Maximum Daily Dosage of Dexedrine for Adults
The maximum daily dosage of Dexedrine (dextroamphetamine) for adults is 60 mg per day, as indicated in the FDA drug labeling. 1
Dosage Guidelines
The FDA-approved dosing information provides clear guidance on Dexedrine administration:
- Initial dosage: For adults, typically start with 10 mg daily
- Titration: Dosage may be increased in increments of 10 mg at weekly intervals
- Maximum dosage: Up to 60 mg per day in divided doses 1
- Administration schedule: First dose upon awakening, with additional doses (1-2) at intervals of 4-6 hours 1
According to the American Academy of Child and Adolescent Psychiatry, some adult patients may be treated with total daily doses of up to 0.9 mg/kg of dextroamphetamine, with a general maximum of 40 mg for dextroamphetamine. 2 However, the more recent FDA labeling provides the definitive maximum of 60 mg daily. 1
Important Clinical Considerations
Dosing Strategy
- Administer at the lowest effective dosage
- Individualize dosage based on patient response
- Avoid late evening doses due to potential insomnia 1
- Allow at least one week between dose adjustments to properly assess response
Monitoring Requirements
- Regular monitoring of vital signs (heart rate and blood pressure)
- Track weight due to potential appetite suppression
- Assess for common side effects: insomnia, decreased appetite, headaches, and abdominal pain
Safety Considerations
- If bothersome adverse reactions appear (e.g., insomnia or anorexia), dosage should be reduced 1
- For doses exceeding standard recommendations, clearly document that symptoms could not be controlled at lower doses and that higher doses are not producing significant side effects (weight loss, blood pressure increase, or agitation) 2
- Monitor for signs of tolerance with higher doses 2
Contraindications
- Patients with advanced cardiovascular disease, high blood pressure, hyperthyroidism, glaucoma, agitation, or a history of substance abuse should not use these medications 3
- Be aware of potential for stimulant diversion, particularly in adults with substance use history
Alternative Considerations
If a patient does not respond adequately to dextroamphetamine or experiences prohibitive side effects, consider:
- Switching to methylphenidate (approximately 70% of patients respond to either dextroamphetamine or methylphenidate alone, and nearly 90% respond if both stimulants are tried) 2
- Non-stimulant options like atomoxetine for patients with substance use concerns
Remember that the goal of treatment is to achieve symptom control with the lowest effective dose while minimizing side effects.