Zenzedi Side Effects: What's Normal and What's Not

Zenzedi (Dextroamphetamine Sulfate) is a prescription stimulant used to treat ADHD and narcolepsy. Like all medications, it comes with potential side effects. Some are mild and go away as your body adjusts. Others are serious and require immediate medical attention. This guide breaks down what to expect, what to watch for, and when to call your doctor.

What Is Zenzedi?

Zenzedi is a brand-name, immediate-release tablet containing Dextroamphetamine Sulfate — a CNS stimulant in the amphetamine class. It's manufactured by Azurity Pharmaceuticals and is available in doses ranging from 2.5 mg to 30 mg. It's FDA-approved for ADHD in patients ages 3–16 and for narcolepsy. For a deeper look at the medication itself, see our guide on what Zenzedi is, its uses, and dosage.

Common Side Effects

Most people who take Zenzedi will experience at least one or two of these side effects, especially when starting the medication or after a dose increase. They're usually mild and often improve over the first few weeks:

• Decreased appetite — This is one of the most common effects. Many people find they simply aren't hungry while the medication is active.
• Insomnia or trouble sleeping — Stimulants can make it hard to fall asleep, especially if taken too late in the day.
• Dry mouth — A frequent complaint; staying hydrated and chewing sugar-free gum can help.
• Weight loss — Often a direct result of reduced appetite.
• Headache — Usually mild and temporary.
• Elevated heart rate — A slight increase in resting heart rate is common with stimulants.
• Elevated blood pressure — Your doctor should monitor this at regular check-ups.
• Restlessness or jitteriness — More common at higher doses.
• Anxiety — Some people feel more anxious or on edge, particularly in the first days.
• Dizziness — Especially when standing up quickly.
• Stomach upset or nausea — Taking the medication with food may help.
• Unpleasant taste — Some patients report a metallic or bitter taste.

Serious Side Effects

These are less common but require immediate medical attention. Call your doctor right away — or go to the emergency room — if you experience any of the following:

• Chest pain, shortness of breath, or fainting — These could be signs of a serious cardiovascular event. Amphetamines carry a risk of stroke, heart attack, and sudden cardiac death, particularly in people with pre-existing heart conditions.
• New or worsening psychiatric symptoms — This includes hallucinations, paranoia, mania, extreme aggression, or psychotic episodes. Even people without a psychiatric history can develop these symptoms on stimulants.
• Peripheral vasculopathy (Raynaud's phenomenon) — Fingers or toes that become numb, cold, painful, or change color (white, blue, red). This indicates a problem with blood circulation.
• Signs of serotonin syndrome — Agitation, rapid heartbeat, fever, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. This risk increases if you take Zenzedi with serotonergic drugs like SSRIs, SNRIs, or Triptans. See our drug interactions guide for details.
• Seizures — Particularly in patients with a history of seizure disorders.
• Prolonged or painful erection (priapism) — Rare but requires emergency treatment.

The Boxed Warning

Zenzedi carries an FDA boxed warning — the most serious type of safety alert. It states: "Amphetamines have a high potential for abuse. Administration for prolonged periods may lead to drug dependence. Misuse may cause sudden death and serious cardiovascular adverse events." This doesn't mean Zenzedi is dangerous when taken as prescribed, but it does mean your doctor should carefully evaluate you before prescribing it and monitor you throughout treatment.

Side Effects in Specific Populations

Children and Adolescents

In addition to the side effects listed above, children taking Zenzedi may experience growth suppression — meaning they may gain weight and height more slowly than their peers. Your child's doctor should monitor their growth regularly and may suggest "drug holidays" (planned breaks from the medication) to allow catch-up growth.

Pregnancy and Breastfeeding

Zenzedi is not recommended during pregnancy. It may cause premature birth, low birth weight, and withdrawal symptoms in the newborn. It also passes into breast milk, so breastfeeding while taking Zenzedi is not advised. If you're pregnant or planning to become pregnant, talk to your doctor about your options.

Older Adults

Stimulants should be used with caution in elderly patients, who may be more susceptible to cardiovascular side effects like elevated blood pressure and heart rate changes.

How to Manage Common Side Effects

If you're experiencing mild side effects, these strategies may help:

• Appetite loss: Eat a good breakfast before your first dose. Have calorie-dense snacks available. Eat a larger dinner when the medication wears off.
• Insomnia: Take your last dose at least 6 hours before bedtime. Avoid caffeine, which adds to the stimulant effect. Maintain a consistent sleep schedule.
• Dry mouth: Drink water frequently. Chew sugar-free gum or use a saliva substitute.
• Headaches: Stay hydrated. Mild OTC pain relief (like Acetaminophen) is generally safe — but check with your doctor first.
• Anxiety or restlessness: Your doctor may lower your dose or adjust your dosing schedule. Deep breathing and regular exercise can also help.
• Stomach upset: Try taking the medication with a small meal or snack.

Never adjust your dose on your own. If side effects are bothering you, talk to your doctor. They can try a lower dose, a different dosing schedule, or a different medication altogether. For alternative options, see our guide on alternatives to Zenzedi.

Final Thoughts

Most Zenzedi side effects are mild and manageable, especially once your body adjusts to the medication. The key is knowing what's normal and what's not. Common issues like appetite changes, trouble sleeping, and dry mouth are expected. But symptoms like chest pain, hallucinations, circulation problems in your extremities, or signs of serotonin syndrome need immediate medical attention. Stay in regular contact with your prescriber, report any new or worsening symptoms, and never hesitate to call your doctor if something feels off.