Mixed amphetamine salts XR

ADDERALL XR

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

BOXED WARNING High potential for abuse, misuse, and addiction; can lead to overdose and death.

FDA dosing	Population	Start	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

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

Concurrent MAOIs or use within 14 days (incl. linezolid, IV methylene blue) — risk of hypertensive crisis

Pregnancy May cause premature delivery and low birth weight; monitor neonates for withdrawal.

Lactation Breastfeeding not recommended.

⚠ BOXED WARNING

Direct muscarinic antagonism0 / 4

weak base