Adderall XR (amphetamine/dextroamphetamine extended-release) Full Prescribing Information DailyMed Drug Information Forms/Strengths Capsules: 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg Dosing Age: Pediatric patients ≥6 years and adults Onset: Approximately 30–60 minutes Duration: 10–12 hours Release Profile: Biphasic – an immediate-release portion followed by a delayed-release phase via beaded capsule technology Considerations: May be taken with or without food; avoid concomitant use with acidifying agents (e.g., fruit juices, vitamin C) which may decrease absorption; high-fat meals may delay Tmax by 2.5 hours but do not affect overall bioavailability Initial Dose (Pediatric): Typically 10 mg once daily in the morning Titration (Pediatric): Increase by 5–10 mg increments at weekly intervals based on clinical response and tolerability Max Dose (Pediatric): Generally should not exceed 30 mg per day Quick Facts Mechanism: Increases the synaptic levels of norepinephrine and dopamine Main Benefits: Improves attention, reduces hyperactivity and impulsivity Side Effects: Decreased appetite, insomnia, headache, stomach upset Formulation Technology: Advanced beaded capsule system providing dual-phase drug release Special Notes: High potential for abuse; use with caution in patients with pre-existing cardiovascular conditions Mechanism of Action Adderall XR contains mixed amphetamine salts that work by enhancing the release of norepinephrine and dopamine, thereby improving neurotransmission which aids in reducing ADHD symptoms. Indications Attention-Deficit/Hyperactivity Disorder (ADHD) (ICD-10: F90.0) Off-Label Uses Narcolepsy (ICD-10: G47.4) – Although primarily indicated for ADHD, Adderall XR may be used off-label in adults for the treatment of narcolepsy. How to Take Take once daily in the morning to avoid insomnia May be taken with or without food; note that high-fat meals can delay absorption Swallow the capsule whole; do not crush or chew General missed-dose advice: Take as soon as remembered unless it is close to the next scheduled dose Side Effects Common: Central Nervous System: Insomnia, headache, irritability Gastrointestinal: Decreased appetite, stomach upset, dry mouth Serious: Cardiovascular: Increased blood pressure, tachycardia, potential for arrhythmias Monitoring/Labs Vital Signs: Monitor blood pressure and heart rate periodically Growth Parameters: In pediatric patients, monitor height and weight at regular intervals Mental Health: Monitor for new or worsening psychiatric symptoms, including mood changes and anxiety Abuse Potential: Monitor for signs of misuse or diversion Education When to Call the Doctor: Experiencing chest pain, shortness of breath, or significant changes in mood or behavior Safety Tips: Take medication strictly as prescribed Do not share medication with others Keep the medication in a secure place out of reach of children Avoid alcohol and other CNS stimulants Report any concerning side effects promptly to your healthcare provider Tips for Pediatric Patients: Ensure dosing is appropriate for your child's weight and age Monitor changes in appetite and growth Maintain regular follow-up visits with the healthcare provider Inform school personnel and caregivers about the medication schedule Long-Term Use Considerations Periodic evaluation of cardiovascular status, especially in patients with underlying conditions Regular monitoring of growth and development in pediatric patients Assess for potential abuse or dependency over extended periods of use Tapering Guidance Clinical Guidelines: Gradual dose reduction is recommended to mitigate withdrawal symptoms Caregiver Considerations: Work closely with your healthcare provider to design an individualized tapering schedule Additional Information Contraindications: History of cardiovascular disease, hyperthyroidism, or glaucoma Pregnancy: Use during pregnancy only if the potential benefit justifies the potential risk to the fetus (Category C) Lactation: May be excreted in breast milk; consult with your healthcare provider before use Drug Interactions: Potential interactions with monoamine oxidase inhibitors (MAOIs), antacids, and other stimulants References U.S. Food and Drug Administration. (2012). Adderall XR Prescribing Information . Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/021303s062lbl.pdf DailyMed. (2021). Adderall XR Drug Information . Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4bd6a68a-35a8-41ad-8b8e-d1e4a7b2123f Faraone, S. V., Biederman, J., & Mick, E. (2020). Pharmacotherapy of attention-deficit/hyperactivity disorder: Current trends. Current Opinion in Psychiatry, 33 (4), 321–326.