The dose of a drug and dosage of the drug are two different terminologies. Dose is defined as the quantity or amount of medicine given by the doctor or taken by the patient at a given period. Dosage is the regimen prescribed by the doctor about how many days and how many times per day the drug is to be taken in specified dose by the patient. The dose is expressed in mg for tablets or gm, micro gm sometimes, ml for syrups or drops for kids syrups. The dose is not fixed for a drug for all conditions, and it changes according to the condition or a disease. It also changes on the age of the patient.
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Dextenal Dosage
Applies to the following strength(s): 5 mg; 10 mg; 15 mg; 5 mg/5 mL; 2.5 mg; 7.5 mg; 20 mg; 30 mg
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
Usual Adult Dose for:
Narcolepsy
Usual Pediatric Dose for:
Attention Deficit Disorder
Narcolepsy
Additional dosage information:
Renal Dose Adjustments
Liver Dose Adjustments
Dose Adjustments
Precautions
Dialysis
Other Comments
Usual Adult Dose for Narcolepsy
-Initial Dose: 10 mg orally per day
-Maintenance Dose: May raise daily dose in 10 mg increments at weekly intervals until optimal response is obtained.
Comments:
-The usual dose is 5 to 60 mg per day in divided doses, depending on the individual patient response.
-IR: Give the first dose on awakening; give 1 to 2 additional doses at intervals of 4 to 6 hours.
-ER/SR: May use this formulation for once-a-day dosage wherever appropriate.
Use: Narcolepsy treatment
Usual Pediatric Dose for Attention Deficit Disorder
Immediate-Release (IR):
Age 3 to 5 Years:
-Initial Dose: 2.5 mg orally per day
-Maintenance Dose: May raise daily dose in 2.5 mg increments at weekly intervals until optimal response is obtained.
IR and Extended-Release (ER)/Sustained-Release (SR):
Age 6 to 17 Years:
-Initial Dose: 5 mg orally 1 or 2 times a day
-Maintenance Dose: May raise daily dose in 5 mg increments at weekly intervals until optimal response is obtained.
-Maximum Dose: Only in rare cases will it be necessary to exceed 40 mg per day.
Comments:
-IR: Give the first dose on awakening; give 1 to 2 additional doses at intervals of 4 to 6 hours.
-ER/SR: May use this formulation for once-a-day dosage wherever appropriate.
-Where possible, occasionally interrupt drug administration to determine if continued therapy is required.
Use: As part of a total treatment program for Attention Deficit Hyperactivity Disorder (ADHD).
Usual Pediatric Dose for Narcolepsy
Age 6 to 11 Years:
-Initial Dose: 5 mg orally per day
-Maintenance Dose: May raise daily dose in 5 mg increments at weekly intervals until optimal response is obtained.
Age 12 Years and Older:
-Initial Dose: 10 mg orally per day
-Maintenance Dose: May raise daily dose in 10 mg increments at weekly intervals until optimal response is obtained.
Comments:
-The usual dose is 5 to 60 mg per day in divided doses, depending on the individual patient response.
-IR: Give the first dose on awakening; give 1 to 2 additional doses at intervals of 4 to 6 hours.
-ER/SR: May use this formulation for once-a-day dosage wherever appropriate.
-Narcolepsy rarely occurs in children under 12 years of age.
-Due to the high abuse potential, this drug should be prescribed/dispensed sparingly and particular attention should be paid to subjects possibly obtaining this drug for non-therapeutic use or distribution to others.
-Administering this drug for prolonged periods of time should be avoided as it may lead to drug dependence.
-Drug misuse may cause sudden death and serious cardiovascular adverse events.
Long-term effects of amphetamines in children have not been well established.
-For ADHD treatment, the IR formulations are not recommended in patients younger than 3 years and the ER/SR formulation is not recommended in patients younger than 6 years.
-For narcolepsy treatment, all formulations of this drug are not recommended in patients younger than 6 years.
Consult WARNINGS section for additional precautions.
US Controlled Substance: Schedule II
Dialysis
Data not available.
Other Comments
Administration Advice:
-Avoid late evening doses because of the potential for insomnia.
-Administer this drug at the lowest effective dosage, and individually adjust dosage.
-Take tablet doses at the same times on each day preferably with or immediately after meals.
Storage Requirements:
-Store this drug between 20 to 25 degrees Celsius (68 to 77 Fahrenheit) and dispense in a tight, light-resistant container.
General:
-Individual patient response to amphetamines varies widely: toxic symptoms can occur at doses as low as 2 mg but are rare with doses of less than 15 mg; 30 mg can produce severe reactions yet doses of 400 to 500 mg are not necessarily fatal.
-Overdosage: Management is largely symptomatic and may include gastric lavage, activated charcoal, a cathartic, and sedation; insufficient data is available to recommend the use of hemodialysis or peritoneal dialysis.
