Amphetamine is one of the first-choice treatments that's used for attention deficit-hyperactivity disorder (ADHD). This medication has a few brand names (e.g., Evekeo, Dynavel XR, Adzenys). It's available in many dosage forms: immediate-release tablets, extended-release tablets, orally disintegrating tablets (ODTs), and oral liquids. Possible side effects include difficulty sleeping, loss of appetite, and high blood pressure. It's important to take amphetamine as prescribed to avoid overdose or withdrawal symptoms (e.g., daytime sleepiness, larger appetite, agitation).
Attention deficit-hyperactivity disorder (ADHD) - immediate-release, extended-release, and ODTs
Narcolepsy (daytime sleepiness) - immediate-release tablets only
Short-term add-on treatment for obesity - immediate-release tablets only
Amphetamine is a stimulant medication. It's not exactly known how amphetamine helps to improve attention and focus. But it's thought to work by raising the levels of chemicals in your brain called norepinephrine, dopamine, and serotonin.
Amphetamine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: History of substance or alcohol use disorder | Taking more amphetamine than prescribed | Long-term use | Suddenly stopping amphetamine
Amphetamine has a risk of misuse. Misusing amphetamine raises your risk for addiction and other serious side effects, such as high heart rate or blood pressure, depression, nightmares, aggressive behavior, and even thoughts of hurting yourself or others. In addition, if you take amphetamine regularly for a long period of time, you can start to rely on the medication to function normally. When you're physically dependent on the medication, you're more likely to have withdrawal symptoms, like irritability, nightmares, and sleep problems, if you suddenly stop taking the medication.
To lower your risk of misuse, addiction, dependence, and withdrawal, take amphetamine exactly as prescribed to you. Don't change the dose or how often you take it without talking to your provider first.
Risk factors: History of heart problems
There have been reports of sudden death, stroke, and heart attack in people who took stimulants like amphetamine at normal doses. This medication can also raise your blood pressure and heart rate. Tell your provider if you have a history of heart problems before starting amphetamine to make sure it's safe for you to take. Your provider will check for heart problems before you start this medication. Tell your provider if you experience unexplained fainting, chest pain with physical activity, or irregular heartbeat while you're taking amphetamine.
Risk factors: History of psychotic episodes or other manic psychiatric conditions
Taking a stimulant like amphetamine can cause new or worsening mental health problems such as hallucinations (seeing things that aren't really there), aggressive behavior, unclear thinking, and mania. This can sometimes happen in someone who previously didn't have any mood problems. If you develop these mood or behavior symptoms while taking amphetamine, talk to your healthcare provider right away because you might have to stop taking it.
Stimulants like amphetamine have been linked to weight loss and a slowed growth rate (both height and weight) in children. Your child's provider will keep track of your child's growth closely to see if this becomes a problem. And if there's too much weight loss or if their growth rate is affected, the provider might pause or stop amphetamine treatment for your child. Talk to your child's provider if you notice a big amount of weight loss in your child or if you have concerns.
Risk factors: History of seizures | High risk of seizures
Although rare, stimulants like amphetamine can cause you to have seizures more easily, particularly if you've had seizures before. If this happens, seek medical help right away. You'll probably have to stop taking amphetamine.
Amphetamine can cause a condition called Raynaud's phenomenon, which can lower blood flow to your fingers and toes. This can cause your fingers and toes to change color from pale, to blue, to red and feel cold, numb, or painful. If this happens, it's usually mild and happens occasionally. But rarely, it can cause sores to form and the tissue to become damaged. Let your provider know if you experience any of these symptoms. Usually, they get better after your provider lowers your amphetamine dose or after you stop the medication.
Risk factors: Taking monoamine oxidase inhibitors (MAOI) within 14 days of amphetamine | Taking other medications that raise serotonin levels in your brain
Serotonin syndrome is a rare, but potentially life-threatening condition where there's too much serotonin in the brain. Serotonin is one of the chemicals in your brain responsible for your mood. Since amphetamine might raise your serotonin levels in the brain, your risk for this condition goes up if you use amphetamine with other medications that also affect serotonin levels. These medications can include antidepressants (e.g., sertraline (Zoloft), duloxetine (Cymbalta)), MAOIs (e.g., phenelzine (Nardil)), and certain migraine medications (e.g., sumatriptan (Imitrex)). Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, high fever, changes in behavior, and confusion. Get medical help right away if you have any of these symptoms.
Stimulants like amphetamine can cause blurred vision and other vision problems. Let your provider know if you notice any changes with your vision.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
One of the first-choice treatments for ADHD
Available in many dosage forms (tablets, dissolvable tablets, liquid)
Some forms available as lower-cost generic medications
Can be used in children
Works within 1 hour for most people to treat symptoms of ADHD
Has a risk of misuse and dependence
Is a controlled substance so there can be special requirements for filling a prescription
Orally disintegrating tablets are only available as a brand-name medication.
