AdultPediatricDosage Forms & Strengths tablet (Evekeo): Schedule II 5mg 10mg extended-release oral tablets (Dyanavel XR): Schedule II 5mg 10mg 15mg 20mg extended-release oral suspension (Dyanavel XR): Schedule II 2.5mg/mL extended-release oral disintegrating tablet (Adzenys XR-ODT): Schedule II 3.1mg 6.3mg 9.4mg 12.5mg 15.7mg 18.8mg extended-release oral suspension (Adzenys ER): Schedule II 1.25 mg/mL Narcolepsy 5-60 mg/day PO in divided doses depending on the individual patient response Administer at the lowest effective dose; individually adjust dosage Obesity Indicated as a short term (a few weeks) adjunct in a regimen of weight reduction based on caloric restriction for patients refractory to alternative therapy (eg, repeated diets, group programs, and other drugs) Usual dosage is up to 30 mg daily, taken in divided doses of 5-10 mg, 30-60 minutes before meals Administer at the lowest effective dose; individually adjust dosage Attention Deficit Hyperactivity Disorder Indicated for attention deficit hyperactivity disorder (ADHD) in adolescents and adults Adzenys XR-ODT: 12.5 mg PO qAM Adzenys ER: 12.5 mg PO qAM Dyanavel XR: 2.5-5 mg PO qAM; may increase by 2.5 -10 mg/day q4-7days; not to exceed 20 mg/day Evekeo: 5 mg PO qDay or q12hr; may increase by 5 mg qWeek until optimal response is obtained; not to exceed 40 mg/day Dosage Modifications Equivalent doses of Adzenys ER or Adzenys XR-ODT and Adderall XR Adzenys ER/XR-ODT 3.1 mg (2.5 mL): Adderall XR 5 mg Adzenys ER/XR-ODT 6.3 mg (5 mL): Adderall XR 10 mg Adzenys ER/XR-ODT 9.4 mg (7.5mL): Adderall XR 15 mg Adzenys ER/XR-ODT 12.5 mg (10 mL): Adderall XR 20 mg Adzenys ER/XR-ODT 15.7 mg (12.5 mL): Adderall XR 25 mg Adzenys ER/XR-ODT 18.8 mg (15 mL): Adderall XR 30 mg Concomitant use of extended-release amphetamines with other medications Do not administer concomitantly or within 14 days after discontinuing MAO inhibitors Coadministration of and gastrointestinal alkalinizing agents should be avoided See Warnings Dosing Considerations Do not substitute for other amphetamine products on a mg-per-mg basis, because of different amphetamine base compositions and differing pharmacokinetic profiles Before initiating Assess for presence of cardiac disease (ie, perform a careful history, family history of sudden death or ventricular arrhythmia, and physical exam) Assess risk of abuse before prescribing, and monitor for signs of abuse and dependence while on therapy; maintain careful prescription records, educate patients about abuse, monitor for signs of abuse and overdose, and periodically re-evaluate the need for use Dosage Forms & Strengths tablet (Evekeo): Schedule II 5mg 10mg oral disintegrating tablet (Evekeo ODT): Schedule II 5mg 10mg 15mg 20mg extended-release oral tablets (Dyanavel XR): Schedule II 5mg 10mg 15mg 20mg extended-release oral suspension (Dyanavel XR): Schedule II 2.5mg/mL extended-release oral disintegrating tablet (Adzenys XR-ODT): Schedule II 3.1mg 6.3mg 9.4mg 12.5mg 15.7mg 18.8mg extended-release oral suspension (Adzenys ER): Schedule II 1.25 mg/mL Attention Deficit Hyperactivity Disorder Evekeo <3 years: Safety and efficacy not established 3-5 years: 2.5 mg PO qDay initially; may increase daily dose by 2.5-mg increments at weekly intervals until optimal response is obtained ≥6 years: 5 mg PO qDay initially; may increase daily dose by 5-mg increments at weekly intervals until optimal response is obtained; only in rare cases will it be necessary to exceed 40 mg/day If necessary, administer additional doses (1-2) at intervals of 4-6 hr Evekeo ODT <3 years: Safety and efficacy not established 3-5 years: 2.5 mg PO qDay; if needed, may increase daily dose at weekly intervals by 2.5 mg depending on response and tolerability 6-17 years: 5 mg PO qDay; if needed, may increase daily dose at weekly intervals by 2.5-5 mg until optimal response obtained If necessary, administer an additional dose after 4-6 hr Only in rare cases will it be necessary to exceed 40 mg/day Where possible, interrupt drug administration occasionally to determine if behavioral symptoms recur and are sufficient to require continued therapy Administer at lowest effective dose and individually adjust Dyanavel XR <6 years: Safety and efficacy not established ≥6 years: Initial: 2.5-5 mg PO qAM May increase dose in increments of 2.5-10 mg/day q4-7 days; not to exceed dose of 20 mg/day Adzenys XR-ODT or Adzenys ER <6 years: Safety and efficacy not established 6-17 years (initial dose): 6.3 mg PO qDay in AM; not to exceed 18.8 mg/day (6-12 years); 12.5 mg/day (13-17 years) Narcolepsy (Evekeo) Seldom occurs in children younger than 12 yr; however, when it does, amphetamine may be prescribed 6-12 years: 5 mg/day PO initially; daily dose may be increased by 5-mg increments at weekly intervals until optimal response obtained ≥12 years: 10 mg/day