DYANAVEL XR

Amphetamine 2.5mg/1mL, Oral suspension, extended release

Marijuana

· Severity: Major

· Notes for Consumers: Combining marijuana with this medicine may increase blood pressure or heart rate. It can also increase nervousness or troubles with sleep. Contact your health care provider right away if you develop a fast or irregular heartbeat, a severe headache, or other new or unusual side effects.

· Notes for Professionals: Avoid administering marijuana and amphetamines together as concurrent use may result in adverse cardiovascular effects, such as tachycardia and cardiac arrhythmias. Marijuana is known to produce significant increases in heart rate and cardiac output lasting for 2-3 hours. Further, rare case reports of myocardial infarction and cardiac arrhythmias have been associated with marijuana use. Amphetamines have also been reported to produce a wide range of cardiovascular effects including cardiac arrhythmias, palpitations, and sinus tachycardia. Coadministration of marijuana with amphetamines may result in significant cardiovascular adverse events and thus, should be avoided.

Amphetamine 2.5mg/1mL, Oral suspension, extended release

Acidic food

· Severity: Moderate

· Notes for Consumers: Most foods are not expected to cause a problem with this medication, so do not significantly alter your diet unless directed to do so by your health care professional. Acidic juices, like citrus juices (examples: orange juice, grapefruit juice) may decrease the absorption of this medication and are best avoided during the 1 hour before a dose, at the time of dosing, and for 1 hour after taking a dose. You may need to limit caffeine intake (food examples: coffee, teas, colas, and chocolate) while taking this medicine. Taking a high amount of caffeine can increase the risk of irritability, nausea, nervousness, palpitations, problems with sleep (insomnia), rapid heartbeat, or other side effects.

· Notes for Professionals: In general, food does not significantly interact with the amphetamine stimulants, a dose may be taken with or without food. However, certain gastrointestinal acidifying agents (e.g., certain fruit juices, etc.) can lower the oral absorption of amphetamines. To ensure proper absorption, it may be prudent for the patient to avoid citrus fruits and citrus juices 1 hour before a dose, at the time of dosing, and for the 1 hour following a dose. In addition, the excretion of amphetamines is increased in acidic urine and decreased in alkaline urine. Foods that acidify the urine, such as cranberry juice, orange juice, or those that contain vitamin C (ascorbic acid) may increase amphetamine renal excretion. Conversely, foods that alkalinize the urine, such as beets, dairy products, kale, spinach may slightly slow urinary excretion of amphetamines. Patients should not significantly alter their diets, however, as these changes in urinary pH from foods are not expected to be clinically significant for most patients.

<b>DISCLAIMER:</b><em> This drug information content is provided for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Patients should always consult their physician with any questions regarding a medical condition and to obtain medical advice and treatment. Drug information is sourced from GSDD (Gold Standard Drug Database ) provided by Elsevier.</em>