Monitoring:
-Cardiovascular: Blood pressure, heart rate, changes in fingers and toes
-Psychiatric: New or worsening psychiatric disorders, including aggressive behavior/hostility, depression, psychosis, mania, and suicidal thoughts or behavior
Patient Advice:
-Avoid driving and other potentially dangerous activities such as operating machinery until you know how this drug affects you.
-Contact your healthcare provider if you experience any of the following on your fingers or toes during treatment: unexplained wounds, new numbness, pain, skin color change, or temperature sensitivity.
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What other drugs will affect Dextenal?
Ask your doctor before using a stomach acid medicine. Some of these medicines can change the way your body absorbs Dextenal, which may increase side effects.
Tell your doctor about all medicines you use, and those you start or stop using during your treatment with Dextenal, especially:
an antidepressant;
blood pressure medication; or
seizure medication.
This list is not complete. Other drugs may interact with Dextenal, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Dextenal interactions
Interactions are the effects that happen when the drug is taken along with the food or when taken with other medications. Suppose if you are taking a drug Dextenal, it may have interactions with specific foods and specific medications. It will not interact with all foods and medications. The interactions vary from drug to drug. You need to be aware of interactions of the medicine you take. Most medications may interact with alcohol, tobacco, so be cautious.
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Acidifying agents: Gastrointestinal acidifying agents (guanethidine, reserpine, glutamic acid HCl, ascorbic acid, fruit juices, etc.) lower absorption of amphetamines. Urinary acidifying agents (ammonium chloride, sodium acid phosphate, etc.) increase the concentration of the ionized species of the amphetamine molecule, thereby increasing urinary excretion. Both groups of agents lower blood levels and efficacy of amphetamines.
Adrenergic blockers: Adrenergic blockers are inhibited by amphetamines.
Alkalinizing agents: Gastrointestinal alkalinizing agents (sodium bicarbonate, etc.) increase absorption of amphetamines. Urinary alkalinizing agents (acetazolamide, some thiazides) increase the concentration of the non-ionized species of the amphetamine molecule, thereby decreasing urinary excretion. Both groups of agents increase blood levels and therefore potentiate the actions of amphetamines.
Antidepressants, tricyclic: Amphetamines may enhance the activity of tricyclic or sympathomimetic agents; d-amphetamine with desipramine or protriptyline and possibly other tricyclics cause striking and sustained increases in the concentration of d-amphetamine in the brain; cardiovascular effects can be potentiated.
MAO inhibitors: MAOI antidepressants, as well as a metabolite of furazolidone, slow amphetamine metabolism. This slowing potentiates amphetamines, increasing their effect on the release of norepinephrine and other monoamines from adrenergic nerve endings; this can cause headaches and other signs of hypertensive crisis. A variety of neurological toxic effects and malignant hyperpyrexia can occur, sometimes with fatal results.
Antihistamines: Amphetamines may counteract the sedative effect of antihistamines.
Antihypertensives: Amphetamines may antagonize the hypotensive effects of antihypertensives.
Chlorpromazine: Chlorpromazine blocks dopamine and norepinephrine reuptake, thus inhibiting the central stimulant effects of amphetamines, and can be used to treat amphetamine poisoning.
Ethosuximide: Amphetamines may delay intestinal absorption of ethosuximide.
Haloperidol: Haloperidol blocks dopamine and norepinephrine reuptake, thus inhibiting the central stimulant effects of amphetamines.
Lithium carbonate: The stimulatory effects of amphetamines may be inhibited by lithium carbonate.
Meperidine: Amphetamines potentiate the analgesic effect of meperidine.
Methenamine therapy: Urinary excretion of amphetamines is increased, and efficacy is reduced, by acidifying agents used in methenamine therapy.
Norepinephrine: Amphetamines enhance the adrenergic effect of norepinephrine.
Phenobarbital: Amphetamines may delay intestinal absorption of phenobarbital; co-administration of phenobarbital may produce a synergistic anticonvulsant action.
Phenytoin: Amphetamines may delay intestinal absorption of phenytoin; co-administration of phenytoin may produce a synergistic anticonvulsant action.
Propoxyphene: In cases of propoxyphene overdosage, amphetamine CNS stimulation is potentiated and fatal convulsions can occur.
Veratrum alkaloids: Amphetamines inhibit the hypotensive effect of veratrum alkaloids.
Drug/Laboratory Test Interactions: Amphetamines can cause a significant elevation in plasma corticosteroid levels. This increase is greatest in the evening.
Amphetamines may interfere with urinary steroid determinations.
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References
DailyMed. "DEXTROAMPHETAMINE SULFATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
FDA/SPL Indexing Data. "TZ47U051FI: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
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