# Dexedrine Spansule

### (Dextroamphetamine sulfate)

<table border="1" id="bkmrk-prescribing-info" style="border-collapse: collapse; width: 100%; border-width: 0px; background-color: rgb(230, 126, 35);"><tbody><tr><td style="background-color: rgb(194, 224, 244); border-width: 0px;">**[Full Prescribing Information](https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=cc717b9b-22ea-4c60-a1d4-ee38a40bce78&type=display)**</td><td class="align-right" style="background-color: rgb(251, 238, 184); border-width: 0px;">[**DailyMed Drug Information**](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cc717b9b-22ea-4c60-a1d4-ee38a40bce78)</td></tr></tbody></table>

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**Forms/Strengths**

- **Capsules:** 5 mg, 10 mg, 15 mg

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### **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

<p class="callout warning">**Not recommended for patients with structural cardiac abnormalities**</p>

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### **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

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### **Indications**

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

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### **Off-Label Uses**

- **N/A**

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### **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.

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### **Side Effects**

- <div class="undefined brandable--article-paragraph-title"><div class="src_paragraph_p__y9RVL ask_oe_light_with_citations_paragraph_p__6oofJ"><span class="MuiTypography-root MuiTypography-serif mui-style-1vritj8">Common: Insomnia, decreased appetite, weight loss, dry mouth</span></div><div class="src_paragraph_p__y9RVL ask_oe_light_with_citations_paragraph_p__6oofJ"><span class="MuiTypography-root MuiTypography-serif mui-style-1vritj8">Serious: Cardiovascular events, psychiatric symptoms, growth suppression in childre</span></div></div>

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### **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.

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### **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.

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### **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).