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Medical Industry Feature: Expert Interview: A Nurse Practitioner’s Perspective on a Treatment Option for ADHD

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MYDAYIS® is indicated for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in patients ≥13 years. Patients ≤12 years experienced higher plasma exposure at the same dose and higher rates of adverse reactions, mainly insomnia and decreased appetite.

IMPORTANT SAFETY INFORMATION

WARNING: ABUSE AND DEPENDENCE
CNS stimulants, including Mydayis, other amphetamine-containing products, and methylphenidate, have a high potential for abuse and dependence. Assess the risk of abuse prior to prescribing and monitor for signs of abuse and dependence while on therapy.

Read Additional Important Safety Information >>
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Expert Interview: A Nurse Practitioner’s Perspective on a Treatment Option for ADHD

Expert Interview: A Nurse Practitioner’s Perspective on a Treatment Option for ADHD
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  • Overview

    Please click for Full Prescribing Information.

    INDICATION AND LIMITATIONS OF USE

    MYDAYIS® (mixed salts of a single-entity amphetamine product) is indicated for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in patients ≥13 years. Patients ≤12 years experienced higher plasma exposure at the same dose and higher rates of adverse reactions, mainly insomnia and decreased appetite.

    IMPORTANT SAFETY INFORMATION

     WARNING: ABUSE AND DEPENDENCE
    • CNS stimulants, including Mydayis, other amphetamine-containing products, and methylphenidate, have a high potential for abuse and dependence. Assess the risk of abuse prior to prescribing and monitor for signs of abuse and dependence while on therapy.

    • Contraindications
      • Known hypersensitivity to amphetamines or other ingredients of Mydayis. Angioedema and anaphylactic reactions have been reported with other amphetamines.
      • Use with monoamine oxidase inhibitors (MAOIs) or within 14 days of last MAOI dose, due to increased risk of hypertensive crisis.
    • Warnings and Precautions
      • Avoid use in patients with known structural cardiac abnormalities, cardiomyopathy, serious heart arrhythmia, coronary artery disease, and other serious heart problems. Sudden death, stroke and myocardial infarction have been reported in adults with CNS stimulants at recommended doses, as well as sudden death in pediatric patients with structural cardiac abnormalities and other serious heart problems while taking CNS stimulants at recommended doses. Further evaluate patients who develop exertional chest pain, unexplained syncope, or arrhythmias during Mydayis treatment.
      • CNS stimulants cause increased blood pressure (mean increase ~2-4 mm Hg) and heart rate (mean increase ~3-6 bpm). Monitor for tachycardia and hypertension.
      • Exacerbation of Pre-existing Psychosis: May exacerbate symptoms of behavior disturbance and thought disorder in patients with a pre-existing psychotic disorder. Induction of a Manic Episode in Patients with Bipolar Disorder: May induce a mixed/manic episode in patients with bipolar disorder. Prior to initiating treatment, screen for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms, or a family history of suicide, bipolar disorder, and depression). New Psychotic or Manic Symptoms: At recommended doses, may cause psychotic or manic symptoms (e.g., hallucinations, delusional thinking, or mania) in patients with no prior history of psychotic illness or mania. Discontinue if symptoms occur.
      • CNS stimulants are associated with weight loss and slowing of growth rate in pediatric patients (monitor weight and height). Treatment may need to be interrupted in patients not growing or gaining weight as expected. Mydayis is not approved in pediatric patients ≤12 years.
      • CNS stimulants are associated with peripheral vasculopathy, including Raynaud’s phenomenon. Signs and symptoms are usually intermittent and mild; very rare sequelae include digital ulceration and/or soft tissue breakdown. Careful observation for digital changes is necessary during treatment with ADHD stimulants; further evaluation and referral may be required.
      • Mydayis may lower the convulsive threshold in patients with prior history of seizure, prior EEG abnormalities in the absence of seizures, and in patients without a history of seizures and no prior EEG evidence of seizures. Discontinue if a seizure occurs.
      • Increased risk of serotonin syndrome when co-administered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations. Discontinue Mydayis if it occurs and initiate supportive treatment.
      • To avoid substitution errors and overdosage, do not substitute for other amphetamines on a mg-per-mg basis because of different amphetamine base compositions and differing PK profiles.
    • Adverse Reactions 
      Most common adverse reactions in patients with ADHD (incidence ≥5% and at a rate at least twice placebo) are:
      • Pediatrics (13 years and older): insomnia, decreased appetite, decreased weight, irritability, and nausea.
      • Adults: insomnia, decreased appetite, decreased weight, dry mouth, increased heart rate, and anxiety.
    • Pregnancy and Lactation
      Mydayis may cause fetal harm. Breastfeeding is not recommended during Mydayis treatment.

    Mydayis is available in 12.5 mg, 25 mg, 37.5 mg, and 50 mg extended-release capsules.

    Please click for Full Prescribing Information. 

    Intended for U.S. Healthcare Professionals Only.

    ADHD affects multiple aspects of an adult patient’s life, and a common obstacle clinicians can face is thinking that only a patient’s work life is affected by their ADHD symptoms.

    Joining Dr. Matt Birnholz from Denver, Colorado is Nurse Practitioner Catherine Poulos from East End Mental Health, who provides her expertise, experience, and perspective on managing ADHD adult patients in addition to discussing Mydayis, a mixed salts of a single-entity amphetamine product, as a treatment option for this disorder. Ms. Poulos is a paid consultant for Shire, now part of Takeda. 

    Curious about other perspectives on ADHD? Hear a psychiatrist take.

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