Evekeo FAQ

Evekeo, a new stimulant medication for ADHD, was approved recently by the Food and Drug Administration. What makes it different from other stimulant medications – and who may take it?

Blue pills, representing the ADHD medication Evekeo

What is Evekeo?
Evekeo is a new ADHD stimulant medication. It’s an amphetamine sulfate similar to Adderall, but with a different composition: whereas Adderall is 75 percent dextroamphetamine and 25 percent levoamphetamine, Evekeo is an even 50 percent of each. Evekeo is an immediate-release, short-acting medication. See the Evekeo web site for more information.

What does Evekeo treat?
Evekeo is approved for treatment of attention deficit disorder in anyone over the age of three. It’s also been approved for the treatment of narcolepsy, and as a short-term obesity treatment in select cases, for patients 12 years of age or older.

How long has Evekeo been on the market?
Evekeo was approved by the FDA in September 2014.

Is Evekeo effective?
A small study, published recently in the Journal of Child and Adolescent Psychopharmacology, showed that Evekeo was effective at controlling inattention, impulsivity, and hyperactivity in 107 children between the ages of six and 12, when compared to a placebo.

What doses does Evekeo come in?
Evekeo is available in 5 mg. and 10 mg. tablets. Tablets are gray or blue and are scored, so they can be easily split in half.

What dose should I take?
Children between the ages of three and five should start with 2.5 mg daily, with the dose slowly increasing by 2.5 mg each week until an optimal dose is reached. Patients six years of age or older can start with 5 mg once or twice daily, depending on what your doctor recommends. The dose can be increased by 5 mg every week until the proper dosage is found.

Is Evekeo for children or adults?
The FDA approved Evekeo for anyone over the age of three with the following safety statement:

Evekeo is contraindicated in patients who:
· have a history of advanced arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension, hyperthyroidism, known hypersensitivity or idiosyncrasy to the sympathomimetic amines
· are tense or agitated
· have a history of drug abuse
· take, or who have taken, monoamine oxidase inhibitor (MAOI) within 14 days; hypertensive crises may result.

Warnings and Precautions
> Sudden death has been reported in children and adolescents with structural cardiac abnormalities or other serious heart problems in association with CNS stimulant treatment at usual doses.

> Sudden death, stroke, and myocardial infarction have been reported in adults taking stimulant drugs at usual doses for ADHD. Stimulant medications can cause an increase in blood pressure (mean increase about 2-4 mmHg) and heart rate (mean increase about 3-6 bpm). All patients should be monitored for larger changes in heart rate and blood pressure.

> Children, adolescents, or adults who are being considered for treatment with Evekeo should have a careful history (including assessment of a family history of sudden death or ventricular arrhythmia) and a physical exam to assess for the presence of cardiac disease.

> Patients developing any signs of heart problems such as exertional chest pain, unexplained syncope, or other symptoms suggestive of cardiac disease while taking Evekeo should undergo a prompt cardiac evaluation.

> Stimulants may exacerbate symptoms in patients with pre-existing psychotic disorder or in patients with new or worsening bipolar disorder. Treatment emergent psychotic or manic symptoms can occur in children or adolescents such as hallucinations, delusional thinking, or mania.

> Aggressive behavior or hostility is also often observed in children and adolescents taking medications for ADHD and should be monitored for the appearance of, or the worsening of, aggressive behavior or hostility.

> Stimulants have been associated with long-term suppression of growth in pediatric patients. Growth should be monitored during treatment with Evekeo, and patients not growing or gaining height or weight as expected may need to have their treatment interrupted.

Adverse Reactions
The most common side effects reported with Evekeo treatment include palpitations, tachycardia, hypertension, overstimulation, restlessness, dizziness, insomnia, euphoria, dyskinesia, dysphoria, tremor, headache, exacerbation of phonic tics and Tourette’s syndrome, seizures (mainly in patients with a history of seizures), visual disturbances, dry mouth, unpleasant taste, gastrointestinal disturbances, weight loss, urticaria, impotence, changes in libido, frequent or prolonged erections, and peripheral vasculopathy, including Raynaud’s phenomenon.

For additional safety information, consult the Evekeo full Prescribing Information and Medication Guide.

Is Evekeo addictive?
Evekeo is a Schedule II controlled substance, meaning that while it has an acknowledged medical purpose, it also has a high potential for abuse. If taken improperly — particularly by someone who doesn’t have ADHD — it can be misused or abused.

Can I take Evekeo while pregnant or nursing?
Evekeo is a Category C medication in regards to pregnancy, meaning that, while no data exists showing that it will be harmful to the fetus, none exists to prove that it’s safe either. ADHD medications are classified as L3: Moderately Safe — meaning “there are no controlled studies in breastfeeding women and the risk of untoward effects to a breastfed infant is possible. Drugs should be given only if the potential benefit justifies the potential risk to the infant.” It’s up to you and your doctor what will be best for your family.

Will my insurance cover the cost of Evekeo?
Possibly not. As a new medication, it may not yet be approved by insurance providers. The maker of Evekeo (Arbor Pharmaceuticals) offers eligible patients a free trial of up to 60 tablets. Click HERE for more information.

Have you or your child taken Evekeo?
Please share your experience with Evekeo on the ADDitude’s community site in the Medication & Treatment Reviews Evekeo forum.

TAGS: ADHD Stimulant Medications, ADD Meds: Dosing, ADHD Medical Care and Insurance

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