
Vyvanse®?
Although
some symptoms may improve within days of starting stimulants, it may
take several weeks before you notice the full benefits of the
medication.
Are
there specific concerns about Adderall®,
Dexedrine®,
Vyvanse® and pregnancy?
If
you are planning on becoming pregnant, notify your healthcare
provider to best manage your medications. People living with ADHD
who wish to become pregnant face important decisions. There is very
little information available regarding the risks of stimulants in
pregnancy when taken as prescribed for ADHD. Abuse of stimulants
(i.e., taking without a prescription or taking more than prescribed)
has been associated with premature delivery, low birth weight, and
neonatal withdrawal symptoms. Untreated ADHD may be associated with
increased risk of substance use. It is important to discuss the
risks and benefits of treatment with your doctor and caregivers.
Stimulants
are not recommended with breastfeeding according to the American
Academy of Pediatrics. Stimulants may concentrate in breast milk and
have negative effects on the infant.
What
should I discuss with my healthcare provider before taking Adderall®,
Dexedrine®,
Vyvanse®?
-
Symptoms
of your condition that bother you the most
-
If
you have thoughts of suicide or harming yourself
-
If
you experience side effects from your medications, discuss them with
your provider. Some side effects pass with time, but others may
require changes in the medication.
-
Any
other psychiatric or medical problems you have, including heart
disease
-
All
other medications you are currently taking (including over the
counter products, herbal and nutritional supplements) and any
medication allergies you have
-
Other
non-medication treatment you are receiving, such as talk therapy or
substance abuse treatment. Your provider can explain how these
different treatments work with the medication.
-
If
you are pregnant, plan to become pregnant, or are breast-feeding
-
If
you drink alcohol or use drugs
How
should I take Adderall®,
Dexedrine®,
Vyvanse®?
Stimulants
are usually taken 1 to 2 times per day with or without food.
-
Tablets
(Dexedrine®,
Adderall®):
Swallow the tablets whole. Chewing the tablets gives an unpleasant
taste and can irritate the mouth and throat.
-
Sprinkle
capsules (Adderall XR®,
Dexedrine Spansule®):
Swallow whole or sprinkle onto food, such as applesauce or pudding
and eat immediately. Do not chew sprinkle capsules or contents.
-
Long-acting
capsules (Vyvanse®):
Swallow whole or open capsule and mix contents with water. Use all
of the powder from the capsule. Drink entire glass of water right
away after mixing.
-
Liquid
(Dexedrine®):
Measure with a dosing spoon or oral syringe which you can get from
your pharmacy
The
dose of stimulant medication is variable. Only your healthcare
provider can determine the correct dose for you.
Use
a calendar, pillbox, alarm clock, or cell phone alert to help you
remember to take your medication. You may also ask a family member
or friend to remind you or check in with you to be sure you are
taking you medication.
What
happens if I miss a dose of Adderall®,
Dexedrine®,
Vyvanse®?
If
you miss a dose of stimulant,
take
it as soon as you remember if it is still early in the day. Do
not take a missed dose after 5:00 PM, as this may interfere with
sleep. Do not take a missed dose of extended-release capsules after
2:00 PM, as this may interfere with sleep.
Discuss missed doses with your healthcare provider. Do not double
your next dose or take more than what is prescribed.
What
should I avoid while taking Adderall®,
Dexedrine®,
Vyvanse®?
Avoid
drinking alcohol or using illegal drugs while you are taking this
medication. They may decrease the benefits (e.g., worsen your
condition) and increase adverse effects (e.g., sedation) of the
medication.
What
happens if I overdose with Adderall®,
Dexedrine®,
Vyvanse®?
If
an overdose occurs call your doctor or 911. You may need urgent
medical care. You may also contact the poison control center at
1-800-222-1222.
A
specific treatment to reverse the effects of stimulants
does not exist.
What
are the possible side effects of Adderall®,
Dexedrine®,
Vyvanse®?
Common
Side Effects
Rare
Side Effects
Contact
your healthcare provider if any of the following occur while taking
stimulants:
-
Significant
increases in blood pressure or heart rate, shortness of breath,
fatigue
-
Severe
anxiety, panic attacks, mania, hallucinations, paranoia or delusions
Serious
Side Effects
Misuse
of amphetamine medications may cause sudden death and serious
cardiovascular adverse events. Amphetamine medications should be
avoided in individuals who have a heart defect (structural
abnormality), uncontrolled high blood pressure, or other disorder of
heart.
Are
there any risks for taking Adderall®,
Dexedrine®,
Vyvanse® for long periods of time?
Stimulants are
Schedule II controlled substances. There is a risk of physical
and/or emotional dependence (addiction) when they are taken for long
periods of time.
Although
treatment with stimulant medications can slow growth, many studies
have shown that these changes are small. Children may catch up with
growth over time; therefore, it should not be a concern for most
children. Height, weight, and eating habits should be discussed
before treatment starts and regularly during treatment. If you are
concerned about your child’s growth, discuss other possible
treatments with your child’s doctor.
What
other medications interact with Adderall®,
Dexedrine®,
Vyvanse®?
Medications
used to treat depression can interact with amphetamine medications
resulting in serious reactions including high body temperature, high
blood pressure, and seizures (convulsions). Tell your healthcare
provider if you are beginning or have recently discontinued any of
these medications.
Stimulants
should not be taken with or within 2 weeks of monoamine oxidase
inhibitor antidepressants (MAOIs), including phenelzine (Nardil®),
Tranylcypromine (Parnate®),
selegiline (Emsam®), and isocarboxazid
(Marplan®)
or the
antibiotic linezolid (Zyvox®). Taking stimulants with or within 2 weeks of MAOIs can result in seizures,
fever or dangerously
high blood pressure that can lead to death.
The
following medications may increase the levels and/or effects of amphetamine medications:
-
Increase
levels:
Antacids (e.g., sodium bicarbonate, calcium carbonate [Tums®]),
acetazolamide
-
Increase
side effects: Atomoxetine
(Strattera®),
caffeine, phenylephrine, fluoxetine (Prozac®),
bupropion (Wellbutrin®),
venlafaxine (Effexor®),
duloxetine (Cymbalta®),
Modafinil (Provigil®),
and armodafinil (Nuvigil®)
The
following foods/medications may decrease the levels and effects of amphetamine medications: ascorbic acid
(vitamin C), acidic beverages (e.g., orange juice, grapefruit juice)
Stimulant
medications may decrease the effects of blood pressure medications.
How
long does it take for Adderall®,
Dexedrine®,
Vyvanse® to work?
Although
you may experience beneficial effects from stimulants within a few
days of starting the medication, it often takes several weeks to get
the full effect of the medication. Your healthcare provider may also
need to gradually adjust the dose to find the dose that works best
for you.
Provided
by the College of Psychiatric and Neurologic Pharmacists
(January
2013)
Summary
of Black Box Warnings
Sudden
Cardiac Death
Misuse
of amphetamines may cause sudden death or serious cardiovascular
adverse events.
Dependence
Amphetamines
have a high potential for abuse. Prolonged use of amphetamines may
lead to drug dependence. Particular attention should be paid to the
possibility of subjects obtaining amphetamines for non-therapeutic
use or distribution to others. They should be prescribed or
dispensed sparingly.
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