Methamphetamine

Methamphetamineis indicated as an integral part of a total treatment program forAttention 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, emotionallability, andimpulsivity. The diagnosis of this syndrome should not be made with finality when these symptoms are only of comparatively recent origin. Non-localizing (soft)neurologicalsigns, learning disability, and abnormal EEG may or may not be present, and a diagnosis ofcentral nervous systemdysfunction may or may not be warranted.

• Methamphetamine is also indicated as a short-term (i.e., a few weeks) treatment forobesityas an adjunct in a regimen of weight reduction based on caloric restriction, for patients in whom obesity isrefractoryto 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有一个高潜在滥用。特定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 the daily dose at weekly intervals of 5 mg/day until optimal response
• Adult, Maintenance: Usualeffective doseis 20-25 mg/day; the 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 the daily dose at weekly intervals of 5 mg/day until optimal response (usually 20-25 mg/day)
• The 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

Common side effects of methamphetamine include:

• High blood pressure(hypertension)
• Palpitations
• Fast heart rate
• Dizziness
• Drug tolerance
• Feeling uneasy
• 兴奋
• Headache
• 失眠
• Restlessness
• Tremor
• Hives
• Constipation
• Diarrhea
• Tastesensealtered
• Dry mouth

Serious side effects of methamphetamine include:

• Cardiorespiratory arrest
• Sudden death (rare)
• Heart attack(myocardial infarction, or MI)
• Cerebrovascular accident
• Gilles de la Tourette's syndrome
• Seizures
• Psychotic disorder
• Sympathomimetic syndrome
• Amphetamine toxicity
• Musclewasting(rhabdomyolysis)

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

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:
  • iobenguane I 123
  • isocarboxazid
  • linezolid
  • phenelzine
  • procarbazine
  • rasagiline
  • selegiline
  • selegiline transdermal
  • tranylcypromine
• 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:
  • amantadine
  • americanginseng
  • celandine
  • desmopressin
  • dexlansoprazole
  • esomeprazole
  • ethosuximide
  • eucalyptus
  • guarana
  • lansoprazole
  • omeprazole
  • pantoprazole
  • rabeprazole
  • sage
  • yerba mate

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.

warnings

• 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 seriouscardiovascularadverse 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
• Advancedarteriosclerosis
• Symptomaticcardiovascular 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 in late evening; may cause insomnia.
• May impair the 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(insulinrequirement may be altered), history of aggressive behavior.
• Do not give in late evening; may cause insomnia.
• May impair the 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.
• 突然的死亡,stroke, and myocardialinfarctionwere reported in adults taking stimulants at usual doses.
• Patients who develop symptoms such as exertional chest pain, unexplainedsyncope, 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/manicepisodes 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 the convulsive threshold in patients with prior history of seizures, 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 caution in patients who use other sympathomimetic drugs.
• Amphetamines may exacerbate motor and phonic tics and Tourette's syndrome; perform a clinical evaluation for tics and Tourette's syndrome in children and their families before treating with stimulant medications.
• High abuse potential.
• Rare instances of prolonged and sometimes painful erections (priapism), sometimes requiring surgical intervention, reported withmethylphenidate产品;通常没有报告在启动期间, but often after an increase in dose; seek immediate medical attention for abnormally sustained or frequent and painful erections.

Drug interaction overview:

• Serotoninsyndrome, a potentially life-threatening reaction, may occur when amphetamines are used in combination with other drugs that affect the serotonergicneurotransmittersystems such as monoamine oxidase inhibitors (MAOIs), selective serotoninreuptakeinhibitors (SSRIs), serotonin-norepinephrinereuptake 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 CYP2D6metabolism; 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 an 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 the 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 the benefits outweigh the 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.