High potential for abuse & dependence. Not indicated or recommended for wt loss. Risk of serious CV reactions; increased BP & heart rate; growth suppression in ped patients; peripheral vasculopathy, including Raynaud's phenomenon. Avoid use in patients w/ known structural cardiac abnormalities, cardiomyopathy, serious heart arrhythmia, CAD, & other serious heart problems. Avoid afternoon doses due to potential for insomnia. Assess risk of abuse prior to prescribing & monitor for signs of abuse & dependence while on therapy. Assess for presence of cardiac disease prior to treatment initiation. Monitor 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 patients w/o prior history of psychotic illness or mania. Closely monitor growth (wt & height) in ped patients. Carefully observe for digital changes during treatment. Immediately discontinue treatment & any concomitant serotonergic agents if symptoms of serotonin syndrome occur. Patients w/ severe renal impairment & ESRD. Not dialyzable. May decrease placental perfusion during pregnancy. Increased risk of premature delivery & low birth wt in 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. Not approved for use in ped patients <6 yr.
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