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Dexedrine Spansule

(Dextroamphetamine sulfate)

Full Prescribing Information DailyMed Drug Information

Forms/Strengths

  •  Capsules: 5 mg, 10 mg, 15 mg

Dosing

  • Age: 6+ y/o
  • Onset: ~ 60 min
  • Duration: ~ 6-8 hours
  • Considerations: Advise to take consistently either with food or without food. May be opened and the entire contents gently sprinkled on a teaspoon of cool applesauce, yogurt, or other soft food
  • Initial Dose: 5 mg once or twice daily
  • Titration: Increase by 5 mg at weekly intervals until optimal response
  • Max Dose: 40 mg per day

Quick Facts

  • Increases synaptic dopamine and norepinephrine by stimulating presynaptic release
  • Enhances focus, attention, and impulse control
  • Extended-release spansule capsule for sustained, day-long effect
  • Unique formulation minimizes plasma level fluctuations
  • Common side effects: decreased appetite, insomnia, headache, increased heart rate

Indications

  • ADHD (ICD-10: F90.0)
  • Narcolepsy (ICD-10: G47.419)

Off-Label Uses

  •  N/A

How to Take

  • Take once or twice daily, as directed, with the first dose in the morning.
  • Can be taken with or without food; high-fat meals may delay absorption.
  • Swallow the capsule whole; do not crush or chew.
  • If needed, the capsule may be opened, and contents sprinkled on applesauce—consume immediately without chewing.
  • Avoid taking late in the day to prevent insomnia.

Side Effects

  • Common: Insomnia, decreased appetite, weight loss, dry mouth
    Serious: Cardiovascular events, psychiatric symptoms, growth suppression in childre

Monitoring / Labs

  • Cardiovascular: Baseline and routine monitoring of heart rate and blood pressure.
  • Growth in Pediatrics: Regular monitoring of height and weight to detect growth suppression.
  • Psychiatric Symptoms: Observe for mood changes, anxiety, or psychosis.
  • Abuse Potential: Monitor for misuse or diversion.

Education

  • When to Call the Doctor:

    • Severe mood changes, aggression, or suicidal thoughts.
    • Chest pain, rapid heartbeat, shortness of breath (cardiovascular concerns).
    • Uncontrolled movements, tics, or worsening anxiety.
    • Numbness, coldness, or color changes in fingers or toes (circulatory issues).
    • Unexplained weight loss or delayed growth in pediatric patients.
  • Safety Tips:

    • Monitor blood pressure and heart rate, especially in patients with cardiovascular risk.
    • Use caution in patients with anxiety, bipolar disorder, or psychosis, as symptoms may worsen.
    • Avoid caffeine and other stimulants, which may amplify side effects.
    • Ensure adequate hydration and nutrition, as appetite suppression is common.
    • Tapering may be required if discontinuing after long-term use.
  • Parent Tips for Pediatric Patients:

    • Encourage a nutrient-dense diet to counteract appetite suppression.
    • Administer in the morning before school for optimal effect.
    • Monitor school performance and behavioral changes.
    • Observe for sleep disturbances; adjust timing if necessary.
    • Communicate regularly with teachers and caregivers about medication effects.

Additional Information

  • Contraindications:

    • Hypersensitivity to amphetamines or formulation components.
    • Use within 14 days of MAOI therapy (risk of hypertensive crisis).
    • Symptomatic cardiovascular disease, moderate-to-severe hypertension, hyperthyroidism, glaucoma.
    • History of substance use disorder, unless benefits outweigh risks.
  • Pregnancy:

    • Category C; use only if benefits outweigh risks.
    • May cause neonatal withdrawal symptoms or low birth weight.
  • Lactation:

    • Excreted in breast milk; not recommended due to potential infant exposure.
  • Drug Interactions:

    • Serotonergic drugs (e.g., SSRIs, SNRIs, MAOIs) increase serotonin syndrome risk.
    • Acidifying agents (e.g., ascorbic acid) may reduce drug absorption.
    • Alkalinizing agents (e.g., sodium bicarbonate) may increase amphetamine levels.
    • May potentiate hypertensive effects of certain medications (e.g., decongestants, beta-agonists).