Usual Adult Dose for Obesity

5 mg orally 30 minutes before each meal

Duration of Therapy: Should not exceed a few weeks

Use: Short-term adjunct in a weight reduction regimen based on caloric restriction; for patients in whom obesity is refractory to alternative therapy (e.g., repeated diets, group programs, other drugs).

Usual Pediatric Dose for Attention Deficit Disorder

Age 6 Years and Older:

• Initial dose: 5 mg orally once or twice a day
• Maintenance dose: Daily dosage may be raised in increments of 5 mg at weekly intervals until an optimum clinical response is achieved; the usual effective dose is 20 to 25 mg per day.

Comments:

• The total daily dose may be given in 2 divided doses.
• Where possible, drug administration should be interrupted occasionally to determine if there is a recurrence of behavioral symptoms sufficient to require continued therapy.

Use: As part of a total treatment program for Attention Deficit Hyperactivity Disorder (ADHD), a behavioral syndrome characterized by moderate to severe distractibility, short attention span, hyperactivity, emotional lability, and impulsivity.

Usual Pediatric Dose for Obesity

Age 12 Years and Older:
5 mg orally 30 minutes before each meal

Duration of Therapy: Should not exceed a few weeks

Use: Short-term adjunct in a weight reduction regimen based on caloric restriction; for patients in whom obesity is refractory to alternative therapy (e.g., repeated diets, group programs, other drugs).

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

US BOXED WARNING:

• Due to the high abuse potential, this drug should be prescribed/dispensed sparingly and particular attention should be paid to subjects possibly obtaining this drug for non-therapeutic use or distribution to others.
• Administering this drug for prolonged periods of time to treat obesity should be avoided as it may lead to drug dependence; it should be tried in weight reduction programs only if alternative therapy has been ineffective.
• Drug misuse may cause sudden death and serious cardiovascular adverse events.

Long-term effects of this drug in children have not been established. Safety and efficacy for use as an anorectic agent have not been established in patients younger than 12 years.

Consult WARNINGS section for additional precautions.

US Controlled Substance: Schedule II

Dialysis

Data not available

Other Comments

Administration Advice:

• Regardless of indication, this drug should be administered at the lowest effective dose and dosage should be individually adjusted.
• Late evening dosage should be avoided because of the resulting insomnia.
• Patients should be advised not to increase dosage, except on advice of their healthcare provider.
• This drug can be taken with or without food.

Storage Requirements:

• This drug should be stored below 30 degrees Celsius (86 Fahrenheit) and protected from light.

General:

• This drug should not be used to combat fatigue or to replace rest in normal persons.
• Overdosage: Management is largely symptomatic and includes gastric evacuation, activated charcoal administration, and sedation; IV phentolamine has been suggested for acute severe hypertension, and chlorpromazine has been used to decrease CNS stimulation and sympathomimetic effects.

Monitoring:

• Cardiovascular: Blood pressure and heart rate; changes in fingers and toes
• General: Signs of abuse and dependence
• Musculoskeletal: Growth suppression
• Psychiatric: Aggressive behavior/hostility, psychotic and manic symptoms

Patient Advice:

• Avoid driving and other potentially dangerous activities such as operating machinery until you know how this drug affects you.

Frequently asked questions

• What medications can cause a false positive for methamphetamines?