What is Evekeo?
Evekeo is a trade name for this formulation of amphetamine sulfate. There is no generic name, because the formulation of amphetamine is not currently available as a generic drug.
It is a Schedule II controlled substance because it has the potential for abuse and dependency. Incorrect use can also lead to sudden death or serious heart problems. These include increased blood pressure and heart rate, stroke, and heart attack.
For these reasons, the United States Food and Drug Administration (FDA) requires the drug to carry a boxed warning.
- Evekeo is an oral medication used to treat narcolepsy, ADHD, and obesity.
- The most common side effects include headache, trouble sleeping, decreased appetite, nervousness, diarrhea or constipation, and weight loss.
- Evekeo has a high potential for abuse and is a controlled substance.
- Those with a history of substance abuse or addiction should inform their doctor before using Evekeo.
What is Evekeo?
Evekeo can help reduce drowsiness problems that occur with narcolepsy.
The active ingredient in Evekeo is amphetamine sulfate. It is a white, crystalline substance and a sympathomimetic amino of the amphetamine group. It is a stimulant drug.
It is a prescription drug and a controlled substance. It acts as a central nervous system (CNS) stimulant.
It has been found to help people with narcolepsy, ADHD, and excess weight, but exactly how this happens is unclear.
It is available as an oral tablet. The oral tablet is only available under the brand-name drug Evekeo.
Evekeo is used for the following conditions:
Narcolepsy: It keeps people awake.
ADHD: It increases attention and reduces impulsiveness.
Overweight and obesity: It can help achieve short-term weight loss.
Common side effects
A number of side effects can occur when using Evekeo.
- upset stomach, including diarrhea or constipation and vomiting
- trouble sleeping
- decreased appetite and weight loss
- unpleasant taste in the mouth and a dry mouth
- sexual dysfunction
- mood swings
Serious side effects
Some more serious side effects can develop.
If the person who is using Evekeo experiences any of the following, they should call their doctor right away.
However, if the symptoms may be life-threatening, or if there appears to be a medical emergency, call 9-1-1.
Heart and cardiovascular problems
These can result in sudden death. They include stroke, heart attack, and increased blood pressure.
Cardiovascular problems may cause the following symptoms:
- fingers or toes that feel numb, cool, or painful
- fingers or toes that change color from pale, to blue, to red
- unexplained wounds on the fingers or toes
They may also cause these serious symptoms, which signal a medical emergency and require urgent help:
- weakness in one part or side of the body
- slurred speech
- pain in the chest, left arm, jaw, or between the shoulders
Call 9-1-1 if any of these occur.
Mental health problems
Any worsening of symptoms, including newly occurring unusual thoughts, should be reported to the doctor.
These may include:
- new behaviors or a worsening of unusual behaviors and thought problems
- new or worsening symptoms of bipolar disorder
- new or worsening aggressive behavior or hostility
If a person is in danger of harm, or if their life might be at risk, it is important to seek help at once.
Sometimes, new psychotic symptoms may appear in children and teenagers with psychiatric problems.
- hearing voices
- seeing things that are not real
- believing things that are not true
- being suspicious
- new signs of being overexcited
Mild side effects may go away within a few days or a couple of weeks. Talk to your doctor or pharmacist if they are more severe or do not go away.
Other risks include:
- delayed growth in children
- clouding of judgment
Evekeo does not cause drowsiness, but it can affect judgment. For this reason, extra care should be taken when driving, using heavy machinery, and similar tasks.
Before using Evekeo, it is important to discuss any other existing medications and supplements with the doctor.
This is because Evekeo can interact with other medications, herbs, or vitamins. An interaction may involve an increase or a decrease in the action of one or more drugs, or a different and unexpected effect.
Stomach acid drugs
The use of antacids, such as proton pump inhibitors (PPIs) and H2 receptor antagonists, may lead to higher levels of Evekeo in the blood. This can increase the impact of any side effects.
Proton pump inhibitors:
H2 receptor antagonists:
Combining Evekeo with tricyclic antidepressants (TCAs) may increase blood pressure and the risk of heart problems.
Monoamine oxidase inhibitor (MAOI) antidepressants
These medications can prevent the body from processing Evekeo correctly, leading to high levels of Evekeo in the blood.
This may increase the risk of extremely high blood pressure, chest pain, severe headache, and high body temperature.
Evekeo should never be taken within 14 days of using MAOI antidepressants.
Examples of MAOIs are:
Drugs that can have this effect include:
- selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine and sertraline
- serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine and venlafaxine
- TCAs such as amitriptyline and clomipramine
- MAOIs such as selegiline and phenelzine
- the opioids fentanyl and tramadol
- the anxiolytic buspirone
- St. John's wort
If a person needs Evekeo while they are taking any of these drugs, the doctor will start them on a lowered dosage of Evekeo and monitor for any signs and symptoms of serotonin syndrome.
Symptoms of serotonin syndrome can include agitation, sweating, muscle twitches, and confusion.
