Mixed amphetamine salts XR
ADDERALL XR
“Amp to Add it all”
What it isMixed amphetamine salts XR (ADDERALL XR, 2001) release norepinephrine, dopamine and serotonin for ADHD; approved ages: 6-17, adults.
Why this oneIts 50% IR / 50% DR beads mimic BID coverage for 8-12 h (Carlat Table 1) and are sprinklable.
What limits itAppetite loss, insomnia, tachycardia and blood-pressure rise often limit it. Do not crush; misuse, diversion and dependence remain.
FDA-approved for
- ADHD (2001)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| ADHD | Adults | 20 mg QAM | ||
| ADHD | Peds 6–12 yr | 10 mg QAM (may start 5 mg); titrate 5–10 mg/wk | 30 mg/day | |
| ADHD | Peds 13–17 yr | 10 mg QAM; may increase to 20 mg/day after 1 wk | 20 mg/day (studied) |
Titration Titrate at weekly intervals
Renal Severe renal impairment (GFR 15–<30): adults 15 mg QAM; peds 6–17 yr 5 mg QAM (max 20 mg for 6–12 yr). ESRD (GFR <15): not recommended.
Hepatic Undefined
Instructions
- Give on awakening; avoid afternoon doses (insomnia)
- May swallow whole or sprinkle entire contents on applesauce (consume immediately, no chewing)
- Do not divide a capsule; with or without food
Available strengths
- ER cap 5, 10, 15, 20, 25, 30 mg
- cap 5, 10, 15, 20, 25, 30 mg
- tab 5, 7.5, 10, 12.5, 15, 20, 30 mg
Contraindications
- Concurrent MAOIs or use within 14 days (incl. linezolid, IV methylene blue) — risk of hypertensive crisis
Cautions
- Serious cardiac events (sudden death) with structural cardiac abnormalities
- Increased blood pressure/heart rate
- Psychiatric adverse reactions
- Long-term growth suppression in children
- Peripheral vasculopathy (Raynaud's)
- Serotonin syndrome
- Tics/Tourette's worsening
Adverse reactions
- Loss of appetite, insomnia
- Dry mouth, weight loss
- Abdominal pain, nausea
- Anxiety, agitation, dizziness
- Tachycardia
Pregnancy May cause premature delivery and low birth weight; monitor neonates for withdrawal.
Lactation Breastfeeding not recommended.
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 5 mg | ER cap | 30 qd | $14.74 | not offered |
| 10 mg | ER cap | 30 qd | $16.18 | not offered |
| 15 mg | ER cap | 30 qd | $16.72 | not offered |
| 20 mg | ER cap | 30 qd | $17.90 | not offered |
| 25 mg | ER cap | 30 qd | $14.68 | not offered |
| 30 mg | ER cap | 30 qd | $13.97 | not offered |
Other forms: Amphetamine (ADDERALL) · Mixed amphetamine salts (triple-bead) (MYDAYIS)
⚠ BOXED WARNING
- Abuse, misuse and addiction
Classes and tags
Clinical profile
Serotonin and MAOI
Provisional washout figures
Elevating mechanismNone identified
Exposure dependenceNo serotonin-elevating mechanism identified
Evidence confidenceModerate
InterpretationNo clinically meaningful serotonin-elevating mechanism identified in this first-pass Gillman-based review.
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