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Amphetamine Dosage

Medically reviewed on March 5, 2018.

Applies to the following strengths: 5 mg; 10 mg; 2.5 mg/mL; 1.25 mg/mL; 3.1 mg; 6.3 mg; 9.4 mg; 12.5 mg; 15.7 mg; 18.8 mg

Usual Adult Dose for Narcolepsy

IMMEDIATE-RELEASE ORAL TABLET:
5 to 60 mg orally per day in divided doses

Comments:
-The first dose should be given on awakening; additional doses should be given at intervals of 4 to 6 hours; late evening doses should be avoided because of resulting insomnia.
-The dose should be individualized based on patient response; reduce dose if bothersome adverse reactions (e.g., insomnia, anorexia) appear.

Use: For the treatment of narcolepsy.

Usual Adult Dose for Obesity

IMMEDIATE-RELEASE ORAL TABLET:
5 to 10 mg orally 30 to 60 minutes before meals
Maximum dose: 30 mg per day

Comments:
-Amphetamines are of limited usefulness for weight loss; potential risks should be weighed against limited usefulness.
-Amphetamines should be administered at the lowest effective dosage and dosage should be individually adjusted; late evening doses should be avoided because of resulting insomnia.

Use: As a short-term adjunct in regimen of weight reduction based on caloric restriction when other treatments have not worked (e.g., repeated diets, group programs, other drugs).

Usual Adult Dose for Attention Deficit Disorder

ORAL DISINTEGRATING TABLETS (ODT) and ORAL SUSPENSION (Adzenys ER 1.25 mg/mL): 12.5 mg orally once a day in the morning

ORAL SUSPENSION (Dyanavel XR 2.5 mg/mL):
Initial Dose: 2.5 or 5 mg orally once a day in the morning
-Increase in increments of 2.5 to 10 mg per day every 4 to 7 days until optimal response is obtained.
Maximum Dose: 20 mg orally per day

Comments:
-ODTs and oral suspension both contain immediate and extended-release components.
-A total treatment program typically includes other remedial measures (e.g., psychological, educational, and social).
-Amphetamines should be administered at the lowest effective dose and dose should be individually adjusted; late evening doses should be avoided because of resulting insomnia.
-Amphetamine products should not be substituted on a mg-per-mg basis because of differing salt compositions and differing pharmacokinetic profiles; see dosage adjustment section for guidance on switching.

Use: As part of a total treatment program for Attention Deficit Hyperactivity Disorder (ADHD).

Usual Pediatric Dose for Narcolepsy

IMMEDIATE-RELEASE ORAL TABLET:
Age 6 to 11 Years:
-Initial Dose: 5 mg orally per day in divided doses
-Maintenance Dose: Daily dose may be raised in 5 mg increments at weekly intervals until optimal response is obtained

Age 12 Years and Older:
-Initial Dose: 5 to 10 mg orally per day in divided doses
-Maintenance Dose: Daily dose may be raised in 5 or 10 mg increments at weekly intervals until optimal response is obtained

Maximum dose: 60 mg per day

Comments:
-The first dose should be given on awakening; additional doses should be given at intervals of 4 to 6 hours; late evening doses should be avoided because of resulting insomnia.
-The dose should be individualized based on patient response; reduce dose if bothersome adverse reactions (e.g., insomnia, anorexia) appear.
-Narcolepsy rarely occurs in children under 12 years of age.

Use: Narcolepsy treatment

Usual Pediatric Dose for Obesity

IMMEDIATE-RELEASE ORAL TABLET:
Age 12 Years and Older:
-Initial Dose: 5 mg orally 30 to 60 minutes before each meal
-Maximum Dose: 30 mg orally per day in divided doses

Comments:
-Amphetamines are of limited usefulness for weight loss; potential risks should be weighed against limited usefulness.
-Amphetamines should be administered at the lowest effective dosage and dosage should be individually adjusted; late evening doses should be avoided because of resulting insomnia.

Use: As a short-term adjunct in regimen of weight reduction based on caloric restriction when other treatments have not worked (e.g., repeated diets, group programs, other drugs).

Usual Pediatric Dose for Attention Deficit Disorder

IMMEDIATE-RELEASE: First dose should be given on awakening; 1 to 2 additional doses should be given at 4 to 6-hour intervals
3 to 5 years:
-Initial Dose: 2.5 mg orally once a day; adjust daily dose in 2.5 mg increments at weekly intervals until optimal response is obtained
6 years or older:
-Initial Dose: 5 mg orally 1 or 2 times a day; adjust daily dose in 2.5 mg increments at weekly intervals until optimal response is obtained
Maximum Dose: 40 mg/day; only in rare cases will it be necessary to exceed this dose

ORAL DISINTEGRATING TABLETS (ODT) and ORAL SUSPENSION (Adzenys ER 1.25 mg/mL)
6 years or older:
Initial dose: 6.3 mg orally once a day in the morning
-Increase in 3.1 mg or 6.3 mg increments weekly
Maximum dose: 18.8 mg/day (6 to 12 years); 12.5 mg (13 to 17 years)

ORAL SUSPENSION (Dyanavel XR 2.5 mg/mL):
6 years or older:
Initial Dose: 2.5 or 5 mg orally once a day in the morning
-Increase in increments of 2.5 to 10 mg per day every 4 to 7 days until optimal response is obtained.
Maximum Dose: 20 mg orally per day

Comments:
-ODTs and oral suspension both contain immediate and extended-release components.
-A total treatment program typically includes other remedial measures (e.g., psychological, educational, and social).
-Amphetamines should be administered at the lowest effective dose and dose should be individually adjusted; late evening doses should be avoided because of resulting insomnia.
-Amphetamine products should not be substituted on a mg-per-mg basis because of differing salt compositions and differing pharmacokinetic profiles; see dosage adjustment section for guidance on switching.

