From the FDA Drug Label
DOSAGE AND ADMINISTRATION Amphetamines should be administered at the lowest effective dosage and dosage should be individually adjusted. Narcolepsy: Usual dose is 5 mg to 60 mg per day in divided doses, depending on the individual patient response In patients 12 years of age and older, start with 10 mg daily; daily dosage may be raised in increments of 10 mg at weekly intervals until optimal response is obtained.
The maximum recommended dose of dextroamphetamine (Immediate Release, not Extended Release) for adults is 60 mg per day in divided doses, depending on the individual patient response.
- Note: The provided drug label does not specifically mention the Extended Release formulation. 1
From the Research
The maximum recommended dose of dextroamphetamine extended-release for adults is 40 mg per day. This medication is typically started at a lower dose (5-10 mg daily) and gradually increased as needed and tolerated, with dosing usually divided into once or twice daily administration depending on the specific extended-release formulation. Dextroamphetamine is a central nervous system stimulant primarily used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. The maximum dose should not be exceeded due to increased risk of cardiovascular effects, including elevated blood pressure and heart rate, as well as potential for dependence and abuse. Individual response varies, and many patients achieve therapeutic benefit at lower doses. Patients should be monitored regularly for side effects such as insomnia, decreased appetite, anxiety, and increased heart rate. Those with cardiovascular conditions, hypertension, hyperthyroidism, glaucoma, or history of substance abuse require special caution when using this medication, and some may need lower maximum doses or alternative treatments.
According to the most recent study 2, the dextroamphetamine transdermal system is a recently approved treatment for ADHD, offering flexibility in wear time and potentially useful for patients with changing schedules. However, dermal discomfort must be considered in addition to the usual amphetamine side effects when prescribing this medication.
Key considerations for prescribing dextroamphetamine extended-release include:
- Starting with a low dose and gradually increasing as needed and tolerated
- Monitoring for side effects such as insomnia, decreased appetite, anxiety, and increased heart rate
- Exercising caution in patients with cardiovascular conditions, hypertension, hyperthyroidism, glaucoma, or history of substance abuse
- Considering alternative treatments or lower maximum doses for patients who require special caution.
It's essential to weigh the benefits and risks of dextroamphetamine extended-release and to individualize treatment based on patient response and medical history, as supported by studies such as 3 and 2.