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NERVOUS SYSTEM › PSYCHOANALEPTICS › PSYCHOSTIMULANTS, AGENTS USED FOR ADHD AND NOOTROPICS › Centrally acting sympathomimetics
fenetylline
N06BA10
Forms & Strengths
- Historically available as 50 mg oral tablets (Captagon)
Adult Dosing
- Historically used: 25 mg to 50 mg orally 1 to 2 times daily
- Maximum recommended historical dose: 100 mg daily
Pediatric Dosing
- Safety and efficacy not established in pediatric patients
- Historically used off-label in children for ADHD at lower weight-based dosages, no longer recommended
Indications
- Historically indicated for attention deficit hyperactivity disorder (ADHD)
- Historically used for narcolepsy and treatment-resistant depression
- Currently classified as an illicit schedule I/controlled substance globally with no accepted medical use
Mechanism of Action
- Prodrug of amphetamine and theophylline
- Metabolized in vivo to yield amphetamine, which stimulates central nervous system release of dopamine and norepinephrine
- Provides mild concurrent phosphodiesterase inhibition via theophylline moiety
Contraindications
- Hypersensitivity to amphetamines or theophylline
- History of cardiovascular disease, moderate to severe hypertension, or advanced arteriosclerosis
- Glaucoma
- Hyperthyroidism
- Concurrent use with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuation
Adverse Reactions
- Insomnia
- Tachycardia and palpitations
- Elevated blood pressure
- Anxiety, agitation, and restlessness
- Decreased appetite and weight loss
- High potential for psychological and physical dependence
Drug Interactions
- Monoamine oxidase inhibitors (MAOIs) leading to hypertensive crisis
- Sympathomimetic agents increasing cardiovascular adverse effects
- Antihypertensives showing antagonized blood pressure-lowering effects
- CNS stimulants increasing risk of central nervous system toxicity
Curated Content: Needs Vetting Before Put to Clinical Use