Category:

• Miscellaneous

Description:

• Anorexiant, CNS stimulant: DEA Schedule II

Indications:

• Short term adjunct to caloric restriction in exogenous obesity (high abuse potential)

• Attention deficit disorder with hyperactivity

Contraindications:

• Hyperthyroidism, moderate to severe hypertension, glaucoma, sever arteriosclerosis

• History of drug abuse, symptomatic cardiovascular disease, agitated states, within 14 days of MAOI administration

Precautions:

• Pregnancy category C; use for medical conditions does not pose significant risk to the fetus for congenital anomalies, but mild withdrawal symptoms may be observed in newborn children ; contraindicated during breast feeding

• Mild hypertension, child <3 years, Tourette’s disorder

• Motor and phonic tics

• Tartrazine sensitivity (15mg sustained release preparation)

Adverse Reactions (Side Effects):

• CNS: addiction, aggressiveness, changes in libido, chills, dependence, dizziness, dyskinesia, dysphoria, euphoria, headache, hyperactivity, insomnia, irritability, over- stimulation, psychotic episodes, restlessness, talkativeness, tremor

• CV: arrhythmias (at large doses), dysrhythmias, hypertension, palpitations, reflex decrease in heart rate, tachycardia

• GI: anorexia, constipation, cramps, diarrhea, dry mouth, metallic taste, nausea, vomiting, weight loss

• GU: impotence

• METAB: reversible elevations in serum thyroxine with heavy use

• SKIN: urticaria

Dosage:

Administered orally

• Adult:            

  • Obesity: PO 5mg 30 minutes before each meal; SUS REL PO 10-15mg every morning; treatment should not exceed a few weeks

• Child:            

  • Attention deficit disorder with hyperactivity: PO 5mg 1-2 times daily initially, increase in increments of 5 mg/day at weekly intervals until an optimum response is achieved; usual effective dose 20-25mg daily (divided twice daily with conventional tablets or once daily with sustained release formulations)

Drug interactions:

• MAOIs: severe hypertensive reactions possible

• Selegiline: Potential for enhanced pressor effect if used in combination

• Sodium bicarbonate (large doses): inhibit elimination and increase the effect of amphetamines