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Methamphetamine

Brand Name: Desoxyn

Generic Name: Methamphetamine

Drug Class: CNS Stimulants, Anorexiants; Stimulants

What Is Methamphetamine and How Does It Work?

Methamphetamine is indicated as an integral part of a total treatment program for Attention Deficit Hyperactivity Disorder (ADHD) which typically includes other remedial measures (psychological, educational, social) for a stabilizing effect in children over 6 years of age with a behavioral syndrome characterized by the following group of developmentally inappropriate symptoms: moderate to severe distractibility, short attention span, hyperactivity, emotional lability, and impulsivity. The diagnosis of this syndrome should not be made with finality when these symptoms are only of comparatively recent origin. Non-localizing (soft) neurological signs, learning disability, and abnormal EEG may or may not be present, and a diagnosis of central nervous system dysfunction may or may not be warranted.

Methamphetamine is also indicated as a short-term (i.e., a few weeks) treatment for obesity as an adjunct in a regimen of weight reduction based on caloric restriction, for patients in whom obesity is refractory to alternative therapy, e.g., repeated diets, group programs, and other drugs.

The limited usefulness of methamphetamine should be weighed against possible risks inherent in use of the drug, such as those described below.

Methamphetamine is available under the following different brand names: Desoxyn.

Dosages of Methamphetamine

Adult and Pediatric Dosage Forms and Strengths

Tablet: Schedule II

  • 5mg

Dosage Considerations – Should be Given as Follows:

Amphetamine has a high potential for abuse. Particular attention should be paid to the possibility of patients obtaining amphetamine for nontherapeutic use or distribution to others, and the drugs should be prescribed or dispensed sparingly.

Administration of amphetamine for prolonged periods of time may lead to drug dependence and must be avoided.

Attention Deficit Hyperactivity Disorder

Adult, Initial: 5 mg orally once/day or every 12 hours; may increase daily dose at weekly intervals of 5 mg/day until optimal response

Adult, Maintenance: Usual effective dose is 20-25 mg/day; daily dose may be divided every 12 hours

Children under 6 years: Safety and efficacy not established

Children 6 years and older: 5 mg orally once/day or every 12 hours, may increase daily dose at weekly intervals of 5 mg/day until optimal response (usually 20-25 mg/day)

Daily dose may be divided every 12 hours

Obesity, Short Term Treatment

Adult: 5 mg orally every 8 hours, 30 minutes before each meal

Children under 12 years: Safety and efficacy not established

Children 12 years and older: As adults; 5 mg orally every 8 hours 30 minutes before each meal

What Are Side Effects Associated with Using Methamphetamine?

Common side effects of methamphetamine include:

Serious side effects of methamphetamine include:

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

QUESTION

Who is at greater risk for developing ADHD? See Answer

What Other Drugs Interact with Methamphetamine?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

Severe Interactions of methamphetamine include:

Methamphetamine has serious interactions with at least 36 different drugs.

Methamphetamine has moderate interactions with at least 204 different drugs.

Mild Interactions of methamphetamine include:

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

What Are Warnings and Precautions for Methamphetamine?

WaWarnings

Amphetamine has a high potential for abuse. Particular attention should be paid to the possibility of patients obtaining amphetamine for nontherapeutic use or distribution to others, and the drugs should be prescribed or dispensed sparingly.

Administration of amphetamine for prolonged periods of time may lead to drug dependence and must be avoided.

Use therapy in weight reduction programs when alternative therapy has been ineffective.

Misuse of amphetamine may cause sudden death and serious cardiovascular adverse events. This medication contains methamphetamine. Do not take Desoxyn if you are allergic to methamphetamine or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

Within 14 days of MAOIs

Advanced arteriosclerosis

Symptomatic cardiovascular disease

Hyperthyroidism

Moderate-severe hypertension

Hypersensitivity to sympathomimetic amines

Glaucoma

Agitated state

History of drug abuse

Patients with ADHD concomitant with Tourette's syndrome

Breastfeeding

Effects of Drug Abuse

Amphetamine has a high potential for abuse. Particular attention should be paid to the possibility of patients obtaining amphetamine for nontherapeutic use or distribution to others, and the drugs should be prescribed or dispensed sparingly.

