Patient Education: Dextroamphetamine (Dexedrine, ProCentra, Zenzedi)

Your healthcare provider has prescribed dextroamphetamine for your child based on current evidence-based guidelines to best address their mental health condition. While this medication is effective, it is important to understand that it may come with potential side effects. As a patient or caregiver, being informed about these risks and benefits is crucial. Additionally, knowing how to monitor for side effects and understanding strategies to reduce or manage them is essential. This guide aims to provide you with this knowledge, ensuring you are well-informed and confident in managing your child’s treatment.

What is Dextroamphetamine?

Dextroamphetamine belongs to a group of medicines known as stimulants. Stimulants help improve ADHD symptoms by increasing the levels of certain chemicals in the brain, called dopamine and norepinephrine, which help with focus and attention.

When is Dextroamphetamine prescribed to Children & Adolescents? 

Your doctor may prescribe dextroamphetamine for

• ADHD combined
• ADHD predominantly inattentive type

What is the Dose of Dextroamphetamine?

To find the right dose for your child, we start with a low dose and gradually increase it. Initial doses typically begin at around 0.15 to 0.3 mg/kg per day. We adjust the dose until there is a significant improvement in ADHD symptoms or until side effects prevent further increases. The maximum recommended daily dose for dextroamphetamine is around 1 mg/kg per day. The FDA has also set specific maximum daily doses for each formulation of dextroamphetamine.

What can be the possible

side-effects from the medication?

Serious but Rare Side-Effects

Heart Rhythm Disturbances

Dextroamphetamine can sometimes cause heart rhythm disturbances, which can feel like a racing, irregular, or skipped heartbeat. This side effect is rare and usually happens in patients who are more likely to have it due to their genes.

How to Minimize the Risk of This Side Effect:

• If your child has a history of heart rhythm disturbances, we will recommend non-stimulant medications as the first treatment option for ADHD. If non-stimulant medications are not effective, stimulants will only be considered after getting approval from a cardiologist.
• If there is a family history of heart rhythm disturbances or sudden unexplained cardiac deaths, we will require a normal EKG before starting the medication.

Psychosis

In patients with a genetic predisposition or history of psychosis, dextroamphetamine can potentially worsen symptoms depending on the dosage. We do not prescribe this medication to patients with a history of psychosis.

How to Manage This Side Effect?

• Unusual Behavior: If your child starts talking to themselves or acting strangely, contact your provider right away to check for psychosis. If it is an emergency, go to urgent care or call 911.

• Hearing Voices or Seeing Things: If your child says they hear voices or see things but you don't notice any other changes, call your provider to schedule an early appointment. This could be a side effect of the medication or a sign of anxiety, and only your child’s provider can tell for sure. Do not ignore this symptom. 

Lowering of Seizure threshold

In patients with a seizure disorder, dextroamphetamine may potentially lower the seizure threshold, although current data are contradictory.

How to Manage This Risk? 

• Neurologist Approval: If your child has an active seizure disorder, approval from their neurologist is required before starting stimulant medication.
• Close Collaboration: We will maintain ongoing communication with your child’s neurologist throughout the treatment process to reduce the risk of this side effect.

To learn more about this medication please visit MedlinePlus, a official US government website, part of National Library of Medicine and managed by National Institute of Health by clicking HERE