Dextroamphetamine Extended-Release Formulations
Yes, dextroamphetamine is available in longer-acting once-daily formulations that allow for single daily dosing. 1
Available Extended-Release Options
- Dextroamphetamine Spansules are an extended-release capsule formulation that can be taken once daily, providing prolonged duration of action compared to immediate-release formulations 1
- The extended-release capsules can be sprinkled on food for patients who have difficulty swallowing pills 1
- Typical dosing for dextroamphetamine extended-release formulations starts at 10 mg once daily in the morning, with titration occurring in 5 mg increments as needed 1
Pharmacokinetic Properties
- Dextroamphetamine extended-release formulations provide a bimodal release profile, mimicking two doses of immediate-release formulation taken several hours apart 2, 3
- Extended-release formulations show a longer time to maximum concentration (Tmax) compared to immediate-release versions, allowing for once-daily dosing 3, 4
- While immediate-release dextroamphetamine is typically administered twice daily (morning and midday), the extended-release formulation eliminates the need for a midday dose 1
Clinical Considerations
- Extended-release dextroamphetamine formulations are particularly beneficial for patients who require symptom control throughout the day without the need for multiple dosing 2, 4
- The duration of action for dextroamphetamine Spansules can last 8-12 hours, providing coverage throughout the school or work day 4
- Morning administration is recommended to minimize sleep disturbances, as stimulants can cause insomnia if taken later in the day 1
Side Effects and Monitoring
- Common side effects include insomnia and agitation, which can be minimized by appropriate timing of the once-daily dose in the morning 1
- Less common side effects include hypertension, palpitations, arrhythmias, and headache 1
- Regular monitoring of blood pressure, heart rate, height, and weight is recommended when using extended-release dextroamphetamine 1
- Dextroamphetamine should be avoided in patients with uncontrolled hypertension, coronary artery disease, and tachyarrhythmias 1
Dosing Considerations
- Starting dose for extended-release dextroamphetamine is typically 10 mg once daily in the morning 1
- Dose can be titrated up to a maximum of 50 mg daily based on clinical response and tolerability 1
- Individual dose titration is important due to substantial intersubject variability in pharmacokinetics 3
Extended-release dextroamphetamine formulations provide an effective once-daily treatment option for ADHD and other conditions requiring stimulant therapy, with the convenience of single daily dosing while maintaining efficacy throughout the day.