Adderall Side Effects

Adderall Side Effects

If you have attention deficit hyperactivity disorder (ADHD), you may get relief from the prescription drug Adderall. It can improve focus, decrease restlessness, and help control impulsive behavior (including the hard-to-stop habit of interrupting people). But, like other medications, it comes with possible side effects.

Some Adderall side effects, like dry mouth, don’t need medical treatment. You should tell your doctor right away about others, such as pain when you pee.

Whether Adderall side effects are annoying or alarming to you, be sure you tell your doctor, who can help you find ways to feel better while the medication does its job.

Adderall is the trade name for a combination of two drugs: dextroamphetamine and amphetamine. If you take a generic version of Adderall, those two drug names will be on your medicine bottle.

The generic type costs less, but that’s about the only difference you’ll notice. Generic dextroamphetamine/amphetamine has the same risk of side effects as brand-name Adderall. It provides the same benefits, too.

Common Side Effects

Many common side effects will get better or go away as your body gets used to the medicine. They might include:

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• Anxiety
• Dry mouth
• Weakness
• Stomachache
• Weight loss
• Constipation
• Less interest in sex
• Unusual sense of well-being
• Difficulty keeping an erection
• Twitching

If you have any of these side effects, ask your doctor how long they are likely to last, as well as what to do if they don’t get better.

Rare Side Effects

Rarely, Adderall causes more serious side effects. Tell your doctor at once if you have any of these:

• A major increase in your blood pressure
• Serious anxiety
• Panic attack
• Big mood swings
• Hallucinations
• Paranoia
• Intense muscle pain or weakness
• An erection that hurts or lasts too long
• Changes of feeling or color in your fingertips or toes

Adderall and Your Heart

In the short term, Adderall can raise your blood pressure and heart rate, and cause you to breathe harder. If you take too much of it, you could put your heart and your health at risk.

To be on the safe side, doctors usually don’t prescribe Adderall to people with:

• Serious heart problems
• High blood pressure that is not controlled with medicine

But more research is needed. One large study found no link between ADHD medications — including stimulants like Adderall — and a higher risk of a heart attack or stroke.

Even without a perfect heart, you may still be able to take Adderall for ADHD. Expect to see a heart doctor (cardiologist) first. You’ll need to get your heart rate and blood pressure checked at follow-up doctor visits.

Tips to Manage Side Effects

You can take steps to reduce some side effects of Adderall. Ask your doctor what might work for you. Some things you can try:

Have good sleep habits. Many people with ADHD have insomnia, or trouble sleeping. Stimulant medicines like Adderall can add to the problem. To get better sleep, limit caffeine and screen time (phone, TV, or video games) close to bedtime.

Don’t take Adderall after 5 p.m. If you miss a dose, take it as soon as you remember — up to a point. The later you take this drug, the more likely it is to keep you awake at night. Try not to take any Adderall after 5 p.m. If you use an extended-release (XR) version, try not to take it after 2 p.m.

Limit or avoid alcohol. Alcohol affects the way your body processes Adderall. That could result in unusual side effects, including sleepiness.

Ask your doctor if you should switch antidepressants. A few antidepressants can increase Adderall’s side effects. These drugs include:

Reduce dry mouth. You can’t stop Adderall from causing dry mouth, but you can take steps to put moisture back in.

• Chew sugar-free gum or suck on sugar-free candies, which get saliva flowing.
• Avoid mouthwash that contains alcohol.
• Sip water throughout the day.
• Try over-the-counter saliva substitutes. (Your pharmacist can point you in the right direction.)
• Try a “dry mouth” mouthwash.
• Avoid antihistamines, which can contribute to dry mouth.
• Put a humidifier in your bedroom.

Show Sources

National Alliance on Mental Illness: “Amphetamine (Adderall).”

Mayo Clinic: “Dextroamphetamine And Amphetamine (Oral Route),” “Dry mouth treatment: Tips for controlling dry mouth.”

National Institute on Drug Abuse: “Prescription Stimulants.”

JAMA: “ADHD Medications and Risk of Serious Cardiovascular Events in Young and Middle-aged Adults.”

Pediatrics Child Health: “Adderall and cardiovascular risk: A therapeutic dilemma.”

FDA: “Generic Drugs: Questions & Answers.”

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD): “ADHD and Sleep Disorders.”

