Dextroamphetamine oral solution
PROCENTRA
What it isBubblegum-flavored IR liquid dextroamphetamine that releases dopamine for ADHD (PROCENTRA, 2008; approved ages 3-16).
Why this oneThe liquid allows measured adjustment for patients who cannot swallow tablets while retaining 3-5 h (Carlat Table 1) of immediate-release coverage.
What limits itAppetite loss, insomnia, and blood-pressure elevation can limit treatment; Schedule II misuse and dependence remain.
FDA-approved for
- ADHD (2008)
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Narcolepsy | Adults & children ≥12 yr | 10 mg QD | 5–60 mg/day divided (first dose on awakening, then 1–2 more at 4–6 hr) | 60 mg/day |
| Narcolepsy | Children 6–12 yr | 5 mg QD | titrate +5 mg/day at weekly intervals | |
| ADHD (Attention Deficit Disorder with Hyperactivity) | Children 3–5 yr | 2.5 mg QD | titrate +2.5 mg/day at weekly intervals | |
| ADHD (Attention Deficit Disorder with Hyperactivity) | Children ≥6 yr | 5 mg QD–BID | titrate +5 mg/day at weekly intervals | 40 mg/day (rarely exceeded) |
Titration Increase at weekly intervals.
Renal Undefined
Hepatic Undefined
Instructions
- Administer at lowest effective dosage; give first dose on awakening, additional 1–2 doses at 4–6 hr intervals
- Avoid late-evening doses (insomnia)
- Interrupt therapy occasionally to assess need for continued treatment
- Not recommended in children under 3 years for ADHD
Contraindications
- Use during or within 14 days of a monoamine oxidase inhibitor (MAOI) — hypertensive crisis may result
Cautions
- Avoid in serious cardiac disease (structural cardiac abnormalities, cardiomyopathy, serious arrhythmia, CAD) — sudden death reported
- Increases blood pressure and heart rate — monitor
- Psychiatric reactions: may exacerbate psychosis, induce mania in bipolar disorder, or cause new psychotic/manic symptoms
- Long-term growth suppression in pediatric patients — monitor height/weight
- May lower seizure threshold
- Peripheral vasculopathy, including Raynaud's phenomenon
- Serotonin syndrome with serotonergic drugs or CYP2D6 inhibitors
- Motor and verbal tics; worsening of Tourette's syndrome
Adverse reactions
- Palpitations, tachycardia, elevated blood pressure
- Overstimulation, restlessness, insomnia, dizziness, euphoria, dyskinesia, tremor, headache
- Dry mouth, unpleasant taste, diarrhea, constipation; anorexia and weight loss
- Impotence, changes in libido
- Urticaria; rhabdomyolysis
Pregnancy Pregnancy Category C; embryotoxic/teratogenic in animals; use only if benefit justifies risk. Infants of dependent mothers risk prematurity, low birth weight, and withdrawal.
Lactation Amphetamines are excreted in human milk; mothers should refrain from nursing.
⚠ BOXED WARNING
- Abuse, misuse and addiction
Classes and tags
Clinical profile
Mechanism of action: Dextroamphetamine oral solution ballicule
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