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"Precursor medications as a source of methamphetamine and/or amphetamine positive drug testing results". "Metabolic Precursors to Amphetamine and Methamphetamine".
Propylhexedrine (e.g., Benzedrex Inhaler) is not required to carry a warning against unsupervised use with hypertension and may be effective. When hypertensive patients request a nasal decongestant, the pharmacist can recommend several alternatives. This includes oxymetazoline (e.g., Afrin), phenylephrine (e.g., Neo-Synephrine), naphazoline (e.g., Privine), and l-desoxyephedrine/levomethamphetamine. Most topical nasal decongestants also carry the warning against unsupervised use with hypertension. Archived from the original on 30 October 2014. "Nonprescription Products to Avoid With Hypertension". "Hippocampus norepinephrine, caudate dopamine and serotonin, and behavioral responses to the stereoisomers of amphetamine and methamphetamine". ^ Kuczenski R, Segal DS, Cho AK, Melega W (February 1995).The Journal of Pharmacology and Experimental Therapeutics. "l-methamphetamine pharmacokinetics and pharmacodynamics for assessment of in vivo deprenyl-derived l-methamphetamine". ^ a b Melega WP, Cho AK, Schmitz D, Kuczenski R, Segal DS (February 1999).Archived from the original on 18 October 2014. National Center for Biotechnology Information, U.S. ACS Chemical Neuroscience: acschemneuro.2c00689. "Distinct Effects of Methamphetamine Isomers on Limbic Norepinephrine and Dopamine Transmission in the Rat Brain". ^ a b c Pauly RC, Bhimani RV, Li JX, Blough BE, Landavazo A, Park J (March 2023)."Human pharmacology of the methamphetamine stereoisomers". ^ a b Mendelson J, Uemura N, Harris D, Nath RP, Fernandez E, Jacob P, et al.L-methamphetamine metabolizes completely into L-amphetamine after a period of time. Levomethamphetamine can register on urine drug screens as either methamphetamine, amphetamine, or both, depending on the subject's metabolism and dosage. In recent years, tighter controls in Mexico on certain methamphetamine precursors like ephedrine and pseudoephedrine has led to a greater percentage of illicit meth from Mexican drug cartels consisting of a higher ratio of levomethamphetamine to dextromethamphetamine within batches of racemic meth. These would be similar to those of other decongestants.Īs of 2006, there were no studies demonstrating "drug liking" scores of oral levomethamphetamine that are similar to racemic methamphetamine or dextromethamphetamine in either recreational users or medicinal users. When the nasal decongestant is taken in excess, levomethamphetamine has potential side effects. Selegiline itself has neuroprotective and neuro-rescuing effects, but concern over the resulting levomethamphetamine's neurotoxicity led to development of alternative MAO B inhibitors, such as rasagiline, that do not produce toxic metabolites. This has caused users to test positive for amphetamines. Selegiline, a selective monoamine oxidase B (MAO B) inhibitor at low doses, is also metabolized into levomethamphetamine and levoamphetamine. Levomethamphetamine is an active metabolite of the antiparkinson's drug selegiline. The elimination half-life of levomethamphetamine is between 13.3 and 15 hours, whereas dextromethamphetamine has a half-life of about 10.5 hours. Among its physiological effects are the vasoconstriction that makes it useful for nasal decongestion. It does not possess the same potential for euphoria or addiction that dextromethamphetamine possesses. Levomethamphetamine crosses the blood-brain-barrier and acts as a norepinephrine transporter inhibitor and TAAR1 agonist, functioning as a selective norepinephrine releasing agent (with limited effects on the release of dopamine), thus levomethamphetamine affects the central nervous system, although its effects are qualitatively distinct relative to those of dextromethamphetamine. Levomethamphetamine is a sympathomimetic vasoconstrictor that is the active ingredient in some over-the-counter (OTC) nasal decongestant inhalers in the United States. Levomethamphetamine is the levorotatory (L- enantiomer) form of methamphetamine.
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