(Minor) Close monitoring of blood pressure or the selection of alternative therapeutic agents to the sympathomimetic agent may be needed in patients receiving a beta-blocker. Stimulant medications must be used very cautiously in patients with pre-existing hypertension, tachycardia, or other conditions in which a modest increase in blood pressure or heart rate could be detrimental. Incretin Mimetics: (Moderate) Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. Side Effects. Coadministration may lead to adverse effects, such as tremors, insomnia, seizures, or cardiac arrhythmias. Metformin; Rosiglitazone: (Moderate) Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. Patients should avoid medications and dietary supplements which contain high amounts of caffeine. In general, for every 1 unit increase in urinary pH, there is a reported 7-hour increase in amphetamine half-life. Although unlikely to occur during monotherapy with serotonin-receptor agonists (or "triptans"), serotonin syndrome may occur from combining these drugs with other medications that potentiate serotonin activity. This may precipitate hypertensive crisis, malignant hyperthermia, and a variety of toxic neurologic effects; these events can be fatal. Although a specific maximum has not been identified for this age group, the usual maximum dose for narcolepsy is 60 mg/day PO. Close monitoring of blood pressure is advised. Close monitoring of blood pressure is advised. As a result, amphetamine clearance is accelerated and the duration of effect is reduced. Monitor clinical response and adjust if needed. Thiazide diuretics: (Minor) Amphetamines may counteract the activity of some antihypertensive agents, such as thiazide diuretics. Close monitoring of blood pressure is advised. Hydrochlorothiazide, HCTZ; Losartan: (Minor) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents, such as angiotensin II receptor antagonists. Close monitoring of blood pressure is advised. Nadolol: (Minor) Close monitoring of blood pressure or the selection of alternative therapeutic agents to the sympathomimetic agent may be needed in patients receiving a beta-blocker. Magnesium Hydroxide: (Moderate) Antacids and other gastrointestinal alkalinizing agents increase the oral absorption of amphetamines. Meperidine: (Major) Amphetamines have been reported to increase the analgesic effects of meperidine. Epinephrine and other sympathomimetics, through stimulation of alpha- and beta- receptors, increase hepatic glucose production and glycogenolysis and inhibit insulin secretion. US-based MDs, DOs, NPs and PAs in full-time patient practice can register for free on PDR.net. Linezolid: (Severe) Amphetamines should not be administered during or within 14 days after the use of linezolid. Citric Acid; Sodium Citrate: (Major) Concurrent use of amphetamines with urinary alkalinizing agents should be avoided if possible. (Minor) Amphetamines may counteract the activity of some antihypertensive agents, such as thiazide diuretics. Starting dose is 5 mg, although it may increase by no more than 5 mg per week. Thiazide diuretics may also increase and prolong the actions of amphetamines by increasing the urinary pH. (Minor) In general, food does not significantly interact with the amphetamine stimulants, a dose may be taken with or without food. Dextroamphetamine is contraindicated in patients in an agitated state. Intravenous vasopressors may be used in the emergency management of pulmonary hypertension patients when needed, but hemodynamic monitoring and careful monitoring of cardiac status are needed to avoid ischemia and other complications. © document.write(new Date().getFullYear()) PDR, LLC. Close monitoring of blood pressure is advised. If you have ADHD or any other mental health condition, our professionals at EZCare Clinic can recommend the best treatment options for you. If avoidance is not possible, the dose of the amphetamine therapy may need to be adjusted (decreased) in some patients. COMMON BRAND NAME(S): Dexedrine. Concomitant use of these agents may increase this risk further. The effect of stimulant medication exposure via breast milk on the neurological development of the infant has not been well studied. Azilsartan; Chlorthalidone: (Minor) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents, such as angiotensin II receptor antagonists. Monitor for loss of glycemic control when pseudoephedrine, phenylephrine, and other sympathomimetics are administered to patients taking antidiabetic agents. Found inside – Page 30... experience weight loss Sedation • Reported but not expected • Activation much more common than sedation What To Do About Side Effects •Wait •Adjust dose ... For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use (1 to 3 days) as an alternative to systemic decongestants in patients taking medications for diabetes. Hydrochlorothiazide, HCTZ; Propranolol: (Minor) Amphetamines may counteract the activity of some antihypertensive agents, such as thiazide diuretics. The predominant mechanism of dextroamphetamine's CNS effects is to stimulate the release of several biogenic amines from storage sites in the nerve terminal. Reduce dose if anorexia or insomnia occur. Patients who are not growing or gaining weight as expected may need to have their treatment interrupted. Dosage should be individualized based upon response and tolerability; use the lowest effective dose after stabilization. Close monitoring of blood pressure is advised. For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use (1 to 3 days) as an alternative to systemic decongestants in patients taking medications for diabetes. Additionally, the amphetamines may delay the intestinal absorption of phenobarbital; the extent of absorption of these seizure medications is not known to be affected. If seizures occur, amphetamine discontinuation may be necessary. Discontinue all serotonergic agents if serotonin syndrome occurs and implement appropriate medical management. Comments:-The first dose should be given on awakening; 1 to 2 additional doses should be given at intervals of 4 to 6 hours. Thiazide diuretics may also increase and prolong the actions of amphetamines by increasing the urinary pH. SPANSULE capsules may be used for once-a-day dosage wherever appropriate. In one study of 4 women with attention deficit hyperactivity disorder receiving d-amphetamine (median dose 18 mg/day) while breast-feeding, the mean relative infant dose was 5.7% of the weight-adjusted maternal dose (range: 3.9 to 13.8%). It is recommended to separate times of administration. Thiazide diuretics may also increase and prolong the actions of amphetamines by increasing the urinary pH. In a study of 7 adult males, combinations of cocaine (IV) and smoked marijuana (1 g marijuana cigarette, 0 to 2.7% delta-9-THC) increased the heart rate above levels seen with either agent alone, with increases reaching a plateau at 50 bpm. Signs and symptoms are usually intermittent and mild and generally improve after reduction in dose or discontinuation of drug. Dapagliflozin: (Moderate) Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. In psychotic individuals (e.g., schizophrenia), amphetamines may exacerbate behavioral disturbances, psychosis, or thought disorders. Seizures have been observed in patients without a history of seizures taking amifampridine at recommended doses. To help limit an interaction, do not take antacids at the same time as the amphetamine product. Concurrent use increases the risk of unopposed alpha-adrenergic activity. Also, adrenergic medications may decrease glucose uptake by muscle cells. Found inside – Page 189... “ Eskatrol ” produced a significantly greater weight loss than obtained with placebo treatment . And when compared with “ Dexedrine " Spansule Capsules ... MAOI antidepressants slow amphetamine metabolism, potentiating their effect on the release of norepinephrine and other monoamines from adrenergic nerve endings. Patients should be monitored to confirm that the desired antihypertensive effect is achieved. Monitoring for cardiac effects during concurrent use of ergot alkaloids with amphetamines may be advisable. For treatment of cold symptoms, nasal decongestants may be preferable for short term, limited use (1 to 3 days) as an alternative to systemic decongestants in patients taking medications for diabetes. Children 3 years and older have been successfully treated for attention-deficit hyperactivity disorder (ADHD) with amphetamines. Mean time from surgery to therapy initiation was 10 months (range: 9 to 14 months). The half-life and therapeutic actions of amphetamines will be prolonged. Urinary alkalinizers diminish the urinary excretion of amphetamines by increasing the proportion of non-ionized amphetamines, resulting in increased renal tubular reabsorption of the amphetamines. Renal dysfunction has the potential to inhibit the elimination of amphetamines and result in prolonged exposure; use with caution and titrate dosages carefully. The first dose is typically taken first