Dexedrine: Uses, Side Effects, Warnings, & More

What Is Dexedrine?

Dexedrine is a Schedule II controlled substance. This is a stimulant used as an ADHD medication. Dexedrine is also used to treat narcolepsy. Dexedrine works on the central nervous system to increase attention and decrease impulsiveness in patients. Dexedrine has a high abuse potential, and taking this medication over a long period of time can lead to drug dependence. Dexedrine is not recommended to be used in children under the age of 6. There is a generic version of Dexedrine available called dextroamphetamine sulfate.¹

How Does Dexedrine Work?

Dexedrine acts on receptors in the brain and spinal cord. These receptors, when acted on, release hormones like dopamine and norepinephrine. This allows your body to be less impulsive and more attentive, which can help improve ADHD symptoms.

What Is Dexedrine Used to Treat?

Dexedrine is FDA-approved to treat ADHD and a sleeping disorder called narcolepsy. When a product is FDA-approved, it means that the drug must show that it is safe and effective for the disorder it is treating and that it meets federal standards in manufacturing.² Dexedrine can be used in patients 6 years and older to help treat ADHD symptoms. Treatment usually includes psychological and educational treatments in addition to taking Dexedrine.¹

Dexedrine is also used off-label (non-FDA-approved) for treating obesity that is caused by issues in the hypothalamus, a structure deep in the brain.³ The hypothalamus releases hormones to maintain balance in the body.⁴ An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.

Side Effects of Dexedrine

When starting this medication, monitor for signs of dizziness and tremor, as these effects may impair one’s ability to drive. Increases in blood pressure and heart rate can also occur at the beginning of treatment with Dexedrine, but these effects should go away with time as the body adjusts to the medication.^1,5

Decreased appetite can also occur and can lead to losing weight or decreased growth in children. It is important to let your provider or pharmacist know if you are losing a lot of weight, as this medication can lead to anorexia. If you experience a decrease in sex drive, you can talk to your provider or pharmacist about ways to treat this problem or switching to a different medication.

Common Side Effects of Dexedrine

Dexedrine can cause stomach issues when taking it, such as constipation, diarrhea, and an overall decrease in appetite. As a result, weight loss can occur. This medication can make it difficult to sleep and may cause tremors. Please let your provider or pharmacist know if you develop an allergic reaction (e.g. hives, itching, swelling, sneezing, or runny nose), experience muscle weakness, or have a significant decrease in weight loss. A fast heart rate is also commonly experienced.

Common side effects of Dexedrine include:^1,5

• Fast heartbeat
• Decreased appetite
• Headache
• Dizziness
• Weight loss
• Tremors
• Dry mouth
• Changes in sex drive

All medications, including Dexedrine, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.

Serious Side Effects of Dexedrine

Though serious side effects are rare, some individuals can experience seizures, especially if they have a previous history of them. Vision changes can also occur (e.g. blurred vision). Children can experience slowing growth of their height and weight while taking this medication. Seek immediate medical care or talk to your provider or pharmacist if you experience any of these serious side effects.

Serious side effects of Dexedrine may include:¹

• Slowing of growth in children
• Seizures
• Blurred vision
• New or worsening behavior
• Circulation issues in fingers and toes

*All medications, including Dexedrine, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Allergic Reactions to Dexedrine

It is important to look for signs of allergic reactions when starting Dexedrine. Common signs of an allergic reaction are hives, rash, and/or itching. Patients with a known allergic reaction to amphetamines or other components in Dexedrine can be at risk of having an allergic reaction to this medication.

Allergic reactions to Dexedrine may include:¹

• Swelling of the face, mouth, lips, or throat
• Itching
• Hives
• Difficulty breathing
• Choking

If you start to experience any one of these symptoms while taking Dexedrine, you should stop taking the medication immediately and contact your provider or pharmacist.

Dexedrine Warnings & Precautions

If starting Dexedrine, talk with your doctor if you have any heart/artery issues or high blood pressure, as this medication can cause an increase in blood pressure as well as stroke and sudden death in individuals with heart problems. This medication can also cause constriction of blood vessels and lead to blood not reaching the outer areas of the body (fingers and toes). Reach out to your provider or pharmacist if you or your child is experiencing numbness, pain, or a change in color in fingers or toes (e.g. turning white, then blue), as this can be a sign of Raynaud’s phenomenon.^1,6

Dexedrine can cause new or worsening behavior, especially for those with previous psychiatric disorders. If you notice worsening or new behaviors or thoughts, talk to your provider or pharmacist as soon as possible. It is very important to take this medication as directed by your doctor, as this medication has a high risk of leading to misuse and addiction. Taking this medication for a long period of time can also lead to dependence.¹

Precautions for taking Dexedrine include:

• Health conditions affecting blood pressure: Dexedrine causes an increase in blood pressure and increases heart rate. Patients with advanced arteriosclerosis (blood vessels grow thick and stiff, restricting blood flow to organs), moderate to severe high blood pressure, heart disease that is symptomatic, or thyroid disease should avoid the use of this medication or use it with caution.^1,5
• Serious heart events: Sudden death, stroke, and heart attacks can occur in individuals with pre-existing structural heart problems. You should speak to your provider about taking Dexedrine if you have heart issues.^1,7
• Potential for misuse and addiction: Dexedrine has been shown to be highly misused (use of a drug for a purpose other than for its prescribed use). If you or your child have ever abused or been dependent on street drugs, prescriptions, or alcohol in the past, communicate with your provider before starting this medication.^1,5
• Worsening psychotic symptoms: Patients with a history of psychotic disorders may have worsened behavioral symptoms. New or worsening bipolar disorder symptoms, as well as aggressive behavior, may occur. Children may start to experience psychotic symptoms like hearing voices and holding beliefs that are not reality. Contact your child’s provider right away if this occurs.¹
• Long-term suppression of growth: There are limited research studies to determine whether or not chronic use of Dexedrine will lead to growth suppression. Children taking Dexedrine should have growth monitored during treatment.^1,5
• Seizures: Clinical evidence suggests that Dexedrine may lower the seizure threshold and can cause seizures in patients with a prior seizure history.^1,8
• Loss in blood circulation to fingers and toes (Raynaud’s phenomenon): Raynaud’s phenomenon causes blood vessels to narrow which restricts blood flow to certain areas of the body. This can cause fingers or toes to feel numb, painful, cool, and possibly change color (e.g. white, blue, or red). If you or your child starts experiencing any of these symptoms while taking Dexedrine, tell your provider as soon as possible.^1,6
• Tics & Tourette’s Syndrome: Amphetamines have been shown to worsen tics and Tourette’s syndrome. Children should be evaluated for their family history of Tourette’s before starting Dexedrine.¹

Interactions With Dexedrine

There are harmful interactions Dexedrine can have with medications, substances, and herbs. The medications listed below may increase the amount of Dexedrine in your body to toxic levels. It is important to tell your provider all the medications and herbal supplements you are taking before starting this medication.

18 substances you should avoid or use with caution while taking Dexedrine include:¹

• Acidifying agents (e.g. aspirin): Lowers the amount of Dexedrine in the blood, therefore, decreasing its effects on the body. Your provider may need to increase your dose of Dexedrine if you are taking one of these agents with it.
• Adrenergic blockers (e.g. metoprolol): Dexedrine inhibits the action of these medications, making them less effective.
• Alkalinizing agents (e.g. Tums, Rolaids): Dexedrine and stomach alkalinizing agents should be avoided being used together. These agents increase the effects of Dexedrine and can lead to toxic levels in the blood.
• Tricyclic antidepressants (e.g. amitriptyline): Dexedrine may enhance the effects of these medications and can lead to worsened heart side effects. If taking tricyclic antidepressants with Dexedrine, one should be monitored frequently.
• CYP2D6 inhibitors (e.g. risperidone): If Dexedrine is used in combination with one of these medications, its effects can be increased and can lead to serotonin syndrome. Your provider should start in low doses of Dexedrine and monitor for signs of serotonin syndrome (agitation, insomnia, confusion, dilated pupils).
• Serotonergic drugs (e.g. escitalopram): Low doses should be started when in combination with Dexedrine and signs of serotonin syndrome need to be monitored.
• MAO Inhibitors (e.g. phenelzine): Dexedrine should not be started within 14 days of taking an MAO inhibitor. If taken together these medications can lead to death, stroke, heart attack, and other heart complications.
• Antihypertensives (e.g. lisinopril): Dexedrine can cause increases in blood pressure, therefore, decreasing the effects of these medications.
• Chlorpromazine: This medication may treat some of the effects of dexedrine toxicity.
• Ethosuximide: Dexedrine can delay the absorption of this medication in the stomach.
• Haloperidol: Haloperidol can block the effects of Dexedrine, making it less effective.
• Lithium carbonate: This medication can decrease the effects of Dexedrine.
• Methenamine: Methenamine increases the amount of Dexedrine that is excreted from the body in the urine. This causes a decrease in Dexedrine’s effects.
• Phenobarbital: Dexedrine can delay the absorption of phenobarbital in the stomach, increasing the risk of seizures.
• Phenytoin: Dexedrine can delay the absorption of Phenytoin in the stomach, increasing the risk of seizures.
• Propoxyphene: If an overdose occurs with propoxyphene, Dexedrine levels can be increased in the blood and cause convulsions that can lead to death.

