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 

 

 Not recommended for patients with structural cardiac abnormalities 

 

 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).