[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Drugs of abuse](https://durgical.com/en/pharmacology/classes/drugs-of-abuse/) › Methamphetamine (metamfetamine)

# Methamphetamine (metamfetamine)

## Drugs of abuse?

Drugs of abuse

A potent synthetic stimulant with high addiction potential. A prescription form exists for ADHD in some countries; illicit «crystal» drives overdoses.

Updated Nov 1, 2026

Also called: Metamfetamine, Crystal, Meth

## Quick facts

**Group**
[Drugs of abuse](https://durgical.com/en/pharmacology/classes/drugs-of-abuse/)

**Target**
Dopamine and noradrenaline transporters (DAT, NET) and VMAT2; also the receptor TAAR1

**Used for**
Clinical relevance

**Key effects**
Insomnia · Tachycardia · Anxiety

**Monitor**
Heart rate · Creatine kinase · On prescription

**ATC**
N06BA03

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

⇄**Dopamine and noradrenaline transporters (DAT, NET) and VMAT2; also the receptor TAAR1**Methamphetamine (metamfetamine)

ⓘ The figure shows methamphetamine bound to the human trace amine-associated receptor 1 (TAAR1), which it activates; no human transporter structure with methamphetamine is available.

**Target in 3D:** Dopamine and noradrenaline transporters (DAT, NET) and VMAT2; also the receptor TAAR1. PDB structure 9JKQ (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/9JKQ) · Drag to rotate · pinch to zoom

Methamphetamine enters nerve terminals through the dopamine and noradrenaline transporters, empties the storage vesicles and makes the transporters run in reverse, releasing large amounts of dopamine and noradrenaline (and some serotonin); it also blocks their reuptake. It reaches the brain fast, especially when smoked or injected, which gives an intense rush and strong reinforcement. The noradrenaline surge produces the sympathomimetic toxidrome.

- Methamphetamine enters through DAT and NET
- It empties vesicles and reverses the transporters
- Dopamine and noradrenaline flood the synapse
- Euphoria and alertness; tachycardia, hypertension, hyperthermia

## Indications

- Attention deficit hyperactivity disorder in children (prescription product approved in the United States) [Attention-deficit/hyperactivity disorder (ADHD) →](https://durgical.com/en/conditions/attention-deficit-hyperactivity-disorder/)
- Clinical relevance: methamphetamine intoxication and stimulant use disorder [Stimulant use disorder (cocaine, amphetamines) →](https://durgical.com/en/conditions/stimulant-use-disorder/)

## Adverse effects

### Common

- Insomnia, anorexia and weight loss
- Tachycardia, palpitations and hypertension
- Anxiety, irritability and paranoia
- Dry mouth and tooth decay («meth mouth») with chronic use

### Serious (rare, important)

- Psychosis with hallucinations and paranoia, sometimes persisting
- Myocardial ischaemia, arrhythmias, aortic dissection and stroke
- Hyperthermia, rhabdomyolysis and acute kidney injury
- Cardiomyopathy and pulmonary hypertension with chronic use
- Addiction; infections (HIV, hepatitis, endocarditis) with injection

## Contraindications

- Use of an MAOI now or within the previous two weeks (hypertensive crisis)
- Hypersensitivity to amphetamines
- Avoided in serious structural heart disease

## Key interactions

**MAOIs**
Hypertensive crisis; contraindicated

**SSRIs, SNRIs, triptans and other serotonergic drugs; CYP2D6 inhibitors**
Serotonin syndrome risk

**Urinary alkalinisers (for example sodium bicarbonate) or acidifiers**
Alkalinisers raise and prolong methamphetamine levels; acidifiers lower them

**Opioids such as fentanyl in the illicit supply**
Mixed overdoses with respiratory depression

## What is monitored

- Heart rate, blood pressure, temperature and ECG
- Creatine kinase, potassium, kidney function and troponin when there is chest pain
- Psychiatric state and suicide risk, also during withdrawal
- On prescription: growth, blood pressure and signs of misuse

## Administration and safety

- Prescription tablets are a high-abuse controlled medicine, kept under strict storage and record keeping
- Illicit methamphetamine is smoked, snorted, injected or swallowed; injection adds infection risk
- Street products may contain opioids such as fentanyl

## Pregnancy and breastfeeding

Linked to placental abruption, preterm birth, low birth weight and withdrawal in the newborn; stopping at any point in pregnancy improves outcomes.

## Nursing care

- Keep the patient in a calm space and protect from injury during agitation
- Monitor temperature and cardiac rhythm continuously in severe intoxication
- Expect a crash with deep sleep, hunger and low mood after a binge; assess suicide risk
- Check skin, teeth and injection sites; screen for HIV and hepatitis when appropriate
- Link to behavioural treatment; contingency management is the best-studied option

## Pharmacokinetics

**Absorption**
Absorbed by mouth, through the nasal mucosa and the lungs; also injected

**Distribution**
Lipid-soluble: crosses the blood–brain barrier and the placenta easily

**Metabolism**
Liver (hydroxylation, N-demethylation, deamination)

**Elimination**
Kidneys, largely unchanged; acidic urine speeds and alkaline urine slows its excretion

**Half-life**
Several hours, longer when the urine is alkaline

## Memory aid

METH = Mouth rots, Excited heart, Temperature up, Hallucinations.

## Test yourself

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

## How does methamphetamine raise synaptic dopamine?

It enters through DAT, empties vesicles via VMAT2 and reverses the transporter so dopamine is released; it also blocks reuptake.

## How does urine pH change methamphetamine elimination?

Acidic urine speeds its renal excretion; alkaline urine slows it and prolongs the effect.

## Is there an approved medicine for methamphetamine use disorder?

No; behavioural treatments such as contingency management and cognitive behavioural therapy are the mainstay.

## Which drug is first line for methamphetamine-induced agitation in the Colombian toxicology guide?

A benzodiazepine; antipsychotics such as haloperidol or olanzapine are options if needed.

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

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

## Connections

## Related drugs 2

- [MDMA (midomafetamine)](https://durgical.com/en/pharmacology/mdma/)
- [Amfetamine](https://durgical.com/en/pharmacology/amfetamine/)

## Related conditions 2

- [Attention-deficit/hyperactivity disorder (ADHD)](https://durgical.com/en/conditions/attention-deficit-hyperactivity-disorder/)
- [Stimulant use disorder (cocaine, amphetamines)](https://durgical.com/en/conditions/stimulant-use-disorder/)

[← Back to the class: Drugs of abuse](https://durgical.com/en/pharmacology/classes/drugs-of-abuse/)

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 - METHAMPHETAMINE HYDROCHLORIDE tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=90c02ac6-e5e2-4c97-8c68-81e4e389a195) (DailyMed (U.S. National Library of Medicine), 2026); [Methamphetamine](https://nida.nih.gov/research-topics/methamphetamine) (National Institute on Drug Abuse (NIDA), 2026); [Guía para el Manejo de Emergencias Toxicológicas](https://minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/GT/guias-manejo-emergencias-toxicologicas-outpout.pdf) (Ministerio de Salud y Protección Social; Organización Panamericana de la Salud, 2017); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N06BA03) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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