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Amphetamine Sulfate Dosage |
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Regardless of indication, Amphetamine Sulfate should be administered at the lowest effective dosage and dosage should be individually adjusted. Late evening doses should be avoided because of resulting insomnia.
Usual dose is 5 to 60 milligrams per day in divided doses depending on the individual patient response.
Narcolepsy seldom occurs in children under 12 years of age; however, when it does, Amphetamine Sulfate Tablets may be used. The suggested initial dose for patients aged 6 to 12 is 5 mg daily; daily dose may be raised in increments of 5 mg at weekly intervals until optimal response obtained. 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 optimal response is obtained. If bothersome adverse reactions appear (e.g., insomnia or anorexia) dosage should be reduced. Give the first dose on awakening; additional doses (5 or 10 mg) at intervals of 4 to 6 hours.
Not recommended for children under 3 years of age.
In children from 3 to 5 years of age, start with 2.5 mg daily; daily dosage may be raised in increments of 2.5 mg at weekly intervals until optimal response is obtained.
In children 6 years of age or older, start with 5 mg once or twice daily; daily dosage may be raised in increments of 5 mg at weekly intervals until optimal response is obtained. Only in rare cases will it be necessary to exceed a total of 40 milligrams per day.
With tablets give first dose on awakening; additional doses (1 to 2) at intervals of 4 to 6 hours.
Where possible, drug administration should be interrupted occasionally to determine if there is a recurrence of behavioral symptoms sufficient to require continued therapy.
Usual dosage is up to 30 mg daily, taken in divided doses of 5 to 10 mg, 30 to 60 minutes before meals. Not recommended for this use in children under 12 years of age.
Do not take Amphetamine Sulfate if you have taken a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) in the last 14 days.
Before taking Amphetamine Sulfate, tell your doctor if you are taking any of the following medicines:
insulin or another medicine to treat diabetes;
guanethidine (Ismelin) or reserpine (Diutensin-R);
doxazosin (Cardura), terazosin (Hytrin), prazosin (Minipress), or guanadrel(Hylorel);
a tricyclic antidepressant such as amitriptyline (Elavil), amoxapine (Asendin), doxepin (Sinequan), nortriptyline (Pamelor), imipramine (Tofranil), clomipramine (Anafranil), protriptyline (Vivactil), or desipramine (Norpramin)
a phenothiazine such as chlorpromazine (Thorazine);
lithium (Lithobid, Lithonate, Eskalith, others); or
haloperidol (Haldol).
You may not be able to take Amphetamine Sulfate, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with Amphetamine Sulfate. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.
Table 2: Drugs having clinically important interactions with amphetamines.
MAO Inhibitors (MAOI) | |
Clinical Impact | MAOI antidepressants slow Amphetamine Sulfate metabolism, increasing amphetamines effect on the release of norepinephrine and other monoamines from adrenergic nerve endings causing headaches and other signs of hypertensive crisis. Toxic neurological effects and malignant hyperpyrexia can occur, sometimes with fatal results. |
Intervention | Do not administer Amphetamine Sulfate during or within 14 days following the administration of MAOI. |
Examples | selegiline, isocarboxazid, phenelzine, tranylcypromine |
Alkalinizing Agents | |
Clinical Impact | Increase blood levels and potentiate the action of Amphetamine Sulfate. |
Intervention | Co-administration of Amphetamine Sulfate and gastrointestinal alkalinizing agents should be avoided. |
Examples | Gastrointestinal alkalinizing agents (e.g., sodium bicarbonate). Urinary alkalinizing agents (e.g. acetazolamide, some thiazides). |
Acidifying Agents | |
Clinical Impact | Lower blood levels and efficacy of amphetamines. |
Intervention | Increase dose based on clinical response. |
Examples | Gastrointestinal acidifying agents (e.g., guanethidine, reserpine, glutamic acid HCl, ascorbic acid). Urinary acidifying agents (e.g., ammonium chloride, sodium acid phosphate, methenamine salts). |
Tricyclic Antidepressants | |
Clinical Impact | May enhance the activity of tricyclic or sympathomimetic agents causing striking and sustained increases in the concentration of d-Amphetamine Sulfate in the brain; cardiovascular effects can be potentiated. |
Intervention | Monitor frequently and adjust or use alternative therapy based on clinical response. |
Examples | desipramine, protriptyline |
Proton Pump Inhibitors | |
Clinical Impact | Time to maximum concentration (Tmax) of Amphetamine Sulfate is increased compared to when administered alone. |
Intervention | Monitor patients for changes in clinical effect and adjust therapy based on clinical response. |
Example | omeprazole |
Amphetamines can cause a significant elevation in plasma corticosteroid levels. This increase is greatest in the evening. Amphetamines may interfere with urinary steroid determinations.
Amphetamine Sulfate contains Amphetamine Sulfate, which is a Schedule II controlled substance in the U.S. Controlled Substance Act (CSA).
Amphetamine Sulfate, is a CNS stimulant that contains Amphetamine Sulfate which has a high potential for abuse. Abuse is characterized by impaired control over drug use, compulsive use, continued use despite harm, and craving.
Signs and symptoms of Amphetamine Sulfate abuse may include increased heart rate, respiratory rate, blood pressure, and/or sweating, dilated pupils, hyperactivity, restlessness, insomnia, decreased appetite, loss of coordination, tremors, flushed skin, vomiting, and/or abdominal pain. Anxiety, psychosis, hostility, aggression, suicidal or homicidal ideation have also been observed. Abusers of amphetamines may use other unapproved routes of administration which can result in overdose and death.
To reduce the abuse of Amphetamine Sulfate, assess the risk of abuse prior to prescribing. After prescribing, keep careful prescription records, educate patients and their families about abuse and on proper storage and disposal of CNS stimulants, monitor for signs of abuse while on therapy, and re-evaluate the need for Amphetamine Sulfate use.
Tolerance
Tolerance (a state of adaptation in which exposure to a drug results in a reduction of the drug's desired and/or undesired effects over time) may occur during the chronic therapy of CNS stimulants including Amphetamine Sulfate.
Dependence
Physical dependence (which is manifested by a withdrawal syndrome produced by abrupt cessation, rapid dose reduction, or administration of an antagonist) may occur in patients treated with CNS stimulants including Amphetamine Sulfate. Withdrawal symptoms after abrupt cessation following prolonged high-dosage administration of CNS stimulants include dysphoric mood; fatigue; vivid, unpleasant dreams; insomnia or hypersomnia; increased appetite; and psychomotor retardation or agitation.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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