Xelstrym (dextroamphetamine) is the second stimulant patch approved for the treatment of attention deficit-hyperactivity disorder (ADHD). It's placed on the skin 2 hours before you need the effects of the medication to start, and it's kept on for up to 9 hours to last throughout the day. This medication can commonly cause headache, trouble sleeping, and a loss of appetite. Xelstrym (dextroamphetamine) is a controlled substance due to the risk of abuse and dependence.
Attention deficit-hyperactivity disorder (ADHD)
Xelstrym (dextroamphetamine) is a stimulant medication. It's not exactly known how Xelstrym (dextroamphetamine) 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.
Xelstrym (dextroamphetamine) 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 abuse | Suddenly stopping Xelstrym (dextroamphetamine) after long-term use
Xelstrym (dextroamphetamine) has a risk of abuse and dependence. Abuse is when a medication is used for non-medical reasons for its desirable physical or emotional effects (e.g., having a lower appetite). Abusing or misusing Xelstrym (dextroamphetamine) raises your risk for serious side effects such as high heart rate, high blood pressure, aggressive behavior, and even thoughts of hurting yourself or others. In addition, over time, you can become physically dependent on Xelstrym (dextroamphetamine) to function normally. This is usually related to having withdrawal symptoms, like anxiety, irritability, nightmares, and sleep problems, if you use the medication for a long time and then suddenly stop. Use Xelstrym (dextroamphetamine) exactly as prescribed to you. Don't change the dose or how often you use 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 at recommended doses. Xelstrym (dextroamphetamine) can also raise your blood pressure and heart rate. Tell your healthcare provider if you have a history of heart problems before starting Xelstrym (dextroamphetamine) to make sure it's safe for you to use. Let your provider know if you experience unexplained fainting, chest pain with physical activity, or irregular heartbeat while you're taking Xelstrym (dextroamphetamine). Your provider will check your heart for any problems.
Risk factors: History of psychotic episodes, bipolar disorder, or other mental health or mood-related conditions
Some people who've taken a stimulant like Xelstrym (dextroamphetamine) can have mental health problems, such as hallucinations (seeing things that aren't really there), aggressive behavior, unclear thinking, and mania. This medication can worsen behavior-related problems that you already have, but these changes in behavior can also happen even if you haven't had these problems before. If you develop these mood- or behavior-related symptoms while taking Xelstrym (dextroamphetamine), talk to your healthcare provider right away because you might have to stop taking it.
In studies, stimulants slowed the growth rate (both in height and weight) in children. Your child's healthcare provider will track your child's growth progress closely. If they suspect slowed growth, they might pause or stop your child's Xelstrym (dextroamphetamine) treatment. If your child isn't getting enough nutrition, if you notice major changes in weight, or if you have any concerns, talk to your child's provider.
Xelstrym (dextroamphetamine) might be linked to poor blood circulation problems, such as Raynaud's phenomenon. People with Raynaud's phenomenon can experience episodes of poor blood flow to the fingers and toes, which can cause the skin to turn pale and to feel cold, numb, or painful. If this happens, symptoms are typically mild. But rarely, it can cause sores or ulcers in more serious cases. Let your healthcare provider know if you notice symptoms of circulation problems, such as bouts of numbness or pain in your fingers or toes. Your provider might need to lower your dose of Xelstrym (dextroamphetamine) or ask you to consider a different medication.
Risk factors: Taking monoamine oxidase inhibitors (MAOI) within 14 days of starting Xelstrym (dextroamphetamine) | 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 Xelstrym (dextroamphetamine) might raise your serotonin levels in the brain, your risk for this condition goes up if you use Xelstrym (dextroamphetamine) with other medications that also affect serotonin levels, such as antidepressants (e.g., sertraline (Zoloft), duloxetine (Cymbalta)), MAOIs (e.g., phenelzine (Nardil)), and certain migraine medications (e.g., sumatriptan (Imitrex)). Tell your healthcare provider and pharmacist about all the medications you take or plan to take (including over-the-counter medications and supplements) so they can make sure your medications are safe for you. Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, high fever, and confusion. Get medical help right away if you have any of these symptoms.