PO initially; daily dose may increase by 10-mg increments at weekly intervals until optimal response is obtained Administer in divided doses according to individual response Administer first dose on awakening; give additional doses (5-10 mg) at intervals of 4-6 hr Obesity (Evekeo) Indicated as a short term (a few weeks) adjunct in a regimen of weight reduction based on caloric restriction for patients refractory to alternative therapy (eg, repeated diets, group programs, and other drugs) <12 years: Safety and efficacy not established ≥12 years: Usual dosage is up to 30 mg daily, taken in divided doses of 5-10 mg, 30-60 minutes before meals Dosage Modifications Agents that alter urinary pH can impact urinary excretion and alter blood levels of amphetamine Acidifying agents (eg, ascorbic acid) decrease blood levels, while alkalinizing agents (eg, sodium bicarbonate) increase blood levels; adjust dosage accordingly Dosing Considerations Before initiating Assess for the presence of cardiac disease (ie, perform a careful history, family history of sudden death or ventricular arrhythmia, and physical exam) Assess risk of abuse before prescribing, and monitor for signs of abuse and dependence while on therapy; maintain careful prescription records, educate patients about abuse, monitor for signs of abuse and overdose, and periodically re-evaluate the need for use Switching From Other Amphetamine Products Do not substitute for other amphetamine products on a mg-per-mg basis, because of different amphetamine base compositions and differing pharmacokinetic profiles Switching from Evekeo to Evekeo ODT can done on a mg-per-mg basis Switching from other amphetamine products to Evekeo ODT, discontinue treatment and titrate with Evekeo ODT using the titration schedule above May substitute Dyanavel XR extended-release oral suspension with Dyanavel XR extended-release tablets on a mg-per-mg basis Avoid late evening doses because of insomnia Interaction CheckerEnter a drug name and amphetamineNo Results No Interactions Found Interactions FoundContraindicatedSerious - Use AlternativeSignificant - Monitor CloselyMinorAll Interactions Sort By: SeverityName Contraindicated (0)Serious - Use Alternative (2)iobenguane I 131amphetamine will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.ozanimodozanimod increases toxicity of amphetamine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.Monitor Closely (8)benzhydrocodone/acetaminophenbenzhydrocodone/acetaminophen, amphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.buprenorphine, long-acting injectionamphetamine, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.dextromethorphanamphetamine, dextromethorphan. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when amphemtamines are coadministered with dextromethorphan. .epinephrine inhaledamphetamine, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.esketamine intranasalesketamine intranasal, amphetamine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .hydrocodonehydrocodone, amphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.sodium zirconium cyclosilicatesodium zirconium cyclosilicate will increase the level or effect of amphetamine by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate. Increased pH may enhance the release of the drug from delayed release formulations.sufentanil SLsufentanil SL, amphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.Minor (0)benzhydrocodone/acetaminophenMonitor Closely (1)benzhydrocodone/acetaminophen, amphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.buprenorphine, long-acting injectionMonitor Closely (1)amphetamine, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.dextromethorphanMonitor Closely (1)amphetamine, dextromethorphan. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when amphemtamines are coadministered with dextromethorphan. .epinephrine inhaledMonitor Closely (1)amphetamine, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.esketamine intranasalMonitor Closely (1)esketamine intranasal, amphetamine. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .hydrocodoneMonitor Closely (1)hydrocodone, amphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.iobenguane I 131Serious - Use Alternative (1)amphetamine will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.ozanimodSerious - Use Alternative (1)ozanimod increases toxicity of amphetamine by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.sodium zirconium cyclosilicateMonitor Closely (1)sodium zirconium cyclosilicate will increase the level or effect of amphetamine by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate. Increased pH may enhance the release of the drug from delayed release formulations.sufentanil SLMonitor Closely (1)sufentanil SL, amphetamine. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect