Adderall

Full Prescribing Information

DailyMed Drug Information

Forms/Strengths

Tablets: 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, 30 mg
These are mixed amphetamine salts (MAS) in a 3:1 ratio of dextroamphetamine to levoamphetamine salts for balanced effects on focus (dextro) and alertness (levo).

Age: ≥ 3 y/o
Onset: 30-60 minutes
Duration: 4-6 hours
Considerations: Administer first dose upon awakening; additional doses at 4-6 hour intervals; may take with or without food (high-fat meals may delay absorption)
Initial Dose:
- 3-5 y/o: 2.5 mg daily
- 6+ y/o: 5 mg 1-2 times daily
Titration:
- 3-5 y/o: 2.5 mg weekly
- 6+ y/o: 5 mg weekly
Max Dose:
- ≤50 kg: 40 mg/day
- >50 kg: 60 mg/day (Narcolepsy)

Increases synaptic dopamine and norepinephrine via presynaptic release, reuptake inhibition (DAT/NET), and VMAT2-mediated vesicular efflux
Enhances focus, attention, impulse control, and wakefulness in ADHD and narcolepsy
Common side effects: decreased appetite, insomnia, dry mouth, weight loss, increased heart rate/blood pressure
Schedule II controlled substance with high abuse/misuse potential
Black box warning: Abuse and dependence; sudden death and serious cardiovascular events reported
May suppress growth in pediatrics; monitor height/weight
3:1 dextro:levo ratio balances cognitive focus (dextro) and peripheral alerting effects (levo)

Treatment-resistant depression (ICD-10: F33.9): Adjunctive for low-energy symptoms
Cognitive enhancement post-TBI (ICD-10: S06.0-S06.9): Improves attention and processing speed
Augmentation in bipolar depression (ICD-10: F31.4): Short-term for anhedonia

Administer once or multiple times daily, as directed.
Take with or without food; high-fat meals may delay absorption.
If using the tablet, swallow whole; do not crush, chew, or split unless scored.
Avoid dosing late in the day to prevent insomnia.

Common:
- Cardiovascular: Tachycardia, hypertension, palpitations
- CNS: Insomnia, headache, irritability, anxiety, dizziness
- GI: Dry mouth, anorexia, weight loss, abdominal pain
- Other: Decreased appetite, euphoria
Serious:
- Black box: Risk of abuse/dependence; sudden death, myocardial infarction, stroke in those with cardiac structural abnormalities
- Psychiatric: Psychosis, mania, aggression, suicidal ideation
- Cardiovascular: Cardiomyopathy, Raynaud's phenomenon
- Growth suppression in children; priapism; serotonin syndrome (with serotonergics); hypersensitivity reactions

When to Call the Doctor:
- Severe mood changes, aggression, or suicidal thoughts.
- Chest pain, shortness of breath, or palpitations (cardiovascular concerns).
- Uncontrolled movements, tics, or worsening anxiety.
- Signs of circulatory issues (e.g., numbness, coldness, or color changes in fingers/toes).
- Unexplained weight loss or growth suppression in pediatric patients.
Safety Tips:
- Monitor blood pressure and heart rate regularly, especially in patients with cardiovascular risk.
- Use caution in patients with history of anxiety, bipolar disorder, or psychosis, as symptoms may worsen.
- Avoid caffeine and other stimulants, which may increase side effects.
- Ensure adequate hydration and nutrition, as appetite suppression is common.
- Do not abruptly discontinue; tapering may be needed in long-term users.
Parent Tips for Pediatric Patients:
- Encourage a high-calorie diet to offset appetite suppression.
- Monitor school performance and behavioral changes.
- Administer the first dose before school for optimal effect.
- Observe for sleep disturbances and adjust dosing schedule if needed.
- Keep communication open with teachers and caregivers regarding medication effects.

Contraindications:
- Hypersensitivity to amphetamines or any formulation components.
- Use within 14 days of MAOI therapy (risk of hypertensive crisis).
- Symptomatic cardiovascular disease, moderate-to-severe hypertension, hyperthyroidism, glaucoma.
- History of substance use disorder, unless benefits outweigh risks.
Pregnancy:
- Category C; use only if benefits outweigh risks.
- May cause neonatal withdrawal symptoms or low birth weight.
Lactation:
- Excreted in breast milk; not recommended due to potential infant exposure.
Drug Interactions:
- Serotonergic drugs (e.g., SSRIs, SNRIs, MAOIs) increase serotonin syndrome risk.
- Acidifying agents (e.g., ascorbic acid) may reduce drug absorption.
- Alkalinizing agents (e.g., sodium bicarbonate) may increase amphetamine levels.
- May potentiate hypertensive effects of certain medications (e.g., decongestants, beta-agonists).