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Is Dextroamphetamine contraindicated in heart condition?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. K. Shobana

Published At January 20, 2018
Reviewed AtFebruary 14, 2024

Patient's Query

Hello doctor,

I am a 55-year-old woman recently diagnosed with ADHD and prescribed stimulants. I have hypertension, and I take Amlodipine 5 mg, Losartan 50 mg, and Propranolol (10 mg to 60 mg) for anxiety which also helps with my blood pressure. My echocardiogram says that my left ventricular wall thickness is mildly increased with grade 1 diastolic dysfunction of the left ventricle (impaired relaxation pattern) with normal left ventricular systolic function. Everything else on the echocardiogram is normal. Is taking a Dextroamphetamine prescription of 5 mg ER and 5 mg IR a day contraindicated with my condition? This is the weakest prescription of Dextroamphetamine, but it helps a lot with my ADHD and anxiety symptoms. The stimulants do not appear to increase my BP, but my BP is not completely controlled. It is usually about 130 over 85. I am having another echocardiogram next month. Please help.

Hello,

Welcome to icliniq.com.

I read your query and understand your concern. So, currently, you do not have any serious heart issues. The impaired relaxation and diastolic dysfunction occur due to chronically elevated BP leading to hypertrophy. It is not a serious heart problem and needs no specific treatment. It is similar to the bodybuilding of athletes secondary to increased workload. Now, regarding Dextroamphetamine, the contraindication is not related to your heart but related to high BP (blood pressure). It is contraindicated in moderate to severe uncontrolled hypertension. So considering you have the lowest possible dose and your observation that it is not affecting BP readings, Dextroamphetamine can be continued. However, keep watch on blood pressure. Now, mentioned BP reading is fine, and you should continue the same antihypertensive. If needed, we can increase Amlodipine to 10 mg. Regarding cholesterol, LDL is significantly higher. I suggest you do vigorous lifestyle modifications, and if you are already doing, then it is better to initiate medicines like tablet Rosuvastatin at bedtime. I suggest you should have a healthy lifestyle. You must avoid a fatty, oily, and high-calorie diet. Also, have a low salt diet. You must perform regular exercises like brisk walking and jogging according to your capacity for at least 30 minutes a day and five days a week. You must eat lots of green leafy vegetables, fruits, and fish once or twice a week, and avoid meat. You must avoid smoking and alcohol (if any). You must try to lose some weight and bring your BMI (body mass index) down. Recheck cholesterol after two to three months. If there is a response, it is fine; otherwise, you will need medicines. Hope this helps you and get back if you have any doubts. Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sagar Ramesh Makode
Dr. Sagar Ramesh Makode

Cardiology

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