Mixed amphetamine salts
ADDERALL
“Amp to Add it all”
What it isStimulant that releases norepinephrine, dopamine and serotonin; ADHD and narcolepsy.
Why this oneIts release mechanism can work when methylphenidate reuptake blockade has not, but it carries greater misuse pressure.
What limits itAppetite loss, insomnia and blood-pressure rise often limit it. Schedule II diversion matters; urinary alkalinization can raise exposure.
FDA-approved for
- ADHD (~1960)
- narcolepsy (~1960)
Off-label
- antidepressant augmentation (limited evidence)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Narcolepsy | Adults and ≥12 yr | 10 mg QD | 5–60 mg/day in divided doses (usual) | Undefined |
| ADHD | Children 3–5 yr | 2.5 mg QD | Titrate to optimal response | Undefined |
| ADHD | Children ≥6 yr | 5 mg QD–BID | Titrate to optimal response | Rarely need >40 mg/day |
| Narcolepsy | Children 6–12 yr | 5 mg QD | Titrate to optimal response | Undefined |
Titration Weekly intervals (ADHD: +2.5 mg/day age 3–5, +5 mg/day ≥6 yr; narcolepsy: +5 mg/day age 6–12, +10 mg/day ≥12 yr)
Renal Undefined
Hepatic Undefined
Not recommended under 3 yr of age.
Instructions
- First dose on awakening; 1–2 additional doses at 4–6 h intervals
- Avoid late-evening doses (insomnia)
Available strengths
- tab 5, 7.5, 10, 12.5, 15, 20, 30 mg
Contraindications
- MAOIs, or within 14 days of stopping (incl. linezolid, IV methylene blue) — hypertensive crisis
- Pheochromocytoma or history of pheochromocytoma
Cautions
- Abuse, misuse, and addiction
- Risks in serious cardiac disease
- Increased blood pressure and heart rate
- Psychiatric adverse reactions (psychosis, mania)
- Long-term growth suppression in pediatrics
- Seizures
- Peripheral vasculopathy, incl. Raynaud's
- Serotonin syndrome
- Motor/verbal tics; worsening Tourette's
Adverse reactions
- Palpitations, tachycardia, elevated BP
- Psychotic episodes, overstimulation, restlessness
- Irritability, euphoria, dysphoria, depression
- Dyskinesia, tremor, motor/verbal tics
- Blurred vision, mydriasis
- Dry mouth, unpleasant taste
- Diarrhea, constipation
- Anorexia, weight loss
- Urticaria, rash, angioedema, anaphylaxis
- Impotence, libido changes, prolonged erections
- Alopecia
- Rhabdomyolysis
Pregnancy No adequate human studies; infants of amphetamine-dependent mothers risk prematurity, low birth weight, and withdrawal.
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 5 mg | tab | per unit | $0.26/ea | not offered |
| 7.5 mg | tab | per unit | $0.28/ea | not offered |
| 10 mg | tab | per unit | $0.23/ea | not offered |
| 12.5 mg | tab | per unit | $0.36/ea | not offered |
| 15 mg | tab | per unit | $0.24/ea | not offered |
| 20 mg | tab | per unit | $0.29/ea | not offered |
| 30 mg | tab | per unit | $0.30/ea | not offered |
Other forms: Mixed amphetamine salts XR (ADDERALL XR) · Mixed amphetamine salts (triple-bead) (MYDAYIS)
Generic entry1984
⚠ BOXED WARNING
- Abuse, misuse and addiction
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityMisuse, hypertension, hyperthermia, psychosis and potentially fatal sympathomimetic toxicity.
Serotonin and MAOI
Provisional washout figures
Elevating mechanismNone identified
Non-elevating actionNone recorded
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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