Mao Inhibitors
Contraindicated
Database
Hypertensive crisis / serotonergic excess
Contraindicated; separate by ≥14 days
Source: Kimi deep-research + Cla
Drug reference
dexamphetamine
Central nervous system stimulant (sympathomimetic amine) · CNS stimulant, Anorectic
START
5 mg PO 1–2 times daily (ADHD); titrate weekly
TYPICAL MAX
40 mg/day (ADHD); 60 mg/day (narcolepsy)
STOP IF
Severe hypertension, psychosis, severe anorexia, or arrhythmia
WATCH
BP, HR, weight / growth (children), mood, dependence; baseline ECG if CV risk
CDSCO approvedATC N06BA02
KDIGO 2024 + manufacturer label
- ONSET
- 30min · absorption
- PEAK
- 3h · Tmax IR
- t½
- 11h · t½
- DURATION
- 5h · IR
EXCRETION
Renal — pH-dependent excretion
route + CYP
INTERACTIONS
3 major
incl. contraindicated
PREGNANCY
Avoid (low birth weight, neonatal withdrawal).
FDA category + note
Top interactionssee all 5 →
- Mao InhibitorsContraindicatedDatabaseKimi deep-research + Cla
- Other SympathomimeticsSevereDatabaseKimi deep-research + Cla
- Serotonergic DrugsSevereDatabaseKimi deep-research + Cla
Mechanism
Releases dopamine and noradrenaline from presynaptic terminals (reverses DAT / NET) and inhibits their reuptake; CNS stimulation, increased focus / wakefulness, sympathomimetic activity at higher doses.
Indications
Attention-deficit hyperactivity disorder (ADHD)Narcolepsy
Dosing
- Adult
- ADHD: 5 mg PO 1–2 times daily; titrate weekly by 5 mg/day; usual 5–40 mg/day in divided doses. Narcolepsy: 5–60 mg/day in divided doses.
- Pediatric
- ≥6 y ADHD: 2.5–5 mg PO 1–2 times daily; titrate to max 40 mg/day (UK BNFc).
- Renal adjustment
- No fixed adjustment.
- Hepatic adjustment
- Reduce dose in significant hepatic impairment.
- Geriatric
- Use with caution; CV risk.
- Max dose
- 40 mg/day (ADHD); 60 mg/day (narcolepsy, divided)
Pharmacokinetics
Onset
~30 min (oral)
Peak effect
~3 h (Tmax IR)
Duration
~4–6 h (IR); ~8–12 h (SR)
Half-life
~10–12 h
Bioavailability
Well absorbed orally
Protein binding
~16%
Metabolism
Hepatic CYP2D6 + deamination
Excretion
Renal (pH-dependent; acid urine increases excretion)
Contraindications
- Significant cardiovascular disease (advanced atherosclerosis, symptomatic CVD, arrhythmias)
- Moderate-to-severe hypertension
- Hyperthyroidism
- Glaucoma
- History of drug abuse
- Concomitant MAO inhibitors
- Hypersensitivity
Side effects
Common
InsomniaDecreased appetite / weight lossHeadacheDry mouthAnxietyPalpitations
Serious
- Sudden cardiac death (susceptible patients — boxed)
- Severe hypertension
- Psychosis / mania
- Growth suppression (children)
- Dependence / abuse (CIIN)
- Serotonin syndrome (with serotonergics)
Pregnancy & lactation
Pregnancy
Avoid (low birth weight, neonatal withdrawal).
Lactation
Avoid (excreted in milk; infant irritability).
Drug interactions
Other Sympathomimetics
Severe
Database
Additive cardiovascular effects
Avoid combination
Source: Kimi deep-research + Cla
Serotonergic Drugs
Severe
Database
Additive serotonergic effect
Monitor; avoid if possible
Source: Kimi deep-research + Cla
Tricyclic Antidepressants
Moderate
Database
Enhanced sympathomimetic effect
Monitor BP/HR
Source: Kimi deep-research + Cla
Urinary Acidifiers
Moderate
Database
Altered amphetamine renal excretion
Avoid co-administration if possible
Source: Kimi deep-research + Cla
Related guidelines
Hypertensive disorders of pregnancy
FOGSI · Obstetrics & Gynaecology · 2019
Alcohol use disorder
MOHFW · Psychiatry · 2021
Substance use disorders
NIMHANS · Psychiatry · 2022
Generalised anxiety disorder and panic disorder
NICE · Psychiatry · 2020
Chronic kidney disease — mineral and bone disorder
KDIGO · Nephrology · 2017
Ask House about dexamphetamine
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20