What You Should Know About Evekeo Side Effects

Every medication comes with potential side effects, and Evekeo (amphetamine sulfate) is no exception. As a Schedule II stimulant, Evekeo is effective for treating ADHD, narcolepsy, and short-term obesity management — but it's important to understand what side effects are normal, which ones are serious, and when you should contact your doctor.

This guide covers the side effects listed in Evekeo's FDA labeling, along with practical advice for managing them.

What Is Evekeo?

Evekeo is a brand-name medication containing racemic amphetamine sulfate — a 1:1 ratio of d-amphetamine and l-amphetamine. It's manufactured by Azurity Pharmaceuticals and is available as standard tablets (5 mg, 10 mg) and orally disintegrating tablets (Evekeo ODT: 5 mg, 10 mg, 15 mg, 20 mg). For a deeper dive, see our full guide on what Evekeo is and how it's used.

Common Side Effects

These side effects are relatively common, especially when first starting Evekeo or after a dose increase. Most are mild and may improve as your body adjusts:

• Decreased appetite — One of the most common stimulant side effects. You may not feel hungry, especially during the day.
• Insomnia — Difficulty falling or staying asleep, particularly if doses are taken too late in the day.
• Dry mouth — A frequent complaint with stimulant medications.
• Weight loss — Often related to decreased appetite.
• Irritability — Some patients notice increased irritability, especially as the medication wears off.
• Nausea — Usually mild and more common in the first few weeks.
• Headache — Can occur as your body adjusts to the medication.
• Stomach pain — Taking Evekeo with food may help reduce this.
• Increased heart rate — A slight increase in resting heart rate is common with stimulants.
• Restlessness — Feeling jittery or unable to sit still.

If any of these side effects persist beyond the first two to three weeks or become bothersome, talk to your doctor. A dose adjustment may help.

Serious Side Effects

These are less common but require immediate medical attention:

• Cardiovascular events — Evekeo carries a boxed warning about the risk of heart attack, stroke, and sudden death, particularly in patients with pre-existing heart conditions. Seek emergency care if you experience chest pain, shortness of breath, or fainting.
• Psychotic symptoms — Hallucinations, paranoia, or delusional thinking. This is more likely at higher doses or in patients with a history of psychotic disorders.
• Serotonin syndrome — A potentially life-threatening condition that can occur when Evekeo is combined with serotonergic drugs like SSRIs or SNRIs. Symptoms include agitation, rapid heartbeat, high body temperature, and muscle rigidity. Learn more about Evekeo drug interactions.
• Peripheral vasculopathy — Including Raynaud's phenomenon (fingers or toes turning white or blue due to reduced blood flow). Report any unexplained wounds on fingers or toes.
• Seizures — Rare, but stimulants can lower the seizure threshold in some patients.
• Growth suppression — In children taking Evekeo long-term, growth (height and weight) should be monitored regularly.
• Dependence and withdrawal — Evekeo has a high potential for abuse and dependence. Stopping suddenly after prolonged use can cause fatigue, depression, and sleep disturbances.

Side Effects in Specific Populations

Children

Evekeo is approved for ADHD in children aged 3 and older. Common side effects in children include decreased appetite, weight loss, insomnia, and irritability. Long-term use may affect growth, so regular monitoring of height and weight is recommended.

Pregnant and Breastfeeding Women

Evekeo is not recommended during pregnancy (Category C). Amphetamines are excreted in breast milk, so breastfeeding while taking Evekeo is not advised. Talk to your doctor about risks and alternatives if you're pregnant or planning to become pregnant.

Older Adults

Elderly patients should use Evekeo with caution due to increased cardiovascular risk. Lower starting doses may be appropriate.

Patients With Heart Conditions

Evekeo is contraindicated in patients with symptomatic cardiovascular disease, moderate to severe hypertension, or advanced arteriosclerosis. A cardiac evaluation may be recommended before starting any stimulant medication.

How to Manage Common Side Effects

Here are some practical strategies:

• For decreased appetite: Eat a good breakfast before your first dose. Have healthy snacks available. Eat a larger dinner when the medication effect is waning.
• For insomnia: Take your last dose earlier in the day — avoid late afternoon or evening doses. Practice good sleep hygiene (consistent bedtime, limit screens).
• For dry mouth: Stay hydrated. Sugar-free gum or lozenges can help stimulate saliva production.
• For stomach pain or nausea: Take Evekeo with food. If nausea persists, your doctor may adjust the dose.
• For headaches: Stay hydrated and maintain regular eating patterns. Over-the-counter pain relief may help, but check with your doctor first.
• For irritability: This often occurs during the "crash" as the medication wears off. Discuss timing adjustments with your prescriber.

Be aware that acidic foods and drinks (like orange juice and vitamin C supplements) can reduce Evekeo's effectiveness, while caffeine can increase stimulant side effects. See our drug interactions guide for more details.

Final Thoughts

Most people who take Evekeo experience only mild side effects that improve over time. The key is knowing which side effects are normal, which ones need attention, and how to manage them day to day.

Always take Evekeo exactly as prescribed, and don't adjust your dose without talking to your doctor. If you're having trouble finding Evekeo at your pharmacy, Medfinder can help you check stock near you.

For more about how Evekeo works in your body, see our guide on Evekeo's mechanism of action explained in plain English.