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Xelstrym is a stimulant that is used to treat attention deficit hyperactivity disorder (ADHD). Common side effects include decreased appetite, headache, trouble sleeping, and nausea and vomiting. Xelstrym is a controlled substance because it can be misused or lead to dependence. Store Xelstrym in a safe place to protect it from theft. Xelstrym comes as a patch that is applied to the skin.

Uses

What is Xelstrym used for?

Xelstrym (dextroamphetamine) is commonly used to treat attention deficit hyperactivity disorder (ADHD).

Xelstrym may also be used for other conditions as determined by your health care provider.

How does Xelstrym work (mechanism of action)?

Xelstrym is part of a group of medicines called stimulants. It may work by increasing levels of natural brain chemicals, such as norepinephrine and dopamine. These chemicals play a role in attention, focus, and impulse control.

How is Xelstrym supplied (dosage forms)?

Brands and other names

  • Xelstrym

Dosage forms and strengths

  • 4.5 mg/9 hours transdermal systems (patch)
  • 9 mg/9 hours transdermal systems (patch)
  • 13.5 mg/9 hours transdermal systems (patch)
  • 18 mg/9 hours transdermal systems (patch)

Dextroamphetamine is also available in forms that are taken by mouth. See Dextroamphetamine for more information. 

How should I store Xelstrym?

Xelstrym should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry, and safe place, such as a locked cabinet. Protect from light and moisture. Keep Xelstrym in its sealed pouch until you are ready to apply it.

Side Effects

What are the most common side effects of Xelstrym?

The most common side effects of Xelstrym are listed below. These side effects may vary depending on your age. Tell your health care provider if you have any of these side effects that bother you.

  • Decreased appetite
  • Headache
  • Trouble sleeping
  • Tics (see below)
  • Stomach pain
  • Nausea and vomiting
  • Irritability
  • Increased blood pressure and heart rate (see below)

There may be other side effects of Xelstrym that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Xelstrym?

While less common, the most serious side effects of Xelstrym are described below, along with what to do if they happen.

Severe Allergic Reactions. Xelstrym may cause allergic reactions, which can be serious. Stop using Xelstrym and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Risk of Misuse and Addiction. Misusing Xelstrym can lead to serious side effects, such as substance use problems, overdose, or death. Misuse means taking a medicine in a way other than as prescribed. Xelstrym can also cause physical dependence, which means your body relies on the medicine. Use Xelstrym exactly as prescribed. Tell your health care provider if you feel that Xelstrym is not working. Call your health care provider right away or go to the nearest emergency room if you have any of the following serious symptoms.

  • Sudden confusion or feeling disoriented
  • Feeling paranoid
  • Suicidal thoughts or actions
  • Seizures
  • Trouble breathing

Increased Blood Pressure and Heart Rate. Xelstrym may increase your heart rate or blood pressure. Keep all appointments with your health care provider to check your blood pressure and heart rate before starting Xelstrym and during treatment. If you measure your blood pressure and the top number (systolic) is 180 mmHg or higher, or the bottom number (diastolic) is 120 mmHg or higher, get medical attention right away. Also, call your health care provider or get medical attention right away if you have chest pain, a fast heartbeat, or if you faint or feel your heartbeat more than usual.

Mental Health Problems. Xelstrym may cause or worsen psychotic-like behaviors, such as hallucinations or mania. People who already have a mental health condition, such as bipolar disorder, may be at higher risk of these side effects. Tell your health care provider right away if you have any of the following symptoms, or if you have been told by others that you have these symptoms.

  • Hearing, seeing, smelling, tasting, or otherwise perceiving things that others do not
  • Delusional thoughts, such as false beliefs that you are being controlled
  • Disorganized thoughts, such as jumping between topics or having a hard time focusing
  • Sudden decline in self-care, such as personal hygiene or academic/work performance
  • Aggressive behavior
  • Very increased energy
  • Significant trouble sleeping
  • Racing, fast-paced thoughts
  • Reckless behavior
  • Unusually grand ideas
  • Excessive happiness or irritability
  • Talking more or faster than usual

Slowed Growth in Children. Children using Xelstrym may be at a higher risk of not gaining height and weight as expected. Keep all appointments with your health care provider to check your child’s height and weight before starting and during treatment with Xelstrym.

Blood Flow Problems. Xelstrym may cause blood flow problems, including a condition called Raynaud’s phenomenon, which occurs when the blood vessels in your fingers and toes overreact and lead to low blood flow. Call your health care provider right away if you have any of the following symptoms.

  • Fingers or toes feeling numb, cool, painful, or sensitive to cold
  • Fingers or toes changing color from pale to blue to red
  • Unexplained wounds on fingers or toes

Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Xelstrym may cause serotonin syndrome when it is used alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.

  • Sweating, fever, or flushing
  • Confusion
  • Feeling agitated or restless
  • Seeing or hearing unusual things
  • Dizziness
  • Fast or racing heartbeat
  • Nausea, vomiting, or diarrhea
  • Muscle twitching, stiffness, or tremor
  • Seizures

Allergic Skin Reaction. Xelstrym can cause an allergic skin reaction, also known as allergic contact dermatitis, near where it is applied. Redness or irritation are common side effects of Xelstrym, but they can sometimes be signs of a more serious reaction. Stop using Xelstrym and call your health care provider right away if you have blisters, bumps, or swelling.

Application Site Reaction. Xelstrym can cause skin reactions at or near where you apply the patch, including pain, redness, itching, burning, discomfort, or swelling. Call your health care provider if you have any of these symptoms and they do not get better within a couple of hours. To lower your risk of a skin reaction, choose a different location each time you apply Xelstrym and do not use the same site two days in a row. 

Tics. Xelstrym may cause or worsen tics, which are sudden, repetitive movements or sounds that can be hard to control. Call your health care provider right away if you have any new or worsening tics.

Warnings & Precautions

Who should not use Xelstrym?

Allergies to Ingredients. People who are allergic to any of the following should not use Xelstrym.

  • Amphetamine 
  • Dextroamphetamine
  • Xelstrym
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Xelstrym.

Drug Interactions. Xelstrym should not be used while you are using certain other medicines. Before using Xelstrym, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about Xelstrym before using it?

Do not use Xelstrym unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share Xelstrym with other people, even if they have the same condition as you. It may harm them.

Keep Xelstrym out of the reach of children. Xelstrym is a controlled substance because it can be misused or lead to dependence. Store Xelstrym in a safe, preferably locked, place to protect it from theft. It is illegal to sell or give away this medicine.

Read and follow the instructions that come with Xelstrym and make sure you understand how to prepare, use, and throw it away properly. If you have any questions, talk to your health care provider.

Only apply one Xelstrym patch at a time and do not wear it for more than nine hours. Change where you apply the patch every day. Xelstrym can be applied to the following areas of your body.

  • Upper arm
  • Chest
  • Upper back
  • Sides of the waist, also known as your flank
  • Hip

Xelstrym may affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how Xelstrym affects you.

Do not use heat sources, such as hair dryers, heating pads, electric blankets, saunas, hot tubs, heat lamps, or heated water beds, on or near the area where you are wearing Xelstrym. Heat can increase the amount of medicine your body absorbs, which may increase your risk of serious side effects.

If you need to dispose of unused or expired Xelstrym, bring it to a medicine take-back program at an authorized collection site, such as a pharmacy or police station. If no take-back program is available, follow the instructions that come with your product or ask your pharmacist or other health care provider how to throw this medicine away safely. Do not flush Xelstrym.

Keep all appointments, including for blood work and heart checkups, before and during treatment with Xelstrym. This will help your health care provider make sure it is safe for you to use Xelstrym.

What should I tell my health care provider before using Xelstrym?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Xelstrym is right for you.

In particular, make sure that you discuss any of the following.

Substance Use Disorder. Tell your health care provider if you have ever misused alcohol, prescription medicines, or street drugs. Xelstrym is a controlled substance and may be misused.

Mental Health Problems. Tell your health care provider if you or anyone in your family has had mental health problems, including psychosis, bipolar disorder, mania, depression, or suicide. Xelstrym may worsen certain mental health conditions.

Heart Problems. People who have serious heart disease or heart defects may be at risk of sudden death if they use Xelstrym. Tell your health care provider if you have any heart problems, including heart disease, heart defects, cardiomyopathy, or an abnormal heart rhythm (arrhythmia). Also, tell your health care provider if anyone in your family has heart problems.

Other Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following.

  • High blood pressure
  • Circulation problems in the fingers or toes
  • Seizures or an abnormal brain wave test, called an electroencephalogram (EEG) test
  • Tics (repeated movements or sounds), Tourette syndrome, or a family history of tics or Tourette syndrome
  • Kidney problems

Pregnancy. It is not known if or how Xelstrym could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should use Xelstrym while you are pregnant or trying to get pregnant. If you become pregnant while using Xelstrym, you can sign up for the National Pregnancy Registry for ADHD Medications by calling 866-961-2388 or at womensmentalhealth.org/research/pregnancyregistry/adhd-medications. This registry collects safety information about the use of ADHD medicines during pregnancy.

Breastfeeding. Do not breastfeed while you are using Xelstrym. Xelstrym passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

How can I get more information about Xelstrym?

For more information about Xelstrym, you can visit the drugmaker’s website at www.xelstrym.com or call them at 800-455-8070.

 

Interactions

Does Xelstrym interact with foods or drinks?

There are no known interactions between Xelstrym and foods or drinks.

It is unknown if drinking alcohol will affect Xelstrym. The risk of certain side effects may increase if you drink alcohol while taking Xelstrym.

Does Xelstrym interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Xelstrym.

  • A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s disease
  • A selective serotonin reuptake inhibitor (SSRI), such as fluoxetine, paroxetine, or sertraline, which is a medicine commonly used for anxiety and depression
  • A serotonin and norepinephrine reuptake inhibitor (SNRI), such as duloxetine or venlafaxine, which is a medicine commonly used for anxiety and depression
  • A triptan, such as eletriptan (Relpax), sumatriptan (Imitrex and others), and others, which is a medicine commonly used to treat migraines
  • Lithium, which is a medicine for certain mental health conditions
  • Fentanyl, meperidine, or tramadol, which are medicines used to treat certain types of pain
  • Buspirone, which is a medicine used to treat anxiety
  • A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
  • Tryptophan, which is a supplement that may be used to help the body make proteins and certain brain-signaling chemicals
  • St. John’s wort, which is a supplement that may be used for depression
  • Acetazolamide, which is a medicine used to treat fluid retention, glaucoma, and altitude sickness
  • A thiazide diuretic, such as chlorthalidone, hydrochlorothiazide, or indapamide, which is a medicine commonly used to lower blood pressure

Many other medicines may alter the blood levels of Xelstrym. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Xelstrym. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Xelstrym?

If you or someone else has used too much Xelstrym, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Xelstrym?

If you miss a dose of Xelstrym, ask your health care provider for advice. You should only wear one patch at a time for no more than nine hours, and a new patch should only be applied every 24 hours. Do not use double or extra doses.

Ask your health care provider what to do if your patch does not fully stick to your skin or falls off.