What to Know About Dexedrine Side Effects

Every medication has potential side effects, and Dexedrine (Dextroamphetamine) is no exception. As a Schedule II CNS stimulant, Dexedrine is effective for treating ADHD and narcolepsy — but it also carries risks that you should understand before starting treatment.

This guide covers the most common side effects, the serious ones to watch for, and clear guidance on when to call your doctor.

What Is Dexedrine?

Dexedrine is a brand name for Dextroamphetamine sulfate, a central nervous system stimulant in the amphetamine class. It works by increasing dopamine and norepinephrine levels in the brain, which improves focus, attention, and wakefulness. It's available as immediate-release tablets and extended-release Spansule capsules.

Common Side Effects

Most people who take Dexedrine experience at least one or two mild side effects, especially when first starting the medication or after a dose increase. These are generally manageable and often improve over time.

Common side effects include:

• Loss of appetite — this is one of the most frequently reported effects
• Weight loss — often a direct result of reduced appetite
• Dry mouth
• Insomnia or trouble falling asleep
• Nervousness or anxiety
• Headache
• Dizziness
• Stomach upset, cramps, or nausea
• Diarrhea or constipation
• Irritability or restlessness
• Increased sweating
• Unpleasant taste in the mouth

These side effects are most noticeable during the first 1-2 weeks of treatment and tend to lessen as your body adjusts.

Serious Side Effects

While uncommon, Dexedrine can cause serious side effects that require immediate medical attention. The FDA-required boxed warning for Dexedrine warns about the potential for abuse, dependence, sudden death, and serious cardiovascular events.

Cardiovascular Risks

• Increased blood pressure and heart rate — your doctor should monitor these at every visit
• Heart attack and stroke — rare, but reported in patients with pre-existing heart conditions
• Sudden cardiac death — in patients with structural cardiac abnormalities or serious heart problems
• Peripheral vasculopathy (Raynaud's phenomenon) — unexplained wounds on fingers or toes, or color changes in skin

Psychiatric Risks

• Psychosis or mania — new-onset psychotic or manic symptoms, even in patients without prior psychiatric history
• Hallucinations — seeing or hearing things that aren't there
• Aggressive behavior

Other Serious Effects

• Seizures — stimulants may lower the seizure threshold
• Serotonin syndrome — when combined with serotonergic medications like SSRIs, SNRIs, or Triptans. Symptoms include agitation, rapid heart rate, high body temperature, and muscle twitching
• Growth suppression in children — long-term stimulant use may slow height and weight gain
• Priapism — prolonged, painful erections (rare but requires emergency treatment)

Specific Populations at Higher Risk

Children and Adolescents

Children may be more susceptible to appetite suppression and growth effects. The FDA recommends monitoring height and weight regularly. Dexedrine IR is approved for children ages 3 and up; the extended-release Spansule is approved for ages 6 and up.

Pregnant and Breastfeeding Women

Dexedrine is classified as Pregnancy Category C. Infants born to mothers dependent on amphetamines may experience premature birth, low birth weight, and withdrawal symptoms. Breastfeeding while taking Dexedrine is not recommended because the drug passes into breast milk.

People with Heart Conditions

If you have structural heart problems, coronary artery disease, arrhythmias, or uncontrolled high blood pressure, Dexedrine may not be safe for you. Your doctor should perform a cardiovascular evaluation before prescribing.

People with a History of Substance Abuse

Because Dexedrine has a high potential for abuse and dependence, it should be used with caution — or avoided entirely — in patients with a history of drug or alcohol abuse.

How to Manage Common Side Effects

Many mild side effects can be managed with simple adjustments:

• Appetite loss: Eat a good breakfast before your dose kicks in. Schedule meals and snacks even when you're not hungry. High-calorie, nutrient-dense foods help maintain weight.
• Insomnia: Take your medication early in the day. Avoid late-afternoon or evening doses. The extended-release Spansule should be taken first thing in the morning.
• Dry mouth: Drink plenty of water throughout the day. Sugar-free gum or lozenges can help stimulate saliva.
• Headaches: Stay hydrated and eat regularly. If headaches persist, talk to your doctor about adjusting your dose.
• Stomach upset: Taking Dexedrine with food may help, though acidic foods can reduce how well the medication is absorbed.
• Irritability: This may indicate your dose is too high or is wearing off too quickly. A dose adjustment or switch to extended-release may help.

Never adjust your dose on your own. Always talk to your prescriber first.

When to Call Your Doctor

Contact your doctor right away if you experience:

• Chest pain, shortness of breath, or fainting
• Rapid or irregular heartbeat
• New or worsening psychiatric symptoms (hallucinations, paranoia, mania)
• Unexplained wounds or color changes on fingers or toes
• Signs of serotonin syndrome (agitation, high fever, muscle rigidity, rapid heart rate)
• Seizures
• Prolonged painful erection lasting more than 4 hours

Call 911 or go to the emergency room for chest pain, difficulty breathing, seizures, or signs of a heart attack or stroke.

Final Thoughts

Dexedrine is an effective medication for ADHD and narcolepsy, but like all stimulants, it requires careful monitoring. Most side effects are mild and manageable, especially with the right dose. The serious risks are rare but real — and knowing what to watch for puts you in control.

Talk to your doctor before starting or changing your dose. And if you're having trouble finding Dexedrine at your pharmacy due to the ongoing amphetamine shortage, Medfinder can help you locate a pharmacy with stock near you.