# Evekeo ### (amphetamine sulfate)
**[Full Prescribing Information](https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=f469fb38-0380-4621-9db3-a4f429126156&type=display)**[**DailyMed Drug Information**](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f469fb38-0380-4621-9db3-a4f429126156)
--- **Forms/Strengths** - **Tablets:** 5 mg, 10 mg --- ### **Dosing** - **Age:** ≥ 3 y/o - **Onset:** ~ 30-60 minutes - **Duration:** 4-6 hours - **Considerations:** Take the first dose on awakening. Additional doses may be given at intervals of 4-6 hours. - **Initial Dose:** - **3-5 y/o:** 2.5 mg daily - **6+ y/o:** 5 mg once or twice daily - **Titration:** - **3-5 y/o:** 2.5 mg weekly - **6+ y/o:** 5 mg weekly - **Max Dose:** 40 mg/day --- ### **Quick Facts** - Increases synaptic dopamine and norepinephrine by enhancing presynaptic release - Improves focus, attention, and impulse control - Immediate-release formulation for rapid onset - Unique racemic amphetamine sulfate formulation - Common side effects: decreased appetite, insomnia, increased blood pressure, headache --- ### **Indications** - **ADHD** (ICD-10: F90.0) - **Narcolepsy:** G47.419 - Exogenous Obesity: E66.9 --- ### **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 **tablet whole** with water; do not crush or chew. - If using the **oral suspension**, **shake well before each use** and measure with an appropriate dosing device. - Avoid taking **late in the day** to prevent insomnia. --- ### **Side Effects** - **Insomnia, decreased appetite, weight loss, increased heart rate, elevated blood pressure, potential for psychotic or manic symptoms, peripheral vasculopathy.** --- ### **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).