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Dextroamphetamine sulfate, USP is the dextro isomer of the compound d,l-amphetamine sulfate, a sympathomimetic amine of the amphetamine group. Chemically, dextroamphetamine is d-alphamethylphenethylamine, and is present in all forms of dextroamphetamine sulfate, USP as the neutral sulfate. Each tablet, for oral administration, contains dextroamphetamine sulfate, USP in either 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg or 30 mg. Each tablet also contains the following inactive ingredients: colloidal silicon dioxide, crospovidone, microcrystalline cellulose and stearic acid.
The 5 mg tablets also contain D&C Red #27 and FD&C Yellow #6. The 7.5 mg tablets also contain FD&C Blue #1 and D&C Yellow #10. The 10 mg tablets also contain FD&C Red #40, FD&C Yellow #6 and FD&C Blue #2. The 15 mg tablets also contain FD&C Blue #1, FD&C Blue #2, and FD&C Red #40. The 20 mg tablets also contain FD&C Blue #1 and D&C Red #27. The 30 mg tablets also contain D&C Yellow #10.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.
Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products or diet aids).
The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/ “ecstasy,” St. John’s wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.
Dextroamphetamine is very similar to amphetamine or lisdexamfetamine. Do not use medications containing amphetamine or lisdexamfetamine while using dextroamphetamine.
This medication may interfere with certain medical/laboratory tests (including blood and urine steroid levels, brain scan for Parkinson’s disease), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.
DOSAGE AND ADMINISTRATION
Amphetamines should be administered at the lowest effective dosage and dosage should be individually adjusted. Late evening doses should be avoided because of the resulting insomnia.
Usual dose is 5 to 60 mg per day in divided doses, depending on the individual patient response.
Narcolepsy seldom occurs in children under 12 years of age; however, when it does, zenzedi may be used. The suggested initial dose for patients aged 6 to 12 is 5 mg daily; daily dose may be raised in increments of 5 mg at weekly intervals until optimal response is obtained. In patients 12 years of age and older, start with 10 mg daily; daily dosage may be raised in increments of 10 mg at weekly intervals until an optimal response is obtained. If bothersome adverse reactions appear (e.g., insomnia or anorexia), dosage should be reduced. Give first dose on awakening; additional doses (1 or 2) at intervals of 4 to 6 hours.
Attention Deficit Disorder with Hyperactivity
Not recommended for pediatric patients under 3 years of age.
In pediatric patients from 3 to 5 years of age, start with 2.5 mg daily; daily dosage may be raised in increments of 2.5 mg at weekly intervals until optimal response is obtained.
In pediatric patients 6 years of age and older, start with 5 mg once or twice daily; daily dosage may be raised in increments of 5 mg at weekly intervals until optimal response is obtained. Only in rare cases will it be necessary to exceed a total of 40 mg per day.
Give first dose on awakening; additional doses (1 or 2) at intervals of 4 to 6 hours.
Where possible, drug administration should be interrupted occasionally to determine if there is a recurrence of behavioral symptoms sufficient to require continued therapy.
WARNING AND PRECAUTIONS
Serious heart problems can occur when taking stimulant medicines, such as Zenzedi, and include:
sudden death in people who have heart problems or heart defects
sudden death, stroke, and heart attack in adults
increased blood pressure and heart rate
Tell your doctor if you or your child has any heart problems, including heart defects, abnormal heart rhythm, high blood pressure, disease known as cardiomyopathy, coronary artery disease, or a family history of these problems or sudden cardiac death. Call your doctor right away if you or your child has any signs of heart problems such as chest pain, shortness of breath, or fainting while taking Zenzedi
Mental (psychiatric) problems can occur including:
new or worsening behavior and thought problems
new or worsening bipolar illness
New aggressive behavior or psychotic symptoms can occur in children and teenagers such as:seeing things or hearing voices,believing things that are not true
Tell your doctor about any drug abuse, alcohol abuse or mental problems that you or your child has had, or about a family history of suicide, bipolar illness, or depression, new or worsening aggressive behavior or hostility. Call your doctor right away if you or your child has any new or worsening mental symptoms or problems while taking Zenzedi.
Circulation problems in fingers and toes
fingers or toes may feel numb, cool, painful
fingers or toes may change color from pale, to blue, to red
Tell your doctor if you or your child has any numbness, pain, color change, or sensitivity to temperature in your fingers and toes or a family history of health conditions including circulation problems in fingers and toes. Call your doctor right away if you or your child has any signs of unexplained wounds appearing on fingers and toes while taking Zenzedi.
Zenzedi may cause serious side effects, including:
slowing of growth (height and weight) in children, seizures, eyesight changes or blurred vision, and serotonin syndrome. Serotonin syndrome can be life threatening and happens when Zenzedi is taken with certain medicines. Symptoms include agitation, hallucinations, coma or other changes in mental status, problems controlling your movements or muscle twitching, fast heartbeat, high or low blood pressure, sweating or fever, nausea or vomiting, diarrhea, and muscle stiffness or tightness
The most common side effects reported with Zenzedi treatment include: fast heartbeat, tremors, trouble sleeping, stomach upset, dry mouth, decreased appetite, headache, dizziness, and weight loss.
Talk to your doctor if you or your child have side effects that are bothersome or do not go away, if you or your child is pregnant, plan on becoming pregnant, or are breast-feeding, about all health conditions (or a family history of), and about the medicines you or your child take. Your doctor will decide whether Zenzedi can be taken with other medicines and if Zenzedi is right for you or your child.
For additional safety information, consult the Zenzedi full prescribtion and medication guide.
Palpitations, tachycardia, elevation of blood pressure. There have been isolated reports of cardiomyopathy associated with chronic amphetamine use.
Central Nervous System
Psychotic episodes at recommended doses (rare), overstimulation, restlessness, dizziness, insomnia, euphoria, dyskinesia, dysphoria, tremor, headache, exacerbation of motor and phonic tics and Tourette’s syndrome.
Dryness of the mouth, unpleasant taste, diarrhea, constipation, other gastrointestinal disturbances. Anorexia and weight loss may occur as undesirable effects.
Impotence, changes in libido, frequent or prolonged erections.
Drug Abuse And Dependence
Zenzedi is a Schedule II controlled substance.
Amphetamines have been extensively abused. Tolerance, extreme psychological dependence and severe social disability have occurred. There are reports of patients who have increased the dosage to many times that recommended. Abrupt cessation following prolonged high dosage administration results in extreme fatigue and mental depression; changes are also noted on the sleep EEG.
Manifestations of chronic intoxication with amphetamines include severe dermatoses, marked insomnia, irritability, hyperactivity and personality changes. The most severe manifestation of chronic intoxication is psychosis, often clinically indistinguishable from schizophrenia. This is rare with oral amphetamines.
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