Amphetamine-Dextroamphetamine
Amphetamine-dextroamphetamine is a central nervous system stimulant used to treat ADHD and narcolepsy. It increases dopamine and norepinephrine levels in the brain.
About Amphetamine-Dextroamphetamine
Amphetamine-Dextroamphetamine is a central nervous system (cns) stimulant — mixed amphetamine salts also sold under brand names including Adderall and Adderall XR. It is primarily used to amphetamine dextroamphetamine is prescribed to treat: • Attention deficit/hyperactivity disorder (ADHD) in children (3+) and adults • Narcolepsy It helps improve attention, focus, and behavior control while reducing hyperactivity and impulsiveness. Amphetamine-Dextroamphetamine is available in immediate-release oral tablet (5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, 30 mg), extended-release oral capsule (5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg), oral disintegrating tablet (5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg), and oral solution (1.25 mg/ml) form. Healthcare providers commonly prescribe Amphetamine-Dextroamphetamine for conditions including Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder, Cardiomyopathy, and Coronary Artery Disease (CAD).
Amphetamine-Dextroamphetamine at a Glance
- Brand names
- Adderall, Adderall XR
- Drug class
- Central Nervous System (CNS) Stimulant — Mixed Amphetamine Salts
- DEA schedule
- Schedule Schedule II (controlled substance)
- Pregnancy category
- FDA Category Category C — Animal reproduction studies have shown adverse effects, and there are no adequate well-controlled studies in pregnant women. Use during pregnancy is associated with risk of premature birth, low birthweight, and neonatal withdrawal symptoms. Use only if the potential benefit clearly justifies the potential risk to the fetus.
- Available forms
- Immediate-release oral tablet (5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, 30 mg), Extended-release oral capsule (5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg), Oral disintegrating tablet (5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg), Oral solution (1.25 mg/mL)
- Therapeutic categories
- Psychiatry, ADHD, CNS Stimulants, Controlled Substances
- Conditions treated
- 12 related conditions on this site
What Amphetamine-Dextroamphetamine Is Used For
Amphetamine-dextroamphetamine is prescribed to treat:
• Attention-deficit/hyperactivity disorder (ADHD) in children (3+) and adults • Narcolepsy
It helps improve attention, focus, and behavior control while reducing hyperactivity and impulsiveness.
Dosage Quick Reference
These are general dosage guidelines for Amphetamine-Dextroamphetamine. Your doctor will determine the appropriate dose for your specific situation.
| Condition | Starting Dose | Maintenance Dose |
|---|---|---|
| ADHD (adults, immediate-release) | 5 mg once or twice daily | Increase by 5 mg weekly; typical 5–40 mg/day in divided doses |
| ADHD (children 6–12, immediate-release) | 5 mg once or twice daily | Increase by 5 mg weekly; max 40 mg/day |
| ADHD (extended-release, adults and children >= 6) | 10 mg once daily in the morning | Increase by 5–10 mg weekly; typical 20–30 mg/day, max 30 mg (children) or 40 mg (adults) |
| Narcolepsy (adults) | 10 mg daily in divided doses | Increase by 10 mg weekly; typical 5–60 mg/day in divided doses |
Side Effects
Common side effects may include:
• Loss of appetite and weight loss • Dry mouth • Insomnia • Headache • Stomach upset • Nervousness • Dizziness • Increased heart rate and blood pressure
Serious side effects (seek immediate medical attention):
• Chest pain • Shortness of breath • Fainting • Seizures.com/what-is-epilepsy/seizure-types) • Hallucinations or psychosis • Prolonged erection (priapism) • Severe allergic reactions • Circulation problems • Serotonin syndrome
See also: Drug Interactions ↓
Drug Interactions
Amphetamine-dextroamphetamine increases catecholamine activity and has multiple clinically significant interactions.
