Dexedrine-page2

Haloperidol

Haloperidol blocks dopamine and norepinephrins 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 administration of phenobarbital and may produce an intestinal absorption of phenobarbital; coadministration of phenobarbital may produce a co-synergistic anticonvulsant action.

Phenytion

amphetamines may delay intestinal absorption of phenytoin; co-adminstration of pheytoin may produce a synergistic anticonvulsant action.

Propoxyphene

in cases of propoxyphene overdosage, amphetamine CNS stimulation is potentiated and fatal convulsions can occur.

Veraltrum Alkaloids

amphetamines inhibit the hypotensive effect of veratrum alkaloids.

Warnings

     Amphetamines have a high potential for abuse.  Administration of amphetamines for prolonged periods of time may lead to drug dependence and must be avoided.  Particular attention should be paid to the possiblity of subjects obtaining amphetamines for nontherapeutic use or distribution to others and the drugs should be prescribed or dispensed sparingly.

Precautions

General

     Caution is to be exercised in prescribing amphetamines for patients with even mild bypertension.  The least amount feasible should be prescribed, or dispensed at one time in order to minimize the possibility of overdosage.

     These products contain FD&C Yellow No.5 (tartrazine), which, may cause allergic type reactions (including bronchial asthma) in certain susceptible individuals.  Although the overall incidence of FD&C Yellow No.5 (tartrazine) sensitivity in the general population is low, it is frequently seen in patients who also have aspirin hypersensitivity.

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 steriod determinations.

Carcinogenesis/ Mutagenesis

     Mutagenicity studies and long-term studies in animal to determine the carcinogenic potential of Dexedrine (dextroamphetamine sulfate) have not been performed.

Pregnancy

     TERATOGENIC EFFECTS:PREGNANCY CATEGORY C:Dexedrine has been shown to have embryotoxic and teratogenic effects when administerd to A/Jax mice and C57BL mice in doses approximately 41 times the maximum human dose.  Embrotoxic effects were not seen in New Zealand white rabbits given the drug in doses 7 times the human dose nor in rats given 12.5 the maximum human dose.  While there are no adequate and well-controlled studies in pregnant women, there has been one report of severe congenital bony deformity, tracheoesophageal fistula, and anal atresia (Vater association) in a baby born to a woman who took dextroamphetamine sulfate with lovastatin during the first trimester of pregnancy.  Dexedrine shoudl be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nonteragenic Effects

     Infants born to mothers dependent on amphetamines have an increased risk of premature delivery and low birth weight.  Also these infants may experience symptoms of withdrawal, as demonstrated by dysphoria, including agitation, and significant lassitude.

Nursing Mothers

     Amphetamines are excreted in human milk.  Mothers taking amphetamines should be advised to refrain from nursing.

Pediatric Use

     Long term effects of amphetamines in pediatric patients have not been well established.

     Amphetamines aer not recommended for use in pediatric patients under 3 years of age with Attention Deficit Disorder with Hyperactivity described under INDICATIONS.  Clinical experience suggests that in psychotic children, administration of amphetamines may exacerbate symptoms of behavior disturbance and thought disorder.

     Amphetamines have been reported to exacerbate motor and phonic tics and Tourette's syndrome.  Therefore, clinical evaluation for tics and Tourette's syndrome in children and their families should precede use of stimulant medications.

     Data are inadequate to determine whether chronic administration of amphetamines may be associated with growth inhibition; therefore growth should be monitored during treatment.

     Drug treatment is not indicated in all cases of Attention Deficit Disorder with Hyperactivity and should be considered only in light of the complete history and evaluation of the child.  The decision to prescribe amphetamines should depend on the physician's assessment of the chronicity and severity of the child's symptoms and their appropriateness for his/her age.  Prescription should not depend solely on teh presence of one or more of the bhavioral characteristics.

     When these symptoms are associated with acute stress reactions treatment with amphetamines is usually not indicated.

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