These medications may lower the effects of amphetamine, and this can reduce its effectiveness.
Blood pressure drugs
Evekeo may reduce the blood pressure-lowering effects of these medications.
- angiotensin II receptor blockers, such as losartan, valsartan, and irbesartan
- angiotensin-converting enzyme (ACE) inhibitors, including enalapril and lisinopril
- diuretics, for example, hydrochlorothiazide and furosemide
Evekeo may lower the effect of seizure medications, increasing the risk of seizures.
Some other groups are advised not to use Evekeo.
These include those with:
- heart problems
- high blood pressure
- circulatory problems, such as Raynaud's phenomenon and peripheral vasculopathy
- psychiatric disorders
- a history of psychosis
- bipolar disorder, as it can trigger a mixed or manic episode
- anxiety or agitation, because it can worsen the symptoms
- a history of drug abuse, because amphetamines can be addictive
- an overactive thyroid, known as hyperthyroidism
Evekeo is a category C pregnancy drug.
This means that:
1. Animal studies have suggested that if the mother takes this drug, it may have a negative impact on the unborn child.
2. Too few studies have been done in humans to confirm the drug's impact on the unborn child.
When infants are born to mothers who are dependent on amphetamine during pregnancy, there appears to be a higher risk of preterm delivery, a low birth weight, or symptoms of withdrawal.
Anyone who is pregnant or planning to become pregnant should discuss this with their health provider before using Evekeo or if they are already using this drug.
Evekeo should be used during pregnancy only if the possible benefits outweigh the potential risk to the fetus.
During breast-feeding, Evekeo may pass into breast milk, causing side effects in a nursing child.
The doctor should be informed if a mother is breastfeeding before prescribing this drug.
It may be necessary to decide whether to stop nursing or to stop this drug. You should not breastfeed while taking this drug.
This drug is approved for use in children 3 years of age and older with ADHD, and children 12 years of age and older with obesity.
This drug can cause an allergic reaction in some people.
Symptoms may include:
- trouble breathing
- swelling of your throat and tongue
Anyone who has ever had an allergic reaction to this or another stimulant medication should not use it. Taking it again could be fatal.
Take care to follow the instructions when taking any medication, and always inform your doctor of any supplements or other drugs you may be using.
This drug may be taken short-term or long-term, depending on the condition being treated.
The dose, form, and how often Evekeo should be taken will depend on:
- the person's age
- the type and severity of the condition
- any other existing medical conditions
- the individual's reaction to the first dose
In each case, the doctor will adjust the dose according to how the person responds.
Narcolepsy: The usual dose is 5 to 60 milligrams (mg) a day, in divided doses, depending on the individual.
Rarely, narcolepsy affects children under the age of 12 years. The dose would be as follows:
- Six to 12 years: Starting with 5 mg a day
- Twelve years and older: Starting with 10 mg a day
ADHD: In children aged 3 to 6 years, the dose starts at 2.5 mg. The dose for children aged 6 years and older will start at 5 mg once or twice a day. If the dose is given twice per day, allow 4 to 6 hours between doses.
Obesity: The usual dose is up to 30 mg a day, taken in divided doses 30 to 60 minutes before meals. Children aged under 12 years will not use this drug for obesity.
The dose will depend on how each person reacts to the medication. It is essential to follow a doctor's instructions when using this medication.
Missing a dose or taking too much
There may be serious risks if a person does not take this drug as prescribed by the doctor.
Missing a dose can result in a noticeable worsening of symptoms. If a person misses a dose, they should take it as soon as possible or wait for the next dose. Taking a double dose could have serious adverse effects.
Taking too much can lead to serious and life-threatening complications.
Less severe symptoms include:
- muscle pain
- fast breathing and fast heart rate
- high or low blood pressure
- vomiting, diarrhea, or both
More severe problems include:
- convulsions, or seizures
These adverse effects can be severe. It is essential to seek emergency medical attention if anyone takes too much of this drug.
Here are some other points about Evekeo.
How can I tell if it is working?
A person with narcolepsy may be able to tell if this drug is working if there is an improvement in sleep disturbances.
For ADHD, there may be improvements in mental and behavioral effects, such as increased attention and decreased impulsiveness and hyperactivity.
For obesity, a decrease in appetite may indicate that the drug is working.
What happens when I am travelling?
When traveling with this medication, it is important to remember to:
- carry it with you or in your carry-on bag
- take your pharmacy's preprinted label to identify the medication and keep the original prescription-labeled box with you when traveling
- be sure you have enough medication before leaving on your trip, as refills of this drug are not readily available
Will I have to go back to the doctor?
Patients should attend all follow-up appointments when using this drug, because the doctor may need to monitor heart rate and blood pressure to ensure no problems are occurring.
In the case of children, they may check their weight and height, as the medication can sometimes affect a child's growth.
If you need this medication but are concerned about the side effects, speak to your doctor. They may be able to offer an alternative.