Adderall Side Effects

Common Adderall side effects may include loss of appetite, nausea and insomnia. Rare but severe side effects of Adderall can include emotional instability, psychiatric disorders and cardiovascular events. Adderall misuse can lead to seizures and death.

• By Michelle Llamas, BCPA
• Edited By Anastasia Climan, RDN, CD-N
• Medically Reviewed by Michael Swank, Ph.D.
• This page features 8 Cited Research Articles

Last Modified: December 6, 2022
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Common Side Effects of Adderall

Loss of appetite, stomachache, dizziness and nervousness are the most common side effects of immediate-release Adderall. Research indicates that the overall incidence of side effects is low and similar to that of other stimulants.

Common side effects of Adderall include:

• Diarrhea
• Dizziness
• Dry mouth
• Fever
• Headache
• Insomnia
• Loss of appetite
• Mood swings
• Nausea
• Stomachache

The U.S. Food and Drug Administration reports that factors such as age, body weight, hormonal cycles and pre-existing conditions can impact your risk of experiencing side effects.

Some Adderall side effects may clear up as the body adjusts to the medication. Side effects typically stop after Adderall treatment ends. If side effects persist, speak with your doctor.

In October 2022, FDA announced a shortage of immediate release amphetamine salts, the active ingredient in Adderall. The agency recommended talking to your medical provider about Adderall alternatives, including Adderall XR which uses extended-release amphetamine salts. The side effects of Adderall and Adderall XR are similar.

Adderall Side Effects in Children

The most common side effects in children are similar to those for adults. Your child’s doctor can typically manage most Adderall side effects with careful adjustments to the dosage and schedule.

As they age, many children also face increased expectations in school and a higher demand for concentration. Some clinicians have found tolerance increases until late adolescence.

For children with ADHD, taking stimulant medication as prescribed neither increases nor decreases the risk of addictive behaviors. Studies indicate that a substance abuse risk may be linked to ADHD itself, rather than its treatments.

When taken in doses and ways other than those prescribed, however, there may be an increased risk of addiction.

Side Effects of Adderall XR

Common side effects of Adderall XR, the extended-release version of the drug, include those reported for Adderall. Some additional symptoms have also been reported when taking Adderall XR.

Common Adderall XR side effects, in addition to those listed for immediate-release Adderall, include:

• Decreased appetite
• Dry mouth
• Insomnia

Your physician can monitor any side effects and may advise that you stop taking Adderall XR if they persist or worsen. Do not stop taking your prescribed medication without speaking to your doctor first.

Warnings and Serious Adderall Side Effects

Serious side effects have been reported, but are rare. Adverse reactions have included dizziness, lack of energy (asthenia), urinary tract infections, irregular heartbeat and elevated blood pressure. In children, rapid, exaggerated mood changes – sometimes called the “rebound effect” – vomiting and nervousness have been reported.

Rare Adderall XR side effects can range from mild, such as hives, to severe skin rashes including Stevens-Johnson Syndrome and toxic epidermal necrolysis. Skin picking (dermatillomania), hair loss, heart palpitations, depression, movement disorders (dyskinesia), tics and tremors have also been documented. Frequent, prolonged and painful erections, as well as impotence, have occurred.

Stimulants can carry risks for people with pre-existing mental health conditions and conditions such as cardiac disease. Before starting Adderall XR, your doctor will discuss your medical history and conduct a physical exam.

Adderall Overdose

When taken as prescribed, Adderall is generally considered safe. Taking it without a prescription or in doses that exceed what was recommended for you, however, can lead to overdose. Treating an overdose immediately is essential to increasing the chances of a full recovery.

Adderall overdose is associated with rhabdomyolysis, also called rhabdo. Muscle breaks down and cell contents are released into the blood. Dark red or brown urine can be a symptom of this potentially fatal condition.

Uncontrollable anxiety, panic or aggression with rapid breathing, an elevated heart rate and uncontrollable shaking can be signs of Adderall overdose. If you experience hallucinations, tremors, seizures or loss of consciousness, seek immediate medical attention.

Serious Cardiovascular Effects

Cardiovascular events such as strokes, heart attacks and sudden death have been reported with stimulants, including Adderall. Adderall can increase blood pressure and heart rate.