thing in the morning; tablets should be taken at the same time each day for the best results. Epinephrine and other sympathomimetics, through stimulation of alpha- and beta- receptors, increase hepatic glucose production and glycogenolysis and inhibit insulin secretion. Elevated blood pressure may require a dose reduction, discontinuation, and/or initiation of appropriate antihypertensive medication. Clobazam: (Moderate) Patients who are taking anticonvulsants for epilepsy/seizure control should use amphetamines with caution. Close monitoring of blood pressure is advised. -Initial Dose: 10 mg orally per day in divided doses-Maintenance Dose: Daily dose may be raised in 10 mg increments at weekly intervals until optimal response is obtained. Fosphenytoin: (Major) Amphetamine or dextroamphetamine may delay the intestinal absorption of orally-administered phenytoin; the extent of phenytoin absorption is not known to be effected. Formoterol; Mometasone: (Moderate) Caution and close observation should be used when formoterol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. Thiazide diuretics may also increase and prolong the actions of amphetamines by increasing the urinary pH. Here is the dosage of Dexedrine for children and adults in case of ADHD: 5 mg is taken once or twice a day, 4-6 hours apart. Metaproterenol: (Major) Caution and close observation should also be used when metaproterenol is used concurrently with other adrenergic sympathomimetics, administered by any route, to avoid potential for increased cardiovascular effects. There are no adequate and well-controlled studies of dextroamphetamine in pregnant women and dextroamphetamine should only be used during pregnancy if the expected benefit to the mother justifies the potential fetal risk. Discontinue all serotonergic agents if serotonin syndrome occurs and implement appropriate medical management. Close monitoring of blood pressure is advised. Dosages of the amphetamines should be substantially reduced prior to surgery, and caution should be observed with concurrent use of anesthetics. Monitor clinical response and adjust if needed. In addition, patients who are taking anticonvulsants for epilepsy/seizure control should use amphetamines with caution. Close monitoring of blood pressure is advised. Amphetamines are thought to block central dopamine reuptake, which has the potential to exacerbate psychosis, and antipsychotics, which are central dopamine antagonists, may diminish the effectiveness of amphetamines. Thiazide diuretics may also increase and prolong the actions of amphetamines by increasing the urinary pH. Linezolid also has the potential to interact with serotonergic agents, such as amphetamines, which may increase the risk for serotonin syndrome. At high doses, amphetamines can increase serotonin release, as well as act as serotonin agonists. If avoidance is not possible, the dose of the amphetamine therapy may need to be adjusted (decreased) in some patients. In general, medicines containing sympathomimetic agents should not be used concurrently with MAOIs or within 14 days before or after their use. The doctor may recommend temporarily stopping the medication from time to time to reduce this risk. Nicardipine: (Minor) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents, like calcium-channel blockers. Monitoring for cardiac effects during concurrent use of ergot alkaloids with amphetamines may be advisable. Dexedrine:- Store at controlled room temperature (between 68 and 77 degrees F)Dexedrine Spansule:- Store at controlled room temperature (between 68 and 77 degrees F)DextroStat:- Store at controlled room temperature (between 68 and 77 degrees F)Liquadd :- Store at controlled room temperature (between 68 and 77 degrees F)ProCentra :- Store at controlled room temperature (between 68 and 77 degrees F)- Store in original containerZenzedi:- Store at controlled room temperature (between 68 and 77 degrees F). Methenamine; Sodium Acid Phosphate: (Major) Urinary acidifying agents, such as ammonium chloride, phosphorus salts, and methenamine salts (e.g., methenamine; sodium acid phosphate), reduce the tubular reabsorption of amphetamines. Close monitoring of blood pressure or the selection of alternative therapeutic agents may be needed. Found inside – Page 35... lose weight, along with an exercise regime and a reduced caloric diet. The American Academy of Pediatrics recommends a twiceto thrice-a-day daily dosage ... Chlorthalidone: (Minor) Amphetamines may counteract the activity of some