- Monoamine oxidase inhibitors (MAOIs — e.g., phenelzine, tranylcypromine, selegiline, linezolid): Concurrent use can precipitate hypertensive crisis. Do not administer amphetamines during or within 14 days of MAOI therapy.
- Serotonergic agents (SSRIs, SNRIs, triptans, tramadol, fentanyl): Increased risk of serotonin syndrome, characterized by agitation, hyperthermia, tachycardia, clonus, and altered mental status. Monitor closely and discontinue if suspected.
- Acidifying agents (ascorbic acid, fruit juices, ammonium chloride): Decrease amphetamine absorption and accelerate urinary excretion, reducing efficacy. Avoid co-administration.
- Alkalinizing agents (sodium bicarbonate, antacids, acetazolamide): Increase amphetamine absorption and reduce urinary excretion, raising plasma levels and risk of toxicity. Monitor for excess stimulant effects.
- Sympathomimetics and decongestants (pseudoephedrine, phenylephrine): Additive cardiovascular and CNS stimulation, increasing the risk of hypertension, tachycardia, and arrhythmia. Avoid concurrent use.
- Tricyclic antidepressants (e.g., amitriptyline, nortriptyline): May enhance amphetamine effects, leading to sustained increases in blood pressure and risk of arrhythmias. Monitor cardiovascular status.
Key Considerations
Controlled substance
Amphetamine-Dextroamphetamine is a Schedule Schedule II controlled substance under federal law. Prescriptions are regulated, refills may be restricted, and the medication has recognized potential for misuse or dependence. Use exactly as prescribed.
Known drug interactions
Amphetamine-Dextroamphetamine has documented interactions with other medications, supplements, and certain foods. Review the Drug Interactions section below and tell your healthcare provider about every medication you take, including over-the-counter products. Jump to section →
Multiple forms available
Amphetamine-Dextroamphetamine comes in more than one form (Immediate-release oral tablet (5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, 30 mg), Extended-release oral capsule (5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg), Oral disintegrating tablet (5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg), Oral solution (1.25 mg/mL)). The right form for you depends on your condition, ease of use, and your provider's recommendation.
Additional Information
What is Amphetamine-Dextroamphetamine?
Amphetamine-dextroamphetamine (commonly known as Adderall) is a Schedule II controlled substance containing a combination of amphetamine salts. It's one of the most prescribed medications for ADHD.
How Does It Work?
This medication affects brain neurotransmitters:
- Increases dopamine and norepinephrine release
- Blocks reuptake of these neurotransmitters
- Enhances focus and attention
- Reduces impulsivity and hyperactivity
- Effects begin within 30-60 minutes
Common Uses
- ADHD: First-line treatment for children (3+) and adults
- Narcolepsy: Improves wakefulness and reduces sleep attacks
Dosage Forms
Immediate-Release (IR) - Adderall:
- Lasts 4-6 hours
- Dosed 1-3 times daily
- Tablets: 5, 7.5, 10, 12.5, 15, 20, 30 mg
Extended-Release (XR) - Adderall XR:
- Lasts 10-12 hours
- Once-daily dosing
- Capsules: 5, 10, 15, 20, 25, 30 mg
- Can open capsule and sprinkle on food
Dosage and Administration
Children (3-5 years):
- Start: 2.5 mg daily
- Increase by 2.5 mg weekly
- Maximum: Based on response
Children (6+ years) and Adults:
- Start: 5 mg once or twice daily (IR)
- Increase by 5 mg weekly
- Typical: 20-30 mg/day
- Maximum: 40 mg/day (children), 60 mg/day (adults)
Administration Tips:
- Take in morning (avoid late doses - insomnia)
- Can take with or without food
- XR: Swallow whole or sprinkle contents on applesauce
- Avoid vitamin C around dose time (reduces absorption)
Important Safety Information
Black Box Warning
⚠️ ABUSE AND DEPENDENCE:
- High potential for abuse and addiction
- Schedule II controlled substance
- Chronic use can lead to physical and psychological dependence
- Misuse can cause sudden death and serious cardiovascular problems
- Assess abuse risk before prescribing
- Monitor for signs of abuse or diversion
Cardiovascular Risks
Sudden Death and Serious Events:
- Reported in children/adolescents with heart defects
- Reported in adults with cardiomyopathy
- Screen for cardiac disease before starting
- Obtain detailed cardiac history
- Consider ECG in high-risk patients
Monitor:
- Blood pressure and heart rate regularly
- Can increase BP and heart rate
- May need to reduce dose or discontinue
Who Should Not Take This Medication?
