[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [ADHD medicines](https://durgical.com/en/pharmacology/classes/adhd-medicines/) › Dexamfetamine

# Dexamfetamine

## ADHD medicines?

ADHD medicines

The right-handed (d) form of amphetamine: a stimulant that releases dopamine and noradrenaline, used for ADHD and narcolepsy. High abuse potential.

Updated Nov 1, 2026

Also called: Dextroamphetamine, d-amphetamine

## Quick facts

**Group**
[ADHD medicines](https://durgical.com/en/pharmacology/classes/adhd-medicines/)

**Target**
Vesicular monoamine transporter 2 (VMAT2) and the dopamine and noradrenaline transporters

**Used for**
Attention-deficit/hyperactivity disorder · Narcolepsy

**Key effects**
Insomnia · Fast heart rate · Irritability

**Monitor**
Blood pressure and heart rate · Signs of misuse · Mood

**ATC**
N06BA02

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

⇄**Vesicular monoamine transporter 2 (VMAT2) and the dopamine and noradrenaline transporters**Dexamfetamine

ⓘ The figure shows dexamfetamine ((S)-amphetamine) bound to the human vesicular monoamine transporter VMAT2.

**Target in 3D:** Vesicular monoamine transporter 2 (VMAT2) and the dopamine and noradrenaline transporters. PDB structure 9W8F (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/9W8F) · Drag to rotate · pinch to zoom

Dexamfetamine is taken up into dopamine and noradrenaline nerve endings by their transporters. Inside, it empties the storage vesicles (VMAT2) and makes the membrane transporters run backwards, so catecholamines pour out into the synapse. It is the more centrally potent of the two amphetamine mirror images. In the prefrontal cortex this improves attention; elsewhere it raises heart rate and blood pressure and drives reward and abuse.

- Enters the nerve ending through DAT and NET
- Empties vesicles (VMAT2) into the cytoplasm
- Transporters run in reverse: dopamine and noradrenaline flood out
- Better attention; higher heart rate, blood pressure and abuse risk

## Indications

- Attention-deficit/hyperactivity disorder (ADHD), as part of a full treatment programme [Attention-deficit/hyperactivity disorder (ADHD) →](https://durgical.com/en/conditions/attention-deficit-hyperactivity-disorder/)
- Narcolepsy [Narcolepsy →](https://durgical.com/en/conditions/narcolepsy/)

## Adverse effects

### Common

- Insomnia, loss of appetite and weight loss
- Fast heart rate and higher blood pressure
- Irritability, nervousness, dry mouth
- Slower growth in children

### Serious (rare, important)

- Abuse, misuse and addiction, with overdose and death (boxed warning)
- Sudden death in people with structural heart disease
- New psychosis or mania, or worsening of existing psychosis
- Seizures; peripheral vasculopathy including Raynaud phenomenon
- Serotonin syndrome with other serotonergic drugs; new or worse tics

## Contraindications

- MAO inhibitor use now or within the previous 14 days (hypertensive crisis)
- Pheochromocytoma or a history of it
- Hypersensitivity to amphetamines

## Key interactions

**MAO inhibitors**
Slower amphetamine breakdown and massive noradrenaline release: hypertensive crisis

**SSRIs, SNRIs, triptans, tramadol, lithium and other serotonergic drugs**
Risk of serotonin syndrome

**Urinary alkalinisers (acetazolamide, some thiazides) or acidifiers (ammonium chloride)**
Alkaline urine raises blood levels and effect; acidic urine lowers them

## What is monitored

- Blood pressure and heart rate
- Height and weight in children
- Signs of misuse, diversion or dependence
- Mood, psychotic symptoms and tics

## Administration and safety

- A controlled stimulant: stored securely, counted, and never shared
- Immediate- and extended-release products are not interchanged one-for-one
- Late-day doses tend to cause insomnia

## Pregnancy and breastfeeding

Infants of mothers dependent on amphetamines have a higher risk of premature birth, low birth weight and withdrawal symptoms; use weighs benefit and risk.

## Nursing care

- Records blood pressure, heart rate, height and weight at baseline and during treatment
- Asks about chest pain on exertion, fainting and a family history of sudden death before starting
- Watches for appetite loss, poor sleep, mood changes, psychotic symptoms and new tics
- Teaches the family about safe storage and disposal, and checks fingers and toes for colour change or pain

## Pharmacokinetics

**Absorption**
Well absorbed by mouth; immediate- and extended-release forms

**Elimination**
In urine; acidic urine speeds excretion and alkaline urine slows it

**Half-life**
About 12 hours

## Memory aid

«D for Dextro, D for Doors open»: dexamfetamine opens the vesicle and the transporter doors so dopamine floods out. Never with an MAOI.

## Test yourself

Think of the answer, then tap the question to see it.

## How does dexamfetamine raise synaptic dopamine, compared with methylphenidate?

It releases dopamine from vesicles (VMAT2) and reverses the transporter; methylphenidate only blocks reuptake.

## Why is dexamfetamine contraindicated within 14 days of an MAO inhibitor?

Together they can cause a hypertensive crisis.

## How does urine pH change dexamfetamine levels?

Acidic urine increases its excretion and lowers levels; alkaline urine does the opposite.

## Which growth parameter is followed in children taking it?

Height and weight, because stimulants can slow growth.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/pharmacology/dexamfetamine/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Amfetamine](https://durgical.com/en/pharmacology/amfetamine/)
- [Methylphenidate](https://durgical.com/en/pharmacology/methylphenidate/)
- [Atomoxetine](https://durgical.com/en/pharmacology/atomoxetine/)

## Related conditions 2

- [Attention-deficit/hyperactivity disorder (ADHD)](https://durgical.com/en/conditions/attention-deficit-hyperactivity-disorder/)
- [Narcolepsy](https://durgical.com/en/conditions/narcolepsy/)

[← Back to the class: ADHD medicines](https://durgical.com/en/pharmacology/classes/adhd-medicines/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - DEXTROAMPHETAMINE SULFATE tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=466cbae8-4f67-4a65-b670-ada6a953d550) (DailyMed (U.S. National Library of Medicine), 2026); [Dextroamphetamine: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a605027.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N06BA02) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/dexamfetamine/