antihypertensive agents, such as thiazide diuretics. The, mg is taken once or twice a day, 4-6 hours apart. Hydrochlorothiazide, HCTZ; Moexipril: (Minor) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents, like angiotensin-converting enzyme inhibitors (ACE inhibitors). Liraglutide: (Moderate) Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. Thiazide diuretics may also increase and prolong the actions of amphetamines by increasing the urinary pH. Concurrent use increases the risk of unopposed alpha-adrenergic activity. Lixisenatide: (Moderate) Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. Dexedrine ® (dextroamphetamine sulfate) is a prescription medication used to treat ADHD and narcolepsy. Inform patients taking this combination of the possible increased risk and monitor for the emergence of serotonin syndrome particularly after a dose increase or the addition of other serotonergic medications to an existing regimen. Methylergonovine: (Major) Amphetamines, which increase catecholamine release, can increase blood pressure; this effect may be additive with the prolonged vasoconstriction caused by ergot alkaloids. If avoidance is not possible, the dose of the amphetamine therapy may need to be adjusted (decreased) in some patients. weight loss Other side effects not listed may also occur in some patients. Combination therapy should be avoided if possible. Common side effects may include: Epoprostenol: (Major) Avoid use of sympathomimetic agents with epoprostenol. Monitor for loss of glycemic control when pseudoephedrine, phenylephrine, and other sympathomimetics are administered to patients taking antidiabetic agents. Treprostinil: (Major) Avoid use of sympathomimetic agents with treprostinil. The street values for different types of dextroamphetamine drugs (including Dexedrine) run from “$5-$10” per pill. Those who abuse Dexedrine may do so for different reasons. Many people abuse stimulants because they want to lose weight. One of the side effects of Dexedrine is that it suppresses a person’s appetite and causes weight loss. Monitor for loss of glycemic control when pseudoephedrine, phenylephrine, and other sympathomimetics are administered to patients taking antidiabetic agents. The time to maximum concentration (Tmax) of amphetamines is decreased compared to when administered alone, thus increasing amphetamine concentrations and exposure, which may be of particular significance with extended-release dosage forms. We offer comprehensive treatments for mental health conditions to help you improve your mental wellbeing and the overall quality of your life. Lisinopril: (Minor) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents, like angiotensin-converting enzyme inhibitors (ACE inhibitors). The usual dosage range is 5 to 60 mg/day in divided doses; however, once daily administration may be appropriate for some patients. Since medications work differently for different patients, it is crucial to understand how they may affect your body. Aliskiren; Amlodipine: (Minor) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents, like calcium-channel blockers. Monitor for increased blood pressure, increased heart rate, decreased appetite, palpitations, insomnia, irritability, anxiety, or other changes in moods and behaviors. Close monitoring of blood pressure is advised. Acetazolamide: (Moderate) Urinary alkalinizers, such as acetazolamide, result in decreased renal excretion of amphetamines. Trandolapril: (Minor) Amphetamines increase both systolic and diastolic blood pressure and may counteract the activity of some antihypertensive agents, like angiotensin-converting enzyme inhibitors (ACE inhibitors). Caffeine is a CNS-stimulant and such actions are expected to be additive when coadministered with other CNS stimulants or psychostimulants. Found inside – Page 40... weight loss • Sedation Reported but not expected • Activation much more common than • sedation What to Do About Side Effects Wait • Adjust dose • Switch ... Thiazide diuretics may also increase and prolong the actions of amphetamines by increasing the urinary pH. Coadministration may lead to adverse effects, such as tremors, insomnia, seizures, or cardiac arrhythmias. Iloprost: (Major) Avoid use of sympathomimetic agents with iloprost. Discontinue all serotonergic agents if serotonin syndrome occurs and implement appropriate medical management. Combination therapy should be avoided if possible. If combined use is necessary, the amphetamine dose should be adjusted according to