The risk of adverse side effects is higher for individuals with pre-existing heart issues, high blood pressure (hypertension) or a history of heart attack. Adults are at greater risk of cardiovascular events than children, and the risk increases with each passing decade of life.

If you develop chest pain or other symptoms, seek medical attention immediately.

Psychiatric Side Effects Linked to Adderall Use

Some researchers have linked Adderall with mental health conditions such as psychosis and schizophrenia. If you have a history of mental illness, you may be more likely to develop psychosis or even suicidal thoughts while taking Adderall.

When people who do not have ADHD take Adderall, they put themselves at risk for amphetamine-related psychiatric disorders.

While rare, longer-term use of Adderall or other stimulants has caused paranoid delusions. Mood and behavioral disturbances, such as anxiety, depression and uncontrollable crying, have also been reported.

Suppression of Growth in Children

Several studies have attempted to determine whether stimulants such as Adderall might suppress or stall a child’s growth. The results have not been conclusive.

The American Academy of Pediatrics has stated that Adderall does not appear to play a role in the eventual adult height of children. According to researchers, other factors, such as nutrition or maturity differences because of ADHD, may play a more significant role in height.

Adderall and Seizures

Some studies have suggested a connection between stimulants and seizures. Those with a history of seizures are suspected to be at particular risk.

Other recent studies, however, have found no evidence of increased risk of seizures with those taking ADHD medication according to prescribed directions. No increased risk was detected in those with a history of seizures or even in those with epilepsy.

Peripheral Vasculopathy and Raynaud’s Phenomenon

Raynaud’s phenomenon, an exaggerated response of the blood vessels to the cold or emotional stress, which occurs in the fingers and toes, is a rare but serious possible adverse effect of stimulants such as Adderall.

Peripheral vasculopathy, another disorder of the blood vessels in the arms and legs, is also reportedly possible with Adderall use.

Serotonin Syndrome

Adderall has a direct impact on the brain’s serotonin levels. Serotonin syndrome can happen when the brain cannot regulate the body’s functions because of an excess of serotonin.

Use of Adderall with other drugs, such as antidepressants or illegal drugs such as MDMA, can increase the risk of serotonin syndrome.

When properly following your doctor’s prescription, the change is typically not enough to cause a drastic leap in serotonin. Adderall use without a prescription or in excess of the recommended dose, however, may cause a spike that can be fatal if untreated.

Long-Term Effects of Adderall

Long-term issues associated with Adderall, especially in those who abuse prescription stimulants, include development of tolerance and dependence.

Other long-term side effects of Adderall can include:

• Aggression
• Changes in mood and behavior
• Dependency and addiction
• Erectile dysfunction and other sexual problems
• Gastrointestinal issues, such as constipation and abdominal pain
• Hallucinations
• Heart problems and stroke
• Irritability
• Lack of motivation
• Problems sleeping
• Weight loss

Stopping Adderall suddenly may lead to withdrawal. Withdrawal symptoms include vivid, unpleasant dreams, sleeping too much or too little, fatigue and brain fog.

Is Adderall Addictive?

Adderall is a controlled substance. Abuse of Adderall and other stimulant drugs is fairly common among students, professionals, athletes and people with eating disorders abusing it to cram for exams, tackle more work, boost energy and lose weight. People have also taken it to boost confidence and help with social anxiety disorder.

If you feel like you need Adderall to get out of bed in the morning and to cope with daily life, or have uncontrollable cravings for it, you may be addicted to the drug.

Signs of Adderall abuse can include:

• Abdominal pain
• Aggression
• Anxiety
• Decreased appetite
• Dilated pupils
• Excessive sweating
• Hostility
• Hyperactivity
• Increased blood pressure
• Increased heart rate
• Insomnia
• Loss of coordination
• Psychosis
• Quicker breathing
• Restlessness
• Skin flushing
• Suicidal or homicidal thoughts
• Tremors
• Vomiting

If you take Adderall for ADHD, avoid mixing it with other substances such as alcohol, illicit drugs or other prescription medications. Don’t take it without a prescription or more frequently than prescribed. Never crush, snort or inject it.

Talk to your doctor about taking an occasional break from Adderall, so your tolerance doesn’t get too high.

Adderall XR Capsules Side Effects Center

Adderall XR (amphetamine and dextroamphetamine salts) is a central nervous system (CNS) stimulant used for treating attention deficit hyperactivity disorder (ADHD) and narcolepsy.