Dexedrine Dosages for FDA-Approved Treatment

Dexedrine is given at the lowest effective dosage for patients when used in treating ADHD. The usual dose ranges from 5 to 60 mg per day in one single dose or multiple divided doses (e.g. twice a day). Dexedrine is only approved in individuals 6 years and older.¹

The starting dose for patients is 5 mg daily or 5 mg twice daily. This dose may be then increased every 1 to 3 weeks until a desired patient response is achieved. The FDA-approved maximum dose is 40 mg a day, but for patients that are over 110 pounds in weight, the maximum dose can be up to 60 mg a day. The patient desired response is measured by an increase in attentiveness and a decrease in impulsivity (tendency to act without thinking).^1,9

Dexedrine Forms & Strengths

Dexedrine is only available in an extended-release capsule. There was previously a tablet form and solution form available. However, both of these products are no longer available for use. There are 3 strengths this dosage comes in: 5, 10, and 15 milligrams. Dexedrine extended-release capsule effects last about 8 hours long.^10,11

Dexedrine is available in the following forms and strengths:¹¹

• 5 milligrams (mg) oral extended-release capsule
• 10 milligrams (mg) oral extended-release capsule
• 15 milligrams (mg) oral extended-release capsule

How Should I Take Dexedrine?

Dexedrine is usually taken once or twice daily starting in the morning and should be taken exactly as prescribed by your provider. Doses in the late evening should be avoided because Dexedrine can cause trouble with sleeping. Dexedrine Spansule capsules should be taken whole and should not be split or chewed. Your provider will adjust the dose until it is right for you. It is extremely important that this medication be taken as prescribed in order to avoid addiction and dependence.^1,12

What Happens If I Miss a Dose of Dexedrine?

If you miss a dose and it is still earlier in the day, take the dose as soon as you remember it. If it is almost time for your next dose, skip the dose you missed and continue the prescribed scheduled dosing. Do not double up on doses if you miss a dose because you can overdose on Dexedrine. When taking Dexedrine over an extended period of time and the medication is suddenly stopped, withdrawal effects can occur.^1,12

Can You Become Addicted to Dexedrine?

Since Dexedrine has a high abuse potential, it is a controlled substance. Patients have been known to increase the dosage to more than prescribed, and dependence (brain or body relies on the medication) on the drug can occur. Due to the high addictive potential of this drug, this medication should be taken as directed by your provider. Your provider might have you stop taking this medication occasionally to see if behavioral symptoms have improved without the use of it.

If Dexedrine is stopped suddenly after taking it for a prolonged time, extreme tiredness and depression may occur. Due to this, the medication should be slowly tapered off and not stopped suddenly.¹

Can You Overdose on Dexedrine?

Yes, it is possible to overdose on Dexedrine. Be sure to take Dexedrine exactly as directed by your provider. If you or your child takes too much of this medication, call your provider, the poison control center (800-222-1222), or go to an emergency center right away.

Signs of a Dexedrine overdose include:¹

• Restlessness
• Tremor
• Rapid breathing
• Confusion
• Hallucinations
• Panic states
• Overactive reflexes

Tiredness and depression can occur after the overdose. Heart effects like irregular heart rhythms and high blood pressure can also result in a Dexedrine overdose.¹

What Should You Do If You Take Too Much Dexedrine?

If you or your child ingests more Dexedrine than prescribed, call a certified poison control center or your provider for help. Chlorpromazine is one medication that is used to treat some symptoms of Dexedrine overdose. A hospital may administer this medication or give another medication to get rid of any leftover medication through bowel excretions.¹

Questions to Ask Your Healthcare Provider About Dexedrine

If you or your child are experiencing symptoms of ADHD such as lack of attention, impulsiveness, or being overactive, contact your healthcare provider (e.g. pharmacist, doctor, psychiatrist, therapist) about Dexedrine as a possible treatment option. If you need to change prescribers, online psychiatry services may be a good option for you.

Questions to ask your care team about Dexedrine include:

• Does Dexedrine interact with any of the medications I am currently taking?
• How long will it take for me to adjust to taking Dexedrine?
• Am I at risk for more serious symptoms if I am already taking other anxiety/depression medications?
• What is the best dosage to ensure fewer side effects?
• When should I reach out to you if I am experiencing sexual side effects?
• Is there anything I should tell my therapist about this new medication?
• How soon will I notice side effects of Dexedrine?
• Where should I keep Dexedrine stored?
• How should I discard Dexedrine if I ever need to?
• How long before bed should I avoid taking this medication so I can sleep?

In My Experience

In my experience, Dexedrine is one of the least common stimulants prescribed in my community (midwest), compared to other more popular stimulants like Adderall and Ritalin. Dexedrine is effective in the patients that I’ve dispensed it to. Higher cost and insurance formularies can sometimes be why Dexedrine is not prescribed or dispensed as much as other stimulants. Other extended-release stimulants last longer throughout the day compared to Dexedrine, so Dexedrine could be an alternative you could discuss with your provider if the other stimulants are causing one major sleeping issue.

Dexedrine is a first option for ADHD or narcolepsy or as an alternate option if previous therapies have failed. If you are interested in Dexedrine as a therapy option, reach out to your provider or pharmacist to discuss if it is a good option for you.

For Further Reading

• Zenzedi (Dextroamphetamine Sulfate): Uses, Dosage, Side Effects, & More
• 10 Tips for Healthy Living With ADHD as an Adult
• Dexedrine Vs Adderall: Differences, Similarities, & Which to Take
• ADHD and Behavior Therapy
• Parent Training for ADHD
• The 3 types of ADHD