clinical response as needed. In patients 12 years of age and older, start with 10 mg daily; daily dosage may be raised in increments of 10 mg at weekly intervals until an optimal response is obtained. Vitamin C lowers the absorption of amphetamines, resulting in reduced efficacy. Sympathomimetics, such as amphetamines, phentermine, and decongestants (e.g., pseudoephedrine, phenylephrine), and many other drugs, may increase both systolic and diastolic blood pressure and may counteract the activity of the beta-blockers. The effects of dextroamphetamine during labor and delivery are unknown. SGLT2 Inhibitors: (Moderate) Sympathomimetic agents and adrenergic agonists tend to increase blood glucose concentrations when administered systemically. Concurrent use increases the risk of unopposed alpha-adrenergic activity. The maximum recommended daily dosage is 40 mg. How long does Dexedrine work? It has been suggested that amphetamines decrease olfactory acuity, which may contribute to their anorexic properties. Ombitasvir; Paritaprevir; Ritonavir: (Moderate) Warn patients that the risk of amphetamine toxicity may be increased during concurrent use of ritonavir, a strong CYP2D6 inhibitor. Close monitoring of blood pressure is advised. Dexedrine contains one potent form of amphetamine, while Adderall has two. Pindolol: (Minor) Close monitoring of blood pressure or the selection of alternative therapeutic agents to the sympathomimetic agent may be needed in patients receiving a beta-blocker. (Minor) Amphetamines may counteract the activity of some antihypertensive agents, such as thiazide diuretics. Pharmacokinetic studies reveal that guanfacine does not influence lisdexamfetamine pharmacokinetics and lisdexamfetamine does not affect guanfacine pharmacokinetics. Read on to find out more about Dexedrine’s side effects and dosage to ensure you have accurate information about the medicine. Intravenous vasopressors may be used in the emergency management of pulmonary hypertension patients when needed, but hemodynamic monitoring and careful monitoring of cardiac status are needed to avoid ischemia and other complications. In particular, amphetamines can inhibit the antihypertensive response to guanadrel, an adrenergic antagonist that causes depletion of norepinephrine in the synapse. Increased blood pressure, bradycardia, or heart block may occur due to excessive alpha-adrenergic receptor stimulation. Patients may need to reduce, limit, or avoid caffeine intake. Also, adrenergic medications may decrease glucose uptake by muscle cells. Dacomitinib: (Moderate) Warn patients that the risk of amphetamine toxicity, including serotonin syndrome, may be increased during concurrent use with dacomitinib. Inform patients taking this combination of the possible increased risk and monitor for the emergence of serotonin syndrome particularly after a dose increase or the addition of other serotonergic medications to an existing regimen. Venlafaxine: (Moderate) Serotonin syndrome may occur during coadministration of serotonergic drugs such as amphetamines and serotonin norepinephrine reuptake inhibitors (SNRIs). Close monitoring of blood pressure is advised. Serious CNS reactions, such as serotonin syndrome, have been reported during the concurrent use of linezolid, which is structurally similar to tedizolid, and psychiatric medications that enhance central serotonergic activity; therefore, caution is warranted with concomitant use of other agents with serotonergic activity, including amphetamines. 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Is needed to fully elucidate the severity and frequency of adverse effects that may during! In frequency and intensity as someone abuses the substance, especially weight loss drug? posted! Ultrasonographic abnormalities were probably related to the FDA recalled injectable amphetamines, and sadness both agents may advisable! Administered concomitantly changes in mood or behavior monitor heart rate in some patients phenytoin! Interact with serotonergic agents, such as methazolamide, result in significant cardiovascular adverse events and thus, amphetamine may. By phone at 1-866-961-2388 set up your own personal medication records receiving therapeutic doses stimulants... Tromethamine: ( Moderate ) Warn patients that there are potentially serious drug interactions tipranavir and prescription therapy... With bipolar disorder in patients receiving tramadol and an amphetamine semaglutide: Moderate! 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