Use: As part of a total treatment program for Attention Deficit Hyperactivity Disorder (ADHD).

Renal Dose Adjustments

Use with caution

Liver Dose Adjustments

Use with caution

Dose Adjustments

Elderly: Dose selection should be conservative starting at the low end of the dosing range and titrating slowly

SWITCHING FROM OTHER AMPHETAMINE PRODUCTS:
-Do not substitute on a mg-per-mg basis
-When switching from other amphetamine products, discontinue that treatment, and titrate using the titration schedule in the Usual Dosage Section

Dose equivalents of Adzenys XR oral suspension and ODTs to Adderall XR extended-release capsules (mixed salts of a single-entity amphetamine)
-Adzenys ER and XR 3.1 mg equivalent to Adderall XR 5 mg
-Adzenys ER and XR 6.3 mg equivalent to Adderall XR 10 mg
-Adzenys ER and XR 9.4 mg equivalent to Adderall XR 15 mg
-Adzenys ER and XR 12.5 mg equivalent to Adderall XR 20 mg
-Adzenys ER and XR 15.7 mg equivalent to Adderall XR 25 mg
-Adzenys ER and XR 18.8 mg equivalent to Adderall XR 30 mg

Precautions

US BOXED WARNINGS: ABUSE AND DEPENDENCE
Immediate-Release Tablets: This drug has a high potential for abuse; administration for prolonged periods of time may lead to drug dependence and must be avoided. Particular attention should be paid to subjects obtaining this drug for non-therapeutic use or distribution to others; these drugs should be prescribed or dispensed sparingly. Drug misuse may cause sudden death and serious cardiovascular adverse events.
Oral Disintegrating Tablets and Oral Suspension: CNS stimulants including this drug, other amphetamine-containing products, and methylphenidate have a high potential for abuse and dependence. Assess risk of abuse prior to prescribing and monitor for signs of abuse and dependence during therapy.

Immediate-Release: Safety and efficacy for use as an anorectic agent have not been established in patients younger than 12 years or as treatment for ADHD in children younger than 3 years.

Oral Disintegrating Tablets and Oral Suspension: Safety and efficacy have not been established 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:
-Take orally with or without food
-Morning dosing is preferred; avoid late evening doses because of resulting insomnia
Oral Disintegrating Tablets (ODT):
-Tablets should not be removed from blister pack until administration
-Using dry hands, tear along perforation, bend blister where indicated and peel back blister's labeled backing to take out tablet; tablet should not be pushed out through foil
-Place tablet on tongue and allow to disintegrate without chewing
-Tablet will disintegrate in saliva so that it can be swallowed; do not crush
Oral Suspension:
-Shake well before administration; measure dose with a calibrated measuring device
-Do not add to food or mix with other liquids before consuming
-Wash oral dispensing device after each use

Storage Requirements:
-Store suspension at room temperature in a well-closed container
-Store ODT tablets in rigid, plastic travel case once removed from carton

General:
-Regardless of indication, this drug should be administered at the lowest effective dose and dosage should be individualized according to the needs and responses of the patient.
-Where possible, interrupt dosing occasionally to determine if continued therapy is required.
-Racemic amphetamine differs from dextroamphetamine (d-isomer of racemic amphetamine) in that the l-isomer is more potent than the d-isomer in cardiovascular activity but much less potent in causing CNS excitatory effects, and the racemic mixture is less effective as an appetite suppressant.
-Oral Disintegrating Tablets and Oral Suspension contain both immediate-release and extended-release components.

Monitoring:
-Prior to treatment, assess for the presence of cardiac disease (perform a careful history, family history of sudden death or ventricular arrhythmia, and physical exam)
-Prior to treatment, assess the risk of abuse
-Cardiovascular: Blood pressure and heart rate; changes in fingers and toes
-Growth suppression: Monitor height and weight
-Psychiatric: Signs of abuse/misuse; aggressive behavior/hostility, psychotic and manic symptoms

Patient Advice:
-Instruct patients/caregivers to read the US FDA-approved patient labeling (Medication Guide and Instructions for Use).
-Patients should be instructed on proper administration and disposal; patients should understand that this drug is a controlled substance because it can be abused or lead to dependence.
-Patients should understand there are serious cardiovascular risks, psychiatric risks, and long-term growth suppression risks associated with use of this drug; they should understand when they will need to immediately seek medical attention.
-Patients should be instructed to notify their physician with any changes to their medication regimen including over the counter products and herbal supplements as there is a potential for drug interactions.
-Patients should notify their physician if they become pregnant or intend to become pregnant or breastfeed.
-Patients should avoid alcohol as consumption of alcohol may result in a more rapid release of the dose of amphetamine.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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