Dextroamphetamine Vs. Phentermine: Drug Comparison

Dextroamphetamine is a stimulant medication that increases levels of dopamine and norepinephrine in the brain, which helps improve focus, attention, and impulse control. Its FDA-approved indications include the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy. Dextroamphetamine comes in oral tablet and extended-release capsule forms. Amphetamines should be administered at the lowest effective dosage, and dosage should be individually adjusted. Common side effects include insomnia, decreased appetite, and increased heart rate. It carries a boxed warning for the potential risk of abuse, dependence, and serious cardiovascular events, especially in individuals with underlying heart conditions.

Phentermine is the active ingredient in brand-name medications including Adipex-P^®. The information below is about brand name Adipex-P. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

Adipex-P (phentermine hydrochloride) is a prescription medication used as a short-term adjunct to weight loss in patients with obesity. It works as an appetite suppressant by stimulating the central nervous system, which increases heart rate and blood pressure while reducing hunger. Adipex-P is typically prescribed alongside a reduced-calorie diet and exercise regimen to enhance weight loss efforts. Common side effects include increased heart rate, dry mouth, insomnia, and nervousness. It is important to note that Adipex-P is intended for short-term use due to the potential for dependence and other adverse effects​.

Sympathomimetic amine of the amphetamine group

Sympathomimetic amine anorectic

Dextroamphetamine is indicated for:

• Narcolepsy

• Attention deficit disorder with hyperactivity, as an integral part of a total treatment program which typically includes other remedial measures (psychological, educational, social) for a stabilizing effect in pediatric patients (ages 3 to 16 years) with a behavioral syndrome characterized by the following group of developmentally inappropriate symptoms: moderate to severe distractibility, short attention span, hyperactivity, emotional lability, and impulsivity

Adipex-P (phentermine hydrochloride) is indicated:

• As a short-term adjunct (a few weeks) in a regimen of weight reduction based on exercise, behavioral modification and caloric restriction in the management of exogenous obesity for patients with an initial body mass index greater than or equal to 30 kg/m², or greater than or equal to 27 kg/m² in the presence of other risk factors (e.g., controlled hypertension, diabetes, hyperlipidemia)

• Typically taken orally with specific dosing depending on what's being treated

• Comes in 5 mg and 10 mg tablets

• Typically taken orally once daily

• Comes in 37.5 mg tablets

Adverse reactions have been reported in the following systems:

• Cardiovascular

• Central nervous system

• Gastrointestinal

• Allergic

• Endocrine

• Musculoskeletal

Adverse events have been reported in the following systems:

• Cardiovascular

• Central nervous system

• Gastrointestinal

• Allergic

• Endocrine

• Known hypersensitivity to amphetamine products

• During or within 14 days following the administration of monoamine oxidase inhibitors

• Drug interactions: MAO inhibitors, serotonergic drugs, CYP2D6 inhibitors, acidifying agents, adrenergic blockers, alkalinizing agents, tricyclic antidepressants, antihistamines, antihypertensives, chlorpromazine, ethosuximide, haloperidol, lithium carbonate, meperidine, methenamine therapy, norepinephrine, phenobarbital, phenytoin, propoxyphene, veratrum alkaloids

• History of cardiovascular disease (e.g., coronary artery disease, stroke, arrhythmias, congestive heart failure, uncontrolled hypertension)

• During or within 14 days following the administration of monoamine oxidase inhibitors

• Hyperthyroidism

• Glaucoma

• Agitated states

• History of drug abuse

• Pregnancy

• Nursing

• Known hypersensitivity, or idiosyncrasy to the sympathomimetic amines

• Drug interactions: Monoamine oxidase inhibitors, alcohol, insulin and oral hypoglycemics, adrenergic neuron blocking drugs

• Abuse, miususe, and addiction

• Risks to patients with serious cardiac disease

• Increased blood pressure and heart rate

• Psychiatric adverse reactions

• Peripheral vasculopathy, including Raynaud's phenomenon

• Serotonin syndrome

• Motor and verbal tics, and worsening of Tourette syndrome

• Pregnancy: Dextroamphetamine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus

• Breastfeeding: Mothers taking amphetamines should be advised to refrain from nursing

• Coadministration with other drugs for weight loss is not recommended

• Rare cases of primary pulmonary hypertension have been reported

• Rare cases of serious regurgitant cardiac valvular disease have been reported

• Tolerance to the anorectic effect usually develops within a few weeks

• Adipex-P may impair the ability of the patient to engage in potentially hazardous activities such as operating machinery or driving a motor vehicle

• Risk of abuse and dependence

• Concomitant alcohol use may result in an adverse drug reaction

• Use caution in patients with even mild high blood pressure

• A reduction in dose of insulin or oral hypoglycemic medication may be required in some patients

• Breastfeeding: Discontinue drug or nursing taking into consideration importance of drug to mother

WARNING ABUSE, MISUSE, AND ADDICTION

Dextroamphetamine sulfate has a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CNS stimulants, including dextroamphetamine sulfate, can result in overdose and death, and this risk is increased with higher doses or unapproved methods of administration, such as snorting or injection.

Before prescribing dextroamphetamine sulfate, assess each patient’s risk for abuse, misuse, and addiction. Educate patients and their families about these risks, proper storage of the drug, and proper disposal of any unused drug. Throughout dextroamphetamine sulfate treatment, reassess each patient’s risk of abuse, misuse, and addiction and frequently monitor for signs and symptoms of abuse, misuse, and addiction.

*This information is from the dextroamphetamine sulfate label used by Aurolife Pharma, LLC. See the Full Prescribing Information for more complete information. Dextroamphetamine may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient dextroamphetamine.

*This information is from the label for brand name Adipex-P^®. See the Full Prescribing Information for more complete information. Phentermine, the active ingredient in Adipex-P, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient phentermine.