What Are Side Effects of Adderall XR?

Side effects of Adderall XR include

• nervousness,
• restlessness,
• excitability,
• dizziness,
• headache,
• weakness,
• fear,
• anxiety,
• irritability,
• agitation,
• blurred vision,
• sleep problems (insomnia),
• dry mouth,
• unpleasant taste in mouth,
• diarrhea,
• constipation,
• stomach pain,
• nausea,
• vomiting,
• fever,
• hair loss,
• loss of appetite,
• weight loss,
• tremor,
• loss of interest in sex,
• impotence,
• difficulty having an orgasm,
• increased blood pressure,
• increased heart rate, and
• palpitations.

Adderall XR is habit forming and chronic use may lead to dependence.

Dosage for Adderall XR

Adderall XR is available as capsules in the following dosages: 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg

Dosage depends on the therapeutic needs and response of the patient.

What Drugs, Substances, or Supplements Interact with Adderall XR?

Adderall may interact with heart or blood pressure medications, diuretics (water pills), cold or allergy medicines (antihistamines), acetazolamide, chlorpromazine, ethosuximide, haloperidol, lithium, meperidine, methenamine, phenytoin , phenobarbital, reserpine, ammonium chloride, ascorbic acid (vitamin C), potassium phosphate, antacids, sodium bicarbonate (Alka-Seltzer), potassium citrate, sodium citrate and citric acid, sodium citrate and potassium, stomach acid reducers, or antidepressants. Tell your doctor all medications and supplements you use.

Additional Information

Our Adderall XR Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

SLIDESHOW

Adderall XR Capsules Consumer Information

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Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• signs of heart problems–chest pain, trouble breathing, feeling like you might pass out;
• signs of psychosis–hallucinations (seeing or hearing things that are not real), new behavior problems, aggression, hostility, paranoia;
• signs of circulation problems–numbness, pain, cold feeling, unexplained wounds, or skin color changes (pale, red, or blue appearance) in your fingers or toes;
• a seizure (convulsions);
• muscle twitches (tics); or
• changes in your vision.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Long-term use of stimulant medicine can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using this medicine.

Common side effects may include:

• stomach pain, nausea, loss of appetite;
• weight loss;
• mood changes, feeling nervous or irritable;
• fast heart rate;
• headache, dizziness;
• sleep problems (insomnia); or
• dry mouth.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

QUESTION

Adderall XR Capsules Professional Information

SIDE EFFECTS

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Clinical Trials Experience

The premarketing development program for ADDERALL XR included exposures in a total of 1315 participants in clinical trials (635 pediatric patients, 350 adolescent patients, 248 adult patients, and 82 healthy adult subjects). Of these, 635 patients (ages 6 to 12) were evaluated in two controlled clinical studies, one open-label clinical study, and two single-dose clinical pharmacology studies (N= 40). Safety data on all patients are included in the discussion that follows. Adverse reactions were assessed by collecting adverse reactions, results of physical examinations, vital signs, weights, laboratory analyses, and ECGs.

Adverse reactions during exposure were obtained primarily by general inquiry and recorded by clinical investigators using terminology of their own choosing. Consequently, it is not possible to provide a meaningful estimate of the proportion of individuals experiencing adverse reactions without first grouping similar types of reactions into a smaller number of standardized event categories. In the tables and listings that follow, COSTART terminology has been used to classify reported adverse reactions.

The stated frequencies of adverse reactions represent the proportion of individuals who experienced, at least once, a treatment-emergent adverse event of the type listed.

Adverse Reactions Leading To Discontinuation Of Treatment

In two placebo-controlled studies of up to 5 weeks duration among children with ADHD, 2.4% (10/425) of ADDERALL XR-treated patients discontinued due to adverse reactions (including 3 patients with loss of appetite, one of whom also reported insomnia) compared to 2.7% (7/259) receiving placebo.

The most frequent adverse reactions leading to discontinuation of ADDERALL XR in controlled and uncontrolled, multiple-dose clinical trials of children (N=595) were anorexia (loss of appetite) (2.9%), insomnia (1.5%), weight loss (1.2%), emotional lability (1%), and depression (0.7%). Over half of these patients were exposed to ADDERALL XR for 12 months or more.

