Mylod%25252525252525252525252525252525252525252525252525252520at

## Overview Mylot%25252525252525252525252525252525252525252525252525252520at is a brand name for **dextroamphetamine sulfate**. It is a central nervous system (CNS) stimulant. ## Primary Indications * Attention-Deficit/Hyperactivity Disorder (ADHD) * Narcolepsy ## Adult Dosing **ADHD:** * Initial dose: 5 mg to 10 mg orally once daily. * Titration: Increase dose by 5 mg to 10 mg weekly. * Usual maintenance dose: 10 mg to 60 mg orally once daily, divided into 2 or 3 doses. * Maximum daily dose: 60 mg. **Narcolepsy:** * Initial dose: 5 mg to 10 mg orally once daily. * Titration: Increase dose by 5 mg to 10 mg every few days. * Usual maintenance dose: 5 mg to 30 mg orally once daily, divided into 2 to 3 doses. * Maximum daily dose: 30 mg. Dosing for ADHD may vary based on specific product formulation (e.g., immediate-release vs. extended-release) and local treatment protocols. ## Pediatric Dosing **ADHD (6 years and older):** * Initial dose: 5 mg orally once or twice daily. * Titration: Increase dose by 5 mg weekly. * Usual maintenance dose: 5 mg to 40 mg orally once daily, divided into 2 or 3 doses. * Maximum daily dose: 40 mg. Dosing for pediatric patients can vary significantly based on age, weight, and response. ## Dose Adjustments * **Renal Impairment:** Use with caution. Dose reduction may be necessary; specific guidance is limited. * **Hepatic Impairment:** Use with caution. Dose reduction may be necessary; specific guidance is limited. ## Contraindications * Hypersensitivity to amphetamines or other sympathomimetic amines. * Advanced arteriosclerosis. * Symptomatic cardiovascular disease. * Moderate to severe hypertension. * Hyperthyroidism. * Glaucoma. * Agitated or psychomotoric restlessness. * History of drug abuse. * Concomitant use with or within 14 days of MAO inhibitors. ## Adverse Effects * **Cardiovascular:** Tachycardia, palpitations, hypertension, chest pain, arrhythmias. * **CNS:** Insomnia, nervousness, restlessness, tremor, dizziness, euphoria, headache, psychosis (hallucinations, delusions), mania. * **Gastrointestinal:** Dry mouth, anorexia, nausea, vomiting, diarrhea, constipation, abdominal pain. * **Genitourinary:** Impotence, changes in libido. * **Other:** Weight loss, fever, rash, Stevens-Johnson syndrome. ## Key Drug Interactions * **MAO Inhibitors:** Severe hypertensive crisis. Avoid concomitant use or use within 14 days of MAOI discontinuation. * **Acidifying Agents (e.g., ascorbic acid):** Decrease amphetamine levels and efficacy by increasing renal excretion. * **Alkalinizing Agents (e.g., sodium bicarbonate):** Increase amphetamine levels and risk of toxicity by decreasing renal excretion. * **Antihypertensives:** May decrease the effect of antihypertensive agents. * **CYP2D6 Inhibitors (e.g., fluoxetine, paroxetine, quinidine):** May increase amphetamine levels. ## Monitoring * **Cardiovascular status:** Blood pressure, heart rate, assess for signs of cardiac events. * **Mental status:** Assess for signs of psychosis, mania, or worsening of behavioral symptoms. * **Growth and development:** In pediatric patients, monitor height and weight. * **Signs of abuse and dependence.** ## Clinical Pearls * Amphetamines can be abused and lead to dependence. Prescribe and dispense judiciously. * Extended-release formulations may offer more consistent symptom control and reduced dosing frequency. * Monitor for paradoxical worsening of tics or onset of new tics. * Dextroamphetamine sulfate is a Schedule II controlled substance. *** **Disclaimer:** This information is intended for healthcare professionals and is not a substitute for professional medical advice. Always consult the most current prescribing information and your institution's protocols before making treatment decisions. Drug information can change rapidly, and this response may not reflect the latest updates.