DrugindexOnline^{2nd edition}

( Desoxyephedrine Hydrochloride ) Pronouncation: (meth-am-FET-uh-meen HIGH-droe-KLOR-ide)
Class: Amphetamine

Trade Names:
Desoxyn
- Tablets 5 mg

Mechanism of Action

Pharmacology

Activates noradrenergic neurons causing CNS and respiratory stimulation; stimulates the satiety center in the brain, causing appetite suppression.

Pharmacokinetics

Absorption

Methamphetamine is rapidly absorbed from the GI tract.

Metabolism

Primary site for metabolism is the liver, by aromatic hydroxylation, N-dealkylation, and deamination. There are at least 7 metabolites.

Elimination

Primary route for excretion is urine (dependent on pH) and the t _½ is 4 to 5 h.

Indications and Usage

Treatment of attention deficit disorder in children; short-term exogenous obesity adjunct.

Contraindications

Advanced arteriosclerosis; symptomatic CV disease; moderate to severe hypertension; hyperthyroidism; hypersensitivity to sympathomimetic amines; glaucoma; agitated states; history of drug abuse. Drug should not be used concomitantly with or within 14 days of MAOI use.

Dosage and Administration

Attention Deficit Disorder
Children

PO 5 mg 1 to 2 times/day; may be increased weekly by 5 mg to max of 20 to 25 mg/day in divided doses.

Exogenous Obesity
Adults and Children (older than 12 yr of age)

PO 5 mg 1 to 3 times/day 30 min before meals. Not to be used beyond a few weeks.

Storage/Stability

Store in tightly closed container at room temperature (59° to 86°F).

Drug Interactions

Guanethidine

Amphetamines may decrease effectiveness.

MAOIs, furazolidone

Hypertensive crisis and intracranial hemorrhage may occur.

Tricyclic Antidepressants

Decreased amphetamine effect.

Urinary acidifiers

Decreased amphetamine levels.

Urinary alkalinizers

Increased amphetamine levels.

Laboratory Test Interactions

Plasma and urinary steroid levels may be altered.

Adverse Reactions

Cardiovascular

Palpitations; tachycardia; hypertension; arrhythmias.

CNS

Hyperactivity; dizziness; insomnia; euphoria; restlessness; tremors; headache.

Dermatologic

Urticaria.

GI

Dry mouth; unpleasant taste; diarrhea; constipation; anorexia.

Genitourinary

Impotence.

Precautions

Warnings High abuse/diversion potential. Drug dependence may develop with chronic use. Avoid long periods of use. Prescribe and dispense sparingly because of high diversion potential.

Pregnancy

Category C .

Lactation

Excreted in breast milk.

Children

Not recommended as anorectic agent in children less than 12 yr of age.

Tartrazine Sensitivity

Some products contain tartrazine, which may cause allergic reactions in susceptible individuals.

Tolerance

Tolerance may occur; do not exceed recommended dose.

Overdosage

Symptoms

Restlessness, tremor, hyperreflexia, rapid respiration, confusion, assaultiveness, hallucinations, panic attack, hyperpyrexia.

Patient Information

• Instruct patient to take medication exactly as prescribed and not to increase dosage unless advised by health care provider.
• Advise patient to take sips of water frequently, suck on ice chips or sugarless hard candy, or chew sugarless gum if dry mouth occurs.
• Instruct patient to report excessive dryness of mouth, constipation, or prolonged insomnia as dosage may need to be adjusted.
• Tell patient to avoid caffeine, which increases drug effect.
• Advise patient that drug may cause dizziness and to use caution while driving or performing other tasks requiring mental alertness or coordination.
• Tell parents to report decreased appetite to pediatrician.