In a separate placebo-controlled 4-week study in adolescents with ADHD, five patients (2.1%) discontinued treatment due to adverse events among ADDERALL XR-treated patients (N=233) compared to none who received placebo (N=54). The most frequent adverse event leading to discontinuation and considered to be drug-related (i.e. leading to discontinuation in at least 1% of ADDERALL XR-treated patients and at a rate at least twice that of placebo) was insomnia (1.3%, n=3).

In one placebo-controlled 4-week study among adults with ADHD with doses 20 mg to 60 mg, 23 patients (12.0%) discontinued treatment due to adverse events among ADDERALL XR-treated patients (N=191) compared to one patient (1.6%) who received placebo (N=64). The most frequent adverse events leading to discontinuation and considered to be drug-related (i.e. leading to discontinuation in at least 1% of ADDERALL XR-treated patients and at a rate at least twice that of placebo) were insomnia (5.2%, n=10), anxiety (2.1%, n=4), nervousness (1.6%, n=3), dry mouth (1.6%, n=3), anorexia (1.6%, n=3), tachycardia (1.6%, n=3), headache (1.6%, n=3), and asthenia (1.0%, n=2).

Adverse Reactions Occurring In Controlled Trials

Adverse reactions reported in a 3-week clinical trial of children and a 4-week clinical trial in adolescents and adults, respectively, treated with ADDERALL XR or placebo are presented in the tables below.

Table 1 : Adverse Reactions Reported by 2% or More of Children (6-12 Years Old) Receiving ADDERALL XR with Higher Incidence Than on Placebo in a 584-Patient Clinical Study

Body System	Preferred Term	ADDERALL XR (n=374)	Placebo (n=210)
General	Abdominal Pain	14%	10%
	(stomachache)	5%	2%
	Fever	4%	2%
	Infection	3%	2%
	Accidental Injury Asthenia (fatigue)	2%	0%
Digestive System	Loss of Appetite	22%	2%
	Vomiting	7%	4%
	Nausea	5%	3%
	Dyspepsia	2%	1%
Nervous System	Insomnia	17%	2%
	Emotional Lability	9%	2%
	Nervousness	6%	2%
	Dizziness	2%	0%
Metabolic/Nutritional	Weight Loss	4%	0%

Table 2 : Adverse Reactions Reported by 5% or More of Adolescents (13-17 Years Old) Weighing ≤ 75 kg/165 lbs Receiving ADDERALL XR with Higher Incidence Than Placebo in a 287 Patient Clinical Forced Weekly-Dose Titration Study*

Body System	Preferred Term	ADDERA LL XR (n=233)	Placebo (n=54)
General	Abdominal Pain (stomachache)	11%	2%
Digestive System	Loss of Appetite b	36%	2%
Nervous System	Insomnia b	12%	4%
	Nervousness	6%	6% a
Metabolic/Nutritional	Weight Loss b	9%	0%
*Included doses up to 40 mg a Appears the same due to rounding b Dose-related adverse reactions Note: The following reactions did not meet the criterion for inclusion in Table 2 but were reported by 2% to 4% of adolescent patients receiving ADDERALL XR with a higher incidence than patients receiving placebo in this study: accidental injury, asthenia (fatigue), dry mouth, dyspepsia, emotional lability, nausea, somnolence, and vomiting.

Table 3 : Adverse Reactions Reported by 5% or More of Adults Receiving ADDERALL XR with Higher Incidence Than on Placebo in a 255 Patient Clinical Forced Weekly-Dose Titration Study*

Body System	Preferred Term	ADDERALL XR (n=191)	Placebo (n=64)
General	Headache	26%	13%
	Asthenia	6%	5%
Digestive System	Dry Mouth	35%	5%
	Loss of Appetite	33%	3%
	Nausea	8%	3%
	Diarrhea	6%	0%
Nervous System	Insomnia	27%	13%
	Agitation	8%	5%
	Anxiety	8%	5%
	Dizziness	7%	0%
	Nervousness	13%	13% a
Cardiovascular System	Tachycardia	6%	3%
Metabolic/Nutritional	Weight Loss	10%	0%
Urogenital System	Urinary Tract Infection	5%	0%
*Included doses up to 60 mg. a Appears the same due to rounding Note: The following reactions did not meet the criterion for inclusion in Table 3 but were reported by 2% to 4% of adult patients receiving ADDERALL XR with a higher incidence than patients receiving placebo in this study: infection, photosensitivity reaction, constipation, tooth disorder (e.g., teeth clenching, tooth infection), emotional lability, libido decreased, somnolence, speech disorder (e.g., stuttering, excessive speech), palpitation, twitching, dyspnea, sweating, dysmenorrhea, and impotence.

