Technical Information about Amphetamines

Warning
Amphetamines have a high potential for abuse. They should be tried in weight reduction programs only for patients in whom other therapies have been ineffective. Administration of amphetamines for prolonged periods of time in obesity may lead to drug dependence and must be avoided. Particular attention should be paid to the possibility of subjects obtaining amphetamines for non-therapeutic use or distribution to others. The drug should be prescribed or dispensed sparingly.

Advanced arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension, hyperthyroidism, known hypersensitivity or idiosyncrasy to the sympathomimetic amines, glaucoma, agitated states, and patients with a history of drug abuse.

During or within 14 days following the administration of monoamine oxidase inhibitors (hypertensive crises may result).

When tolerance to the "anorectic" effect develops, do not increase the recommended in an attempt to increase the effect Discontinue the drug. Administration of amphetamine may exacerbate symptoms of some behavior disturbances and thought disorder. Data are inadequate to determined whether chronic administration of amphetamine may be associated with growth inhibition; therefore, growth should be monitored during treatment.

Amphetamines may enhance the activity of tricyclic or sympathomimetic agents. Using d-amphetamine with desipramine or protriptyline and possibly other tricyclics causes striking and sustained increases in the concentration of d-amphetamine in the brain; cardiovascular effects can be potentiated.

Amphetamines have been reported to exacerbate motor and phonic tics and Tourette's syndrome.  Therefore, clinical evaluation for tics and Tourette's syndrome in children and their families should be carried out before stimulant medications are given.

Dextroamphetamine sulfate is a Schedule II controlled substance.

Amphetamines have been extensively abused. Tolerance, extreme psychological dependence, and severe social disability have occurred. There are reports of patients who have increased the dosage to many times that recommended. Abrupt cessation following prolonged high dosage administration results in extreme fatigue and mental depression.

Manifestations of chronic intoxication with amphetamines include severe dermatoses, marked insomnia, irritability, hyperactivity, and personality changes. The most severe manifestation of chronic intoxication is psychosis, often clinically indistinguishable from schizophrenia. This is rare with oral amphetamines.

Deaths, most likely from cardiovascular causes has been reported in patients taking amphetamines.   Caution should be taken in any patients with preexisting heart disease or a family history of early age fatal heart disease.

Use caution in prescribing amphetamines for patients with hypertension.

Amphetamine has been shown to have embryotoxic and teratogenic effects when administered to mice in doses approximately 41 times the maximum human dose. There are no adequate and well-controlled studies in pregnant women. Amphetamines should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Infants born to mothers dependent on amphetamines have a higher risk of premature delivery and low birth weight. Also, these infants may experience symptoms of withdrawal as demonstrated by dysphoria, including agitation, and significant lassitude.

Amphetamines are excreted in human milk. Mothers taking amphetamines should be advised to refrain from nursing.