Evekeo (amphetamine sulfate) Full Prescribing Information DailyMed Drug Information 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).