Hypertension

[see WARNINGS AND PRECAUTIONS]

In a controlled 4-week outpatient clinical study of adolescents with ADHD, isolated systolic blood pressure elevations ≥15 mmHg were observed in 7/64 (11%) placebo-treated patients and 7/100 (7%) patients receiving ADDERALL XR 10 or 20 mg. Isolated elevations in diastolic blood pressure ≥ 8 mmHg were observed in 16/64 (25%) placebo-treated patients and 22/100 (22%) ADDERALL XR-treated patients. Similar results were observed at higher doses.

In a single-dose pharmacokinetic study in 23 adolescents with ADHD, isolated increases in systolic blood pressure (above the upper 95% CI for age, gender, and stature) were observed in 2/17 (12%) and 8/23 (35%), subjects administered 10 mg and 20 mg ADDERALL XR, respectively. Higher single doses were associated with a greater increase in systolic blood pressure. All increases were transient, appeared maximal at 2 to 4 hours post dose and not associated with symptoms.

Adverse Reactions Associated With The Use Of Amphetamine, ADDERALL XR, Or ADDERALL

The following adverse reactions have been identified during post-approval use of amphetamine, ADDERALL XR, or ADDERALL. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Cardiovascular

Palpitations. There have been isolated reports of cardiomyopathy associated with chronic amphetamine use.

Central Nervous System

Psychotic episodes at recommended doses, overstimulation, restlessness, irritability, euphoria, dyskinesia, dysphoria, depression, tremor, tics, aggression, anger, logorrhea, dermatillomania, paresthesia (including formication), and bruxism.

Eye Disorders

Vision blurred, mydriasis.

Gastrointestinal

Unpleasant taste, constipation, intestinal ischemia, and other gastrointestinal disturbances.

Allergic

Urticaria, rash, hypersensitivity reactions including angioedema and anaphylaxis. Serious skin rashes, including Stevens-Johnson Syndrome and toxic epidermal necrolysis have been reported.

Endocrine

Impotence, changes in libido, frequent or prolonged erections.

Skin

Vascular Disorders

Musculoskeletal And Connective Tissue Disorders

DRUG INTERACTIONS

Clinically Important Interactions With Amphetamines

Table 4: Drugs Having Clinically Important Interactions with Amphetamines

Monoamine Oxidase Inhibitors (MAOIs)
Clinical Impact	Concomitant use of MAOIs and CNS stimulants can cause hypertensive crisis. Potential outcomes include death, stroke, myocardial infarction, aortic dissection, ophthalmological complications, eclampsia, pulmonary edema, and renal failure.
Intervention	Do not administer ADDERALL XR concomitantly or within 14 days after discontinuing MAOI [see CONTRAINDICATIONS].
Examples	selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue
Serotonergic Drugs
Clinical Impact	The concomitant use of ADDERALL XR and serotonergic drugs increases the risk of serotonin syndrome.
Intervention	Initiate with lower doses and monitor patients for signs and symptoms of serotonin syndrome, particularly during ADDERALL XR initiation or dosage increase. If serotonin syndrome occurs, discontinue ADDERALL XR and the concomitant serotonergic drug(s) [see WARNINGS AND PRECAUTIONS].
Examples	selective serotonin reuptake inhibitors (SSRI), serotonin norepinephrine reuptake inhibitors (SNRI), triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, St. John’s Wort
CYP2D6 Inhibitors
Clinical Impact	The concomitant use of ADDERALL XR and CYP2D6 inhibitors may increase the exposure of ADDERALL XR compared to the use of the drug alone and increase the risk of serotonin syndrome.
Intervention	Initiate with lower doses and monitor patients for signs and symptoms of serotonin syndrome particularly during ADDERALL XR initiation and after a dosage increase. If serotonin syndrome occurs, discontinue ADDERALL XR and the CYP2D6 inhibitor [see WARNINGS AND PRECAUTIONS and OVERDOSAGE].
Examples	paroxetine and fluoxetine (also serotonergic drugs), quinidine, ritonavir
Alkalinizing Agents
Clinical Impact	Increase blood levels and potentiate the action of amphetamine.
Intervention	Co-administration of ADDERALL XR and gastrointestinal or urinary alkalinizing agents should be avoided.
Examples	Gastrointestinal alkalinizing agents (e.g., sodium bicarbonate). Urinary alkalinizing agents (e.g. acetazolamide, some thiazides).
Acidifying Agents
Clinical Impact	Lower blood levels and efficacy of amphetamines.
Intervention	Increase dose based on clinical response.
Examples	Gastrointestinal acidifying agents (e.g., guanethidine, reserpine, glutamic acid HCl, ascorbic acid). Urinary acidifying agents (e.g., ammonium chloride, sodium acid phosphate, methenamine salts).
Tricyclic Antidepressants
Clinical Impact	May enhance the activity of tricyclic or sympathomimetic agents causing striking and sustained increases in the concentration of d-amphetamine in the brain; cardiovascular effects can be potentiated.
Intervention	Monitor frequently and adjust or use alternative therapy based on clinical response.
Examples	desipramine, protriptyline
Proton Pump Inhibitors
Clinical Impact	Time to maximum concentration (Tmax) of amphetamine is decreased compared to when administered alone.
Intervention	Monitor patients for changes in clinical effect and adjust therapy based on clinical response.
Examples	Omeprazole

Drug Abuse And Dependence

Controlled Substance

ADDERALL XR contains amphetamine, a Schedule II controlled substance.

Abuse

ADDERALL XR is a CNS stimulant that contains amphetamine, which has a high potential for abuse. Abuse is characterized by impaired control of drug use, compulsive use despite harm, and craving.

Signs and symptoms of amphetamine abuse may include increased heart rate, respiratory rate, blood pressure, and/or sweating, dilated pupils, hyperactivity, restlessness, insomnia, decreased appetite, loss of coordination, tremors, flushed skin, vomiting, and/or abdominal pain. Anxiety, psychosis, hostility, aggression, suicidal or homicidal ideation have also been observed. Abusers of amphetamines may use other unapproved routes of administration which can result in overdose and death [see OVERDOSAGE].

To reduce the abuse of CNS stimulants, including ADDERALL XR, assess the risk of abuse prior to prescribing. After prescribing, keep careful prescription records, educate patients and their families about abuse and proper storage and disposal of CNS stimulants. Monitor for signs of abuse while on therapy and re-evaluate the need for ADDERALL XR use.

Dependence

Tolerance (a state of adaptation in which exposure to a specific dose of a drug results in a reduction of the drug’s desired and/or undesired effects over time, in such a way that a higher dose of the drug is required to produce the same effect that was once obtained at a lower dose) may occur during chronic therapy of CNS stimulants including ADDERALL XR.

Physical Dependence (which is manifested by a withdrawal syndrome produced by abrupt cessation, rapid dose reduction, or administration of an antagonist) may occur in patients treated with CNS stimulants including ADDERALL XR. Withdrawal symptoms after abrupt cessation of CNS stimulants include dysphoric mood; fatigue; vivid, unpleasant dreams; insomnia or hypersomnia; increased appetite; and psychomotor retardation or agitation.

© Adderall XR Capsules Patient Information is supplied by Cerner Multum, Inc. and Adderall XR Capsules Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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Mydayis Drug Imprint

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capsule, blue, imprinted with M Amphet Salts, 5 mg

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capsule, orange/white, imprinted with ADDERALL XR, 25 mg

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Adderall 10 mg

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Adderall 20 mg

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Adderall 5 mg

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Adderall XR 10 mg

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Adderall XR 15 mg

capsule, blue/white, imprinted with ADDERALL XR, 15 mg

Adderall XR 20 mg

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Adderall XR 25 mg

capsule, orange/white, imprinted with ADDERALL XR, 25 mg

Adderall XR 30 mg

capsule, brown/orange, imprinted with ADDERALL XR, 30 mg

Adderall XR 5 mg

capsule, blue, imprinted with ADDERALL XR, 5 mg

Amphetamine-Dextroamphetamine 003784544

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Amphetamine-Dextroamphetamine 10 mg 003784543

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Amphetamine-Dextroamphetamine 7.5 mg 003784542

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