What is this medication?

DEXTROAMPHETAMINE (dex troe am FET a meen) treats attention-deficit hyperactivity disorder (ADHD). It works by improving focus and reducing impulsive behavior. It belongs to a group of medications called stimulants.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): XELSTRYM

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Anxiety or panic attacks
• Circulation problems in fingers and toes (Raynaud's disease)
• Glaucoma
• Heart attack
• Heart disease
• High blood pressure
• History of alcohol or drug abuse or addiction
• Kidney disease
• Liver disease
• Mental health disease
• Seizures
• Stroke
• Suicidal thoughts, plans, or attempt
• Thyroid disease
• Tourette's syndrome
• An unusual or allergic reaction to dextroamphetamine, other amphetamines, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is for external use only. Follow the directions on the prescription label. Apply the patch to dry, smooth skin on the chest, upper arm, upper back, flank, or hip. Alternate site of application each day. Avoid injured, irritated, or oily areas. Apply the patch 2 hours before the effect of the medication is needed. Use care separating the patch from the release liner. Follow package instructions carefully. Do not apply to waistline where clothing may cause the patch to rub off. Do not use patches that have been cut or torn. Wash hands after applying this medication. Do not use your medication more often than directed.

Take this patch off after 9 hours of wearing it. After removing fold the patch so it sticks to itself. Throw away in a lidded trash can.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

Talk to your care team about the use of this medication in children. While this medication may be prescribed for children as young as 6 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If the patch falls off, you may replace it with another patch at a different site. You must remove that patch also at the same time; do not wear it for a longer period of time.

If you forget to apply a patch in the morning, you may do so later in the day, but you should remove the patch at the same time of day you normally remove the patch to reduce the possibility of side effects late in the day or at night.

What may interact with this medication?

Do not take this medication with any of the following:

• Linezolid
• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
• Methylene blue (injected into a vein)
• Other stimulant medications for attention disorders, weight loss, or to stay awake

This medication may also interact with the following:

• Acetazolamide
• Ammonium chloride
• Ascorbic acid
• Atomoxetine
• Certain medications for blood pressure, heart disease, irregular heart beat
• Certain medications for depression, anxiety, or psychotic disturbances
• Cold or allergy medications
• Lithium
• Methenamine
• Narcotic medicines for pain
• Sodium bicarbonate
• St. John's Wort
• Tryptophan

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. This prescription requires that you follow special procedures with your care team and pharmacy. You will need to have a new written prescription from your care team every time you need a refill.

This medication may affect your concentration, or hide signs of tiredness. Until you know how this medication affects you, do not drive, ride a bicycle, use machinery, or do anything that needs mental alertness.

Decreased appetite is a common side effect when starting this medication. Eating small, frequent meals or snacks can help. Talk to your care team if you continue to have poor eating habits. This medication may slow your child's growth if it is taken for a long time at high doses. Your care team will monitor your child's growth.

Do not apply this patch close to bedtime or wear longer than directed. It may prevent you from sleeping.

This medication patch is sensitive to certain body heat changes. If your skin gets too hot, more medication will come out of the patch. Call your care team if you get a fever. Do not take hot baths. Do not sunbathe. Do not use hot tubs, saunas, hair dryers, heating pads, electric blankets, heated waterbeds, or tanning lamps. Do not do exercise that increases your body temperature.

Tell your care team right away if you notice unexplained wounds on your fingers or toes while taking this medication. You should also tell your care team if you experience numbness or pain, changes in the skin color, or sensitivity to temperature in your fingers or toes.

For males, contact your care team right away if you have an erection that lasts longer than 4 hours or if it becomes painful. This may be a sign of a serious problem and must be treated right away to prevent permanent damage.

Serotonin syndrome is when your body has too much serotonin in it. This happens when this medication is used with other ones that increase serotonin levels. Common medications that increase serotonin levels are antidepressants, some medications for migraines, and some antibiotics. The symptoms of serotonin syndrome include irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, and diarrhea. Contact your care team right away if you think you have serotonin syndrome.

Tell your care team if this medication loses its effects, or if you feel you need to take more than the prescribed amount. Do not change the dosage without talking to your care team.

If you are going to need surgery, an MRI, CT scan, or other procedure, tell your care team that you are using this medication. You may need to remove this patch before the procedure.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• Increase in blood pressure
• Irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea, which may be signs of serotonin syndrome
• Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
• Prolonged or painful erection
• Raynaud's—cool, numb, or painful fingers or toes that may change color from pale, to blue, to red
• Seizures
• Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Headache
• Irritation at application site
• Loss of appetite
• Nausea
• Stomach pain
• Tics
• Trouble sleeping
• Weight loss

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets. This medication can be abused. Keep it in a safe place to protect it from theft. Do not share it with anyone. It is only for you. Selling or giving away this medication is dangerous and against the law.

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep this medication in the original packaging until you are ready to use it. Protect from light and moisture. Get rid of any unused medication after the expiration date.

This medication may cause harm and death if it is taken by other adults, children, or pets. It is important to get rid of the medication as soon as you no longer need it or it is expired. You can do this in two ways:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, follow the directions in the MedGuide.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.