Administration of amphetamine for prolonged periods of time may lead to drug dependence and must be avoided.

Short-Term Effects

Do not give at late evening; may cause insomnia.

May impair ability to drive and/or operate heavy machinery.

  • See "What Are Side Effects Associated with Using Methamphetamine?"

Long-Term Effects

Administration of amphetamine for prolonged periods of time may lead to drug dependence and must be avoided.

  • See "What Are Side Effects Associated with Using Methamphetamine?"

Cautions

Bipolar disorder, mild hypertension, history of seizures, diabetes (insulin requirement may be altered), history of aggressive behavior.

Do not give at late evening; may cause insomnia.

May impair ability to drive and/or operate heavy machinery.

Alkaline urine will significantly increase half-life.

Stimulants used to treat ADHD are associated with peripheral vasculopathy, including Raynaud's phenomenon.

Sudden deaths, stroke, and myocardial infarction reported in adults taking stimulants at usual doses.

Patients who develop symptoms such as exertional chest pain, unexplained syncope, or other symptoms suggestive of cardiac disease during stimulant treatment should undergo a prompt cardiac evaluation.

Particular care should be taken in using stimulants to treat ADHD patients with comorbid bipolar disorder because of concern for possible induction of mixed/manic episode in such patients.

Aggressive behavior or hostility is often observed in children and adolescents with ADHD; monitor for the appearance of or worsening of aggressive behavior or hostility.

Monitor growth of children ages 7 to 10 years during treatment with stimulants; may need to interrupt therapy in patients not growing or gaining weight as expected.

Stimulants may lower convulsive threshold in patients with prior history of seizure, patients with prior EEG abnormalities in absence of seizures, and very rarely, patients without a history of seizures and no prior EEG evidence of seizures; discontinue therapy in the presence of seizures.

Use with caution in patients who use other sympathomimetic drugs.

Amphetamines may exacerbate motor and phonic tics and Tourette's syndrome; perform clinical evaluation for tics and Tourette's syndrome in children and their families prior to treating with stimulant medications.

High abuse potential.

Rare instances of prolonged and sometimes painful erections (priapism), sometimes requiring surgical intervention, reported with methylphenidate products; typically not reported during initiation, but often subsequent to an increase in dose; seek immediate medical attention for abnormally sustained or frequent and painful erections.

Drug interaction overview:

  • Serotonin syndrome, a potentially life-threatening reaction, may occur when amphetamines are used in combination with other drugs that affect the serotonergic neurotransmitter systems such as monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John's Wort
  • Amphetamines are known to be metabolized, to some degree, by cytochrome P450 2D6 (CYP2D6) and display minor inhibition of CYP2D6 metabolism; potential for a pharmacokinetic interaction exists with coadministration of CYP2D6 inhibitors which may increase risk with increased exposure to amphetamines; in these situations, consider alternative non-serotonergic drug or alternative drug that does not inhibit CYP2D6
  • If concomitant use with other serotonergic drugs or CYP2D6 inhibitors is clinically warranted, initiate therapy with lower doses, monitor patients for emergence of serotonin syndrome during drug initiation or titration, and inform patients of increased risk for serotonin syndrome

Pregnancy and Lactation

Use methamphetamine with caution during pregnancy if benefits outweigh risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.

Do not nurse while taking methamphetamine.

SLIDESHOW

ADHD Symptoms in Children See Slideshow
References
SOURCE:
https://reference.medscape.com/drug/desoxyn-methamphetamine-999218
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f03a68d5-ed00-8a2d-af68-28be909ea85f
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