Dexamfetamine

CNS Stimulant·Psychiatry - ADHD & Stimulants

ADHD, Narcolepsy

S8Authority requiredPBSS8 STIMULANTDexamphetamine (Generic)+2

Max Dose

40 mg/day

Half-life

10 h

Misuse Risk

HIGH

Appetite Loss

COMMON

Rapid Summary

Overview

Highly potent, pure dextro-isomer of amphetamine. Releases massive stores of dopamine and noradrenaline. The highest abuse potential of the ADHD medications.

Maximum Dose

Max 40 mg/day (State specialist guidelines may permit higher, e.g., 60 mg/day).

Clinical Focus

Immediate-release formulation with intense euphoric 'rush' potential. Strongly heavily regulated.

Bottom Line

Dexamfetamine is a potent stimulant for ADHD and narcolepsy, but is a Schedule 8 drug with high abuse potential requiring cardiovascular monitoring and strict prescribing controls.

Formulation & Access

Brand Names

Dexamphetamine (Generic)

Oral Routes

Tablets (5 mg). Usually scored to halve.

Prescribing & PBS

Highly Restricted (S8). Authority Required (PBS). Requires strict specialist permits.

Indications & Use

Primary

PBSTGA

ADHD, Narcolepsy.

Clinical Place

Often used when Methylphenidate fails or causes intolerable side effects. Highly effective but being replaced by Lisdexamfetamine (Vyvanse) to curb abuse.

Quick reference

Class & Role

CNS Stimulant — Highly potent, pure dextro-isomer of amphetamine.

Route / Formulation

Tablets (5 mg). Usually scored to halve. (Dexamphetamine (Generic))

Usual Dose & Max

Start PO 5 mg BD (Morning and Midday). Titrate up weekly. Max 40 mg/day. Do not give after 3 PM to avoid insomnia.

Key Indication Doses

ADHD: Start PO 5 mg BD (Morning and Midday). Titrate up weekly. Max 40 mg/day. Do not give after 3 PM to avoid insomnia. Narcolepsy: PO 5-60 mg/day in divided doses.

Best Uses

Dexamfetamine is a potent stimulant for ADHD and narcolepsy, but is a Schedule 8 drug with high abuse potential requiring cardiovascular monitoring and strict prescribing controls.

Avoid / Cautions

History of substance abuse, symptomatic cardiovascular disease, moderate-to-severe hypertension, hyperthyroidism, concurrent MAOIs, active psychosis. Pregnancy Category B3 (Risk of premature delivery and neonatal withdrawal).

Key Risks

Neurological: Extreme abuse, addiction, and diversion risk. HIGH — Insomnia, anxiety, amphetamine psychosis (hallucinations/paranoia), tics. Cardiovascular: Tachycardia, hypertension, palpitations. Gastrointestinal: Severe anorexia, weight loss, dry mouth.

Key Interactions

MAOIs (Fatal hypertensive crisis). Must wait 14 days after stopping MAOI. Vitamin C / Acidic juices. Acidic urine massively accelerates the excretion of amphetamine, dropping blood levels. Ural / alkaline urine traps the drug in the blood, causing toxicity.

Monitoring

Baseline and routine BP, HR, Weight. Assess for signs of diversion (patient selling pills) or abuse (running out of script early). No specific routine laboratory tests required.

Clinical Pearl

If a patient accidentally overdoses on Dexamfetamine, giving them massive doses of Vitamin C (ascorbic acid) will acidify their urine, trapping the amphetamine in the urine and flushing it out of the body rapidly.

Access

Authority requiredDexamphetamine (Generic)5 mg tablet

Brand: Dexamphetamine (Generic)
PBS status: Authority required
Formulation: Tablets (5 mg)

Dexamfetamine

CNS Stimulant·Psychiatry - ADHD & Stimulants

ADHD, Narcolepsy

S8Authority requiredPBSS8 STIMULANTDexamphetamine (Generic)+2

Max Dose

40 mg/day

Half-life

10 h

Misuse Risk

HIGH

Appetite Loss

COMMON

Rapid Summary

Overview

Highly potent, pure dextro-isomer of amphetamine. Releases massive stores of dopamine and noradrenaline. The highest abuse potential of the ADHD medications.

Maximum Dose

Max 40 mg/day (State specialist guidelines may permit higher, e.g., 60 mg/day).

Clinical Focus

Immediate-release formulation with intense euphoric 'rush' potential. Strongly heavily regulated.

Bottom Line

Dexamfetamine is a potent stimulant for ADHD and narcolepsy, but is a Schedule 8 drug with high abuse potential requiring cardiovascular monitoring and strict prescribing controls.

Formulation & Access

Brand Names

Dexamphetamine (Generic)

Oral Routes

Tablets (5 mg). Usually scored to halve.

Prescribing & PBS

Highly Restricted (S8). Authority Required (PBS). Requires strict specialist permits.

Indications & Use

Primary

PBSTGA

ADHD, Narcolepsy.

Clinical Place

Often used when Methylphenidate fails or causes intolerable side effects. Highly effective but being replaced by Lisdexamfetamine (Vyvanse) to curb abuse.

Quick reference

Class & Role

CNS Stimulant — Highly potent, pure dextro-isomer of amphetamine.

Route / Formulation

Tablets (5 mg). Usually scored to halve. (Dexamphetamine (Generic))

Usual Dose & Max

Start PO 5 mg BD (Morning and Midday). Titrate up weekly. Max 40 mg/day. Do not give after 3 PM to avoid insomnia.

Key Indication Doses

ADHD: Start PO 5 mg BD (Morning and Midday). Titrate up weekly. Max 40 mg/day. Do not give after 3 PM to avoid insomnia. Narcolepsy: PO 5-60 mg/day in divided doses.

Best Uses

Dexamfetamine is a potent stimulant for ADHD and narcolepsy, but is a Schedule 8 drug with high abuse potential requiring cardiovascular monitoring and strict prescribing controls.

Avoid / Cautions

Key Risks

Key Interactions

Monitoring

Baseline and routine BP, HR, Weight. Assess for signs of diversion (patient selling pills) or abuse (running out of script early). No specific routine laboratory tests required.

Clinical Pearl

Access

Authority requiredDexamphetamine (Generic)5 mg tablet

Brand: Dexamphetamine (Generic)
PBS status: Authority required
Formulation: Tablets (5 mg)