Using Xelstrym (dextroamphetamine) can cause dry, itchy skin (contact dermatitis), a type of skin sensitivity. Skin redness is common and isn't a sign of skin sensitivity by itself. But skin redness that happens with swelling, small skin-colored bumps, or blisters that don't get better within 2 days or spreads to other areas of skin could be signs of severe skin sensitivity. Contact your provider right away if you have any of these symptoms.
Source: Prescribing Information
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):
Can use in adults and children 6 years and older
Used once per day because it lasts a long time
An option to switch from taking stimulants by mouth to Xelstrym (dextroamphetamine) patch – but with some dose adjustments
Can bathe, shower, or swim with the patch on
Takes 2 hours to start working
A controlled medication, so there are special requirements for getting the prescription filled
Not the best choice for pregnant or breastfeeding females or people with heart conditions
Might worsen tics or Tourette syndrome if you already have these problems
Use Xelstrym (dextroamphetamine) exactly as your provider instructed you to. Don't change your dose or stop using the medication without talking to your provider first. Doing so can lead to withdrawal symptoms, such as large appetite, irritability, trouble sleeping, and depression. If you want to stop Xelstrym (dextroamphetamine), your provider will lower your dose slowly over time before you can completely stop.
Avoid driving the first few days after you start Xelstrym (dextroamphetamine) and after dose changes until you know how this medication affects you. Some people have reported blurry vision or other changes in vision while using stimulants, which could affect your ability to drive.
Your skin might get irritated while using Xelstrym (dextroamphetamine) patches. Skin reactions, like pain, itching, burning, redness, discomfort, and swelling, typically go away within 2 to 4 hours after applying the patch. Contact your provider if they don't go away or become severe.
Avoid direct heat (e.g., hair dryers, heating pads, electric blankets) while wearing the Xelstrym (dextroamphetamine) patch. Heat can cause the patch to release more medication into your body, which can raise the risk of severe side effects like distress, aggressive behavior, and confusion.
How to use Xelstrym (dextroamphetamine)
Make sure you know how to apply Xelstrym (dextroamphetamine) patches properly and safely. Carefully read the instructions for use, and ask your pharmacist if you have any questions on how to apply the patch.
Apply a Xelstrym (dextroamphetamine) patch 2 hours before you need it to start working, and leave it on for at most 9 hours. Don't reuse patches or use more than one patch in a 24-hour period.
Before applying Xelstrym (dextroamphetamine), clean the area of skin with soap and water, and dry well. Make sure the area isn't too hairy and doesn't have any lotion, oils, or gels on it so the patch can stay on better.
Stick the Xelstrym (dextroamphetamine) patch onto your hip, upper arm, chest, upper back, or the side of your body near your stomach. Use different places each time you use a new patch to prevent skin irritation.
Avoid touching the sticky side of the patch because this is where the medication is. If you accidentally touch it, wash your hands with soap and water right away.
If the edges of the patch lift up while you're wearing it, press them down firmly to stick it back on your skin. Don't use tape, dressings, or other adhesives to keep the edges down. If the patch comes off completely, throw it away, and apply a brand new patch. Make sure the total amount of time you have a patch on (the one that fell off and the new one) is no more than 9 hours.
After removing Xelstrym (dextroamphetamine), throw the patch away by folding it in half with the sticky sides together and putting it in a lidded trash can to prevent exposing pets or children to this medication. Don't flush Xelstrym (dextroamphetamine) down the toilet. Remember to wash your hands with soap and water afterwards.
In general, apply 1 patch onto the skin once per day, 2 hours before you need it to start working. Keep the patch on for up to 9 hours, and then remove.
There are four patch strengths: 4.5 mg, 9 mg, 13.5 mg, and 18 mg.
Adults aged 18 years and older: The typical starting dose is 9 mg once per day.
Children 6 to 17 years old: The typical starting dose is 4.5 mg once per day.
Your provider will adjust your dose based on how well it's helping your ADHD symptoms and if you're having side effects. The typical maximum dose is 18 mg once per day, but it can differ if you have severe kidney problems.
Severe allergy to amphetamine-containing products
Currently take or have taken an MAOI, linezolid (Zyvox), or methylene blue (ProvayBlue) in the last 14 days
Attention deficit-hyperactivity disorder (ADHD)
Attention-deficit hyperactivity disorder (ADHD)
Attention-deficit hyperactivity disorder (ADHD) in people 6 years and older
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