- Advanced arteriosclerosis
- Symptomatic cardiovascular disease
- Moderate to severe hypertension
- Hyperthyroidism
- Glaucoma
- Agitated states
- History of drug abuse
- During or within 14 days of MAO inhibitor
Psychiatric Side Effects
Can cause or unmask:
- Psychotic symptoms (hallucinations, delusions)
- Mania in bipolar patients
- Aggression or hostility
- Depression
- Suicidal ideation
Before starting:
- Screen for bipolar disorder, depression, psychosis
- Obtain family psychiatric history
- Monitor for psychiatric symptoms
Growth Suppression
In children:
- May slow growth rate and weight gain
- Monitor height and weight regularly (plot on growth charts)
- May need treatment interruptions
- Most children eventually reach expected adult height
Seizures
- May lower seizure threshold
- Use cautiously in patients with seizure history
- Discontinue if seizures occur
Peripheral Vasculopathy
- Can cause Raynaud's phenomenon
- Fingers/toes may become painful, numb, or change color
- More common in cold weather
- Report symptoms immediately
Serotonin Syndrome Risk
When combined with:
- SSRIs, SNRIs
- MAO inhibitors
- Triptans
- Other serotonergic drugs
Symptoms:
- Agitation, hallucinations
- Fast heart rate
- Fever, sweating
- Muscle rigidity
- Nausea, vomiting
Drug Interactions
Contraindicated:
- MAO inhibitors (wait 14 days after stopping MAO inhibitor)
Significant Interactions:
- Antacids/alkalinizing agents (increase absorption)
- Acidifying agents/vitamin C (decrease absorption)
- Antihypertensives (reduced effectiveness)
- TCAs (increased cardiovascular effects)
- Proton pump inhibitors (may reduce effect)
- Anticonvulsants (monitor seizure control)
- SSRIs/SNRIs (serotonin syndrome risk)
Avoid:
- Fruit juices high in vitamin C around dose time
- St. John's Wort
Monitoring
Regular monitoring required:
- Height and weight (children/adolescents)
- Blood pressure and heart rate (each visit)
- Cardiovascular symptoms
- Psychiatric symptoms
- Sleep patterns
- Appetite and nutrition
- Signs of abuse or misuse
- Academic/occupational performance
Tolerance and Dependence
Long-term use:
- Tolerance can develop (higher doses needed for same effect)
- Physical and psychological dependence possible
- Withdrawal symptoms upon discontinuation:
- Extreme fatigue
- Depression
- Increased appetite
- Sleep disturbances
- Taper gradually if discontinuing
Abuse Potential
High risk of misuse:
- Sought for euphoria, weight loss, or performance enhancement
- Can be crushed and snorted
- Keep medication secure
- Monitor pill counts
- Watch for signs of abuse:
- Running out early
- Requesting early refills
- Doctor shopping
- Mood swings
- Weight loss
Supply Chain Issues
Frequent shortages:
- Due to DEA manufacturing quotas
- May need to try multiple pharmacies
- Plan refills in advance
- Consider alternative formulations if needed
Managing Side Effects
Loss of appetite:
- Take after meals
- High-calorie/protein snacks when appetite returns
- Monitor weight regularly
- Nutritionist consultation if significant weight loss
Insomnia:
- Take early in day
- Avoid afternoon/evening doses
- Good sleep hygiene
- May need dose reduