Adderal XR

[Amphetamine Mixed Salts]

Overdosage & Contraindications
CONTRAINDICATIONS

Advanced arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension, hyperthyroidism, known hypersensitivity or idiosyncrasy to the sympathomimetic amines, glaucoma.

Agitated states.

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Patients with a history of drug abuse.
During or within 14 days following the administration of monoamine oxidase inhibitors (hypertensive crises may result).

OVERDOSAGE

Individual patient response to amphetamines varies widely. Toxic symptoms may occur idiosyncratically at low doses.

Symptoms:

Manifestations of acute overdosage with amphetamines include restlessness,
tremor,
hyperreflexia,
rapid respiration,
confusion,
assaultiveness,
hallucinations,
panic states,
hyperpyrexia,
rhabdomyolysis.

Fatigue and depression usually follow the central nervous system stimulation.

Cardiovascular effects include
arrhythmias,
hypertension or hypotension,
circulatory collapse.

Gastrointestinal symptoms include
nausea,
vomiting,
diarrhea,
abdominal cramps.

Fatal poisoning is usually preceded by convulsions and coma.

Treatment:

Consult with a Certified Poison Control Center for up-to-date guidance and advice. Management of acute amphetamine intoxication is largely symptomatic and includes gastric lavage, administration of activated charcoal, administration of a cathartic and sedation. Experience with hemodialysis or peritoneal dialysis is inadequate to permit recommendation in this regard.

Acidification of the urine increases amphetamine excretion, but is believed to increase risk of acute renal failure if myoglobinuria is present. If acute severe hypertension complicates amphetamine overdosage, administration of intravenous phentolamine has been suggested. However, a gradual drop in blood pressure will usually result when sufficient sedation has been achieved. Chlorpromazine antagonizes the central stimulant effects of amphetamines and can be used to treat amphetamine intoxication. The prolonged release of mixed amphetamine salts from ADDERALL XRª should be considered when treating patients with overdose.