Dexamfetamine

Stimulant medicines for ADHD, such as dexamfetamine, can be more complex than other medicines because of special prescribing, dispensing and funding rules that apply to them.

Dexamfetamine is a controlled drug

In Aotearoa New Zealand dexamfetamine is a controlled drug, which means it's carefully monitored and regulated to make sure it’s used safely. This is because it affects the brain and can be addictive or misused if not taken properly. Because of this, prescribers need to follow special rules when prescribing it, and pharmacies must keep records when they dispense it.

• You can get a prescription with repeats that cover up to 3 months, depending on your prescriber’s decision, but pharmacies can only dispense dexamfetamine in 30-day supplies at a time.
• You usually need to pick up the medicine within 7 days of it being dispensed, or the prescription may expire or require reauthorization.
  
  

Dexamfetamine is funded under a Special Authority

In Aotearoa New Zealand dexamfetamine is funded under a Special Authority, for people who meet the criteria.

• The term 'Special Authority' refers to a specific kind of approval needed for funding certain subsidised medicines by Pharmac.
• Pharmac is the government agency in New Zealand that decides which medicines and medical devices are publicly funded. Pharmac uses this process to ensure medicines are funded for people who will benefit most from the treatment. Read more about Special Authority.
  
  

Who can apply?

Applications for Special Authority for stimulant medicines used to treat ADHD can be made by specialists such as a paediatrician or psychiatrist, who can apply directly. General practitioners (GPs) or nurse practitioners can also apply, provided they have a written recommendation from a paediatrician or psychiatrist.

Does the Special Authority expire?

For stimulant medicines used to treat ADHD, the Special Authority does not expire, as the renewal criteria were removed in 2024, making the approval valid for the patient’s lifetime.

In Aotearoa New Zealand dexamfetamine is available as tablets (5 mg). 

• Always take dexamfetamine exactly as your healthcare provider has told you. The pharmacy label on your medicine will tell you how much dexamfetamine to take, how often to take it and any special instructions.
• The dose of dexamfetamine will be different for different people, depending on your age and your response to the medication.
• Your healthcare provider will start you on a low dose and increase it gradually over a few weeks. This allows your body to get used to the medicine and reduces side effects.

• Timing: Dexamfetamine is usually taken 1 to 3 times a day. Take your first dose when you wake up in the morning. If more doses are prescribed, take them by early afternoon. Taking this medication late in the day may cause trouble sleeping (insomnia). 
• Swallow your tablets with a glass of water: You can take dexamfetamine with or without food, as directed by your healthcare provider.
• Missed dose: If you forget to take your dose, take it as soon as you remember. But if it's nearly time for your next dose, just take the next dose at the right time. Don't take double the dose to make up for a forgotten dose. Avoid taking dexamfetamine in the late afternoon or evening because it can cause sleep problems.

Here are some things to know when you're taking dexamfetamine. Other things may be important as well, so ask your healthcare provider what you should know about.

Taking other medicines

Dexamfetamine interacts with some medications, herbal supplements and rongoā Māori, so check with your healthcare provider or pharmacist before starting dexamfetamine and before starting any new products.

Limit or avoid drinking alcohol while you're taking dexamfetamine

Dexamfetamine and alcohol affect your heart and blood pressure, increasing your risk of side effects. Dexamfetamine is a stimulant that increases your body’s activity, while alcohol is a depressant and lowers your level of functioning. Since they have opposite effects, dexamfetamine can mask the effects of alcohol making it take longer to feel the effects of alcohol which can risk alcohol poisoning.

Be careful when driving or using tools until you know how this medicine affects you

Dexamfetamine may cause blurred vision, make you feel dizzy, or affect your focus – especially when you start taking it.

You may need to take dexamfetamine for several months or even years, but it's unlikely that you'll need to take it for the rest of your life. If you’re taking dexamfetamine for ADHD you may become better at managing your symptoms as you get older by developing better coping strategies.

• Regular check-ups: You'll have regular check-ups, usually every 6 months or so, to see how well the medicine is working and if any changes are needed. Your healthcare provider will check your blood pressure, heart rate and weight.
• Medicine holiday: Your healthcare provider may recommend stopping dexamfetamine for a while, or reducing the dose. For children, this will normally be during the school holidays and can be called 'a medicine break'. This is to check whether it’s still helping.
• Teenage reassessment: As your child gets to puberty, or just after, they will be assessed to see if the medicine is still needed. If the medicine is still helping, it may be recommended your child keeps taking it, even as an adult. 
• Don't stop dexamfetamine suddenly: Talk to your healthcare provider first, as it might be best to reduce the dose gradually. This reduces the risk of having side effects when you stop taking this medicine.

Like all medicines, dexamfetamine can cause side effects, although not everyone gets them. If you're concerned about any symptoms, talk to your healthcare provider. The following information offers some guidance but doesn't include all possible side effects.

Common side effects

Tell your healthcare provider if these side effects bother you.

• Dizziness.
• Trouble sleeping: Take your dose in the morning. If you're taking more than one dose per day, take the other dose(s) before early afternoon.
• Headache.
• Reduced appetite, weight loss.
• Sweating.
• Dry mouth.

Tell your healthcare provider immediately or phone Healthline free on 0800 611 116 if these occur

• Anxiety, nervousness, irritability, changes in mood.
• Problems with your vision.
• Chest pain, seizures or feelings of increased heart rate.
• Suicidal feelings or behaviour such as agitation, aggression, self-harm, worsening of low mood.

Read more about medicines and side effects and reporting a reaction you think might be a side effect.