Not all forms are the same or can be substituted for one another.
Might not be safe during pregnancy or breastfeeding
Take your first dose of amphetamine as soon as you wake up to avoid having trouble sleeping later at night.
Take amphetamine exactly as prescribed. Don't change your dose or stop taking the medication without talking to your provider first. Doing so can lead to bothersome withdrawal symptoms, such as daytime sleepiness, large appetite, trouble sleeping, irritation, and depression.
Amphetamine can be taken with or without food. But since stimulants like amphetamine tend to lower appetite (and potentially lead to weight loss), make sure to follow a healthy and balanced diet. If you or your child seems to have lost their appetite or have had concerning weight changes while taking amphetamine, let your provider know.
Amphetamine can interact with other medications. These interactions can lead to more side effects. Make sure your provider knows all the medications you're taking before starting amphetamine. Don't start any new medications while taking amphetamine without talking to your provider or pharmacist first.
Avoid driving the first few days after you start amphetamine and after dose changes until you know how this medication affects you. Amphetamine might cause dizziness. It might also cause blurry vision, which can affect how well you see.
For the Dyanavel XR tablets: The Dyanavel XR tablets can be chewed or swallowed whole. The 5 mg tablet is scored, so it can be cut in half with a pill splitter.
For the extended-release amphetamine oral suspensions (Dyanavel XR, generic): Store the amphetamine oral suspension at room temperature and keep the medication in the original bottle you got from the pharmacy. When it's time to take your medication, make sure to shake the bottle well before measuring your dose. Measure the dose using the dosing syringe or measuring cup provided by the pharmacy. Don't use household spoons or measuring cups; they're not accurate and might cause you to take the wrong dose. Contact your pharmacist or provider if you have any questions about how to measure your dose.
For the orally disintegrating tablets (Adzenys XR ODT, Evekeo ODT): Keep the ODTs in the blister pack until you're ready to use them; this helps prevent the tablets from getting wet and dissolving. Use dry hands to remove them, and don't push them through the foil to avoid breaking the tablets. Place the ODT on the tongue and let the tablet dissolve without crushing or chewing it.
Your dose will depend on what you're using amphetamine for, your age, the brand or form of amphetamine you're prescribed, and what other medications you're taking. Your provider will adjust your dose based on how well amphetamine is working for you and whether you're having side effects.
Immediate-release forms
Tablets (generic, Evekeo brand)
ADHD: For ages 3 to 5 years old, the typical starting dose is 2.5 mg by mouth once daily. For ages 6 years and older, the typical starting dose is 5 mg by mouth once or twice daily.
Narcolepsy (ages 6 and older): The typical dose is 5 mg to 60 mg by mouth per day, split into multiple doses throughout the day. The first dose of the day should be taken right after waking up and then any additional doses can be taken every 4 to 6 hours.
Obesity (ages 12 and older): The typical dose is up to 30 mg by mouth per day, split into multiple doses throughout the day. The medication should be taken 30 to 60 minutes before meals.
Age 6 to 17 years old: The typical starting dose is 5 mg dissolved on the tongue once or twice daily. If needed, another dose can be given 4 to 6 hours later if your child's provider says it's okay to do so.
Extended-release forms
Ages 6 years and older: The typical starting dose is 2.5 mg or 5 mg by mouth once daily in the morning. The maximum dose is 20 mg per day.
Ages 6 years and older: The typical starting dose is 6.3 mg (5 mL) once daily in the morning. The maximum dose is 18.8 mg per day for children ages 6 to 12 years old and 12.5 mg per day for children ages 13 to 17 years old.
Ages 18 years and older: The typical dose is 12.5 mg (10 mL) by mouth once daily.
Ages 6 to 17 years old: The typical starting dose is 6.3 mg dissolved on the tongue once daily in the morning. The maximum dose is 18.8 mg per day for children ages 6 to 12 years old and 12.5 mg per day for children ages 13 to 17 years old.
Ages 18 years and older: The typical dose is 12.5 mg dissolved on the tongue once daily.
Certain heart problems (e.g., heart disease)
Moderate-to-severe high blood pressure
Overactive thyroid (hyperthyroidism)
Feeling agitated
History of drug misuse
Currently take or have taken a monoamine oxidase inhibitor (MAOI) in the last 14 days
Attention deficit-hyperactivity disorder (ADHD) - immediate-release, extended-release, and ODTs
Narcolepsy (daytime sleepiness) - immediate-release tablets only
Short-term add-on treatment for obesity - immediate-release tablets only
Attention-deficit hyperactivity disorder (ADHD)
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