amphetamine and dextroamphetamine, Adderall, Adderall XR

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GENERIC NAME: amphetamine and dextroamphetamine

BRAND NAME: Adderall, Adderall XR

DRUG CLASS AND MECHANISM: Adderall contains amphetamine salts (amphetamine and dextroamphetamine) and is used for treating attention-deficit hyperactivity disorder (ADHD) and narcolepsy. Amphetamines stimulate the brain by increasing the level of neurotransmitters, dopamine and norepinephrine, in the brain. (Neurotransmitters are chemicals produced by nerves that are released and attach to other nearby nerves as a means of communication among nerves.) The exact mechanism of action in ADHD is unknown. Adderall XR is an extended release form of Adderall. Adderall was approved by the FDA in 1996.

GENERIC AVAILABLE: Yes (Adderall), No (Adderall XR)

PRESCRIPTION: Yes

PREPARATIONS: Adderall tablets: 5, 7.5, 10, 12.5, 15, 20, and 30 mg. Adderall XR capsules: 5, 10, 15, 20, 25, and 30 mg.

STORAGE: Tablets should be stored at room temperature, between 15 C and 30 C (59 F and 86 F).

PRESCRIBED FOR: Adderall is used for the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy. Adderall XR is only approved for treatment of ADHD.

DOSING: Adderall usually is taken once or twice a day. Doses should be separated by at least 4-6 hours. The recommended dose is 2.5 to 60 mg daily depending on the patient's age and the condition being treated. Adderall XR is taken once daily. The recommended dose is 5-40 mg daily administered in the morning. The entire contents of the Adderall XR capsules may be sprinkled into applesauce and consumed immediately. Amphetamines should be administered during waking hours and late evening doses should be avoided in order to avoid insomnia.

DRUG INTERACTIONS: Amphetamines should not be taken with monoamine oxidase (MAO) inhibitor drugs including phenelzine (Nardil), tranylcypromine (Parnate), and Zyvox; use of amphetamine within 14 days of using MAO inhibitor drugs should be avoided. Patients receiving antihypertensive medications may experience loss of blood pressure control with amphetamine. Antacids may increase absorption of amphetamine salts and increase their effectiveness and side effects.

PREGNANCY: Amphetamines should not be used during pregnancy. Infants who are born to mothers dependent on amphetamines exhibit symptoms of withdrawal and have an increased risk of low birth weight.

NURSING MOTHERS: Mothers taking amphetamines should refrain from nursing their infants because these drugs are excreted in human milk and can have undesirable effects on the child.

SIDE EFFECTS: Side effects of amphetamines include excessive stimulation of the nervous system leading to nervousness, restlessness, excitability, dizziness, headache, insomnia, fear, anxiety, tremor, and even hallucinations and convulsions (seizures). Blood pressure and heart rate may increase, and patients may experience palpitations of the heart. Sudden death, stroke, heart attack, depression, manic episodes, aggressive behavior or hostility, psychosis, growth suppression (long-term use), dependence, and withdrawal symptoms may also occur.

Priapism defined as painful and nonpainful penile erection lasting more than 4 hours, have been reported in pediatric and adult patients treated with stimulants. The erection usually resolves when the drug is stopped. Prompt medical attention is required in the event of suspected priapism.

Reference: FDA Prescribing Information


Last Editorial Review: 2/4/2014




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