Methamphetamine

DEA Class; Rx

Common Brand Names; Desoxyn

Sympathomimetic amine in the amphetamine class
Approved for attention-deficit hyperactivity disorder (ADHD); however, use not supported by treatment guidelines
High potential for abuse and addiction; misuse associated with serious cardiac adverse events and sudden death

Indicated for treatment of attention-deficit hyperactivity disorder (ADHD).

Within 14 days of MAOIs

Advanced arteriosclerosis

Symptomatic cardiovascular 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

Common

• Hypertension, palpitations, tachyarrhythmia

• Dizziness, drug tolerance, dysphoric mood, euphoria, headache, insomnia, restlessness, tremor

• Urticaria

• Constipation, diarrhea, taste sense altered, xerostomia

Serious

• Cardiorespiratory arrest, sudden death (rare), myocardial infarction

• Cerebrovascular accident, Gilles de la Tourette’s syndrome, seizure, psychotic disorder

• Also see sympathomimetic syndrome, amphetamine toxicity

• Musculoskeletal: Rhabdomyolysis

• Alopecia

• Intestinal ischemia

Difficulties with accommodation and blurring of vision reported with stimulant treatment.

Methamphetamine should not be used to combat fatigue or to replace rest in normal persons

Prescribing and dispensing of methamphetamine should be limited to smallest amount that is feasible at one time in order to minimize possibility of overdosage.

Do not give at late evening; may cause insomnia

May impair ability to drive and/or operate heavy machinery

Alkaline urine will significantly increase half-life

Stimulants may lower convulsive threshold in patients with prior history of seizure, 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

Amphetamines may exacerbate motor and phonic tics and Tourette’s syndrome; perform clinical evaluation for tics and Tourette’s syndrome in children and their families prior to treating with stimulant medications

High abuse potential; use caution

Rare instances of prolonged and sometimes painful erections (priapism), sometimes requiring surgical intervention, reported with methylphenidate products; typically not reported during initiation, but often subsequent to an increase in dose; seek immediate medical attention for abnormally sustained or frequent and painful erections

Consistently methylphenidate medicated children (ie, treatment for 7 days per week throughout the year) have a temporary slowing in growth rate; published data are inadequate to determine whether chronic use of amphetamines may cause a similar suppression of growth, it is anticipated that they likely have this effect; monitor growth during treatment with stimulants; patients who are not growing or gaining height or weight as expected may need to have their treatment interrupted

Pregnancy Category: C

Lactation: do not nurse