Dexampex, Dexedrine, Oxydess II , Spancap No. 1
Classifications: respiratory and cerebral stimulant; amphetamine; anorexiant; Therapeutic:amphetamine; anorexiant
Pregnancy Category: C
Controlled Substance: Schedule II
5 mg, 10 mg tablets; 5 mg, 10 mg, 15 mg sustained release capsules
An isomer of amphetamine, it has anorexigenic action; this is thought to result from CNS stimulation and possibly from loss
of acuity of smell and taste.
Is a more potent appetite suppressant than amphetamine. CNS stimulating effect approximately twice that of racemic amphetamine.
In hyperkinetic children, amphetamines reduce motor restlessness by an unknown mechanism.
Adjunct in short-term treatment of exogenous obesity, narcolepsy, and attention deficit disorder with hyperactivity in children
(also called minimal brain dysfunction or hyperkinetic syndrome).
Adjunct in epilepsy to control ataxia and drowsiness induced by barbiturates; to combat sedative effects of trimethadione
in absence seizures.
Hypersensitivity to sympathomimetic amines, closed-angle glaucoma, agitated states, psychoses (especially in children),
structural cardiac abnormalities, valvular heart disease; congenital heart disease, coronary heart disease, advanced arteriosclerosis,
symptomatic heart disease, moderate to severe hypertension, hyperthyroidism, history of drug abuse, during or within 14
d of MAO INHIBITOR therapy, as anorexiant in children <12 y, for attention deficit disorder in children <3 y, pregnancy (category C); lactation.
Bipolar disease; salicylate hypersensitivity; seizure disorders; suicidal ideation, depression; salicylate hypersensitivity.
Safety and efficacy in children <3 y have not been established.
Route & Dosage
Adult: PO 520 mg 13 times/d at 46 h intervals
Child: PO 612 y, 5 mg/d, may increase by 5 mg at weekly intervals; >12 y, 10 mg/d, may increase by 10 mg at weekly intervals
Attention Deficit Disorder
Child: PO 35 y, 2.5 mg 12 times/d, may increase by 2.5 mg at weekly intervals; ≥6 y, 5 mg 12 times/d, may increase by 5 mg at weekly intervals (max: 40 mg/d)
Adult: PO 510 mg 13 times/d or 1015 mg of sustained release once/d 3060 min a.c.
- Ensure that sustained release capsule is not chewed or crushed. It MUST be swallowed whole.
- Give 3060 min before meals for treatment of obesity. Give long-acting form in the morning.
- Give last dose no later than 6 h before patient retires (1014 h before bedtime for sustained release form) to avoid
- Store in tightly closed containers at 15°30° C (59°86° F) unless otherwise directed.
Adverse Effects (≥1%)CNS:
euphoria, dizziness, headache; with prolonged use:
, psychotic reactions. CV:
Palpitations, tachycardia, elevated BP. GI:
Dry mouth, unpleasant taste, anorexia, weight loss, diarrhea, constipation
, abdominal pain. Other:
Impotence, changes in libido, unusual fatigue
, increased intraocular pressure, marked dystonia of head, neck, and extremities;
Diagnostic Test Interference
Dextroamphetamine may cause significant elevations in plasma corticosteroids (evening levels are highest) and increases in urinary epinephrine excretion (during first 3 h after drug administration).
InteractionsDrug: Acetazolamide, sodium bicarbonate
decrease dextroamphetamine elimination; ammonium chloride, ascorbic acid
increase dextroamphetamine elimination; effects of both barbiturates
and dextroamphetamine may be antagonized; furazolidone
may increase BP effects of amphetamines
interaction may persist for several weeks after discontinuing furazolidone;
antagonizes antihypertensive effects of guanethidine; mao inhibitors
can causehypertensive crisis (fatalities reported)do not administer amphetamines
during or within 14 d of these drugs; phenothiazines
may inhibit mood elevating effects of amphetamines
; tricyclic antidepressants
enhance dextroamphetamine effects because of increased norepinephrine
release; beta-adrenergic agonists
increase cardiovascular adverse effects.
15 h. Duration:
Up to 10 h. Distribution:
All tissues especially the CNS. Metabolism:
In liver. Elimination:
Renal elimination; excreted in breast milk. Half-Life:
Assessment & Drug Effects
- Monitor children, adolescents, and adults for signs and symptoms of adverse cardiac reactions (e.g., arrhythmias).
- Monitor growth rate closely in children.
- Interrupt therapy or reduce dosage periodically to assess effectiveness in behavior disorders.
- Monitor children and adolescents for development of aggressive or abnormal behaviors.
- Note: Tolerance to anorexiant effects may develop after a few weeks; however, tolerance does not appear to develop when dextroamphetamine
is used to treat narcolepsy.
Patient & Family Education
- Swallow sustained release capsule whole with a liquid; do not chew or crush.
- Do not drive or engage in other potentially hazardous activities until response to drug is known.
- Taper drug gradually following long-term use to avoid extreme fatigue, mental depression, and prolonged sleep pattern.