Patient ≥6 yr Recommended starting dose: 30 mg once daily in the morning. Dose may be adjusted in increments of 10 or 20 mg at approx wkly intervals. Max: 70 mg/day. Patient w/ severe renal impairment (GFR 15-<30 mL/min/1.73 m2) Max: 50 mg/day. Patient w/ end stage renal disease (GFR <15 mL/min/1.73 m2) Max: 30 mg/day.
Not indicated or recommended for wt loss. Assess risk of abuse prior to prescribing; monitor for signs of abuse & dependence while on therapy. Associated w/ serious CV adverse events; assess for cardiac disease presence prior to treatment initiation. Monitor all patients for potential tachycardia & HTN. May exacerbate symptoms of behavior disturbance & thought disorder in patients w/ pre-existing psychotic disorder. May induce a mixed/manic episode in patients w/ bipolar disorder. May cause psychotic or manic symptoms in childn & adolescents w/o prior history of psychotic illness or mania. Closely monitor growth (wt & height) in ped patients. Associated w/ peripheral vasculopathy, including Raynaud's phenomenon; carefully observe for digital changes during treatment. Immediately discontinue treatment & any concomitant serotonergic agents & initiate supportive symptomatic treatment if symptoms of serotonin syndrome occur. Not dialyzable. Increased risk of premature delivery & low birth wt for infants born to amphetamine-dependent mothers. Monitor infants for w/drawal symptoms eg, feeding difficulties, irritability, agitation, & excessive drowsiness. Breastfeeding is not recommended during treatment. Childn <6 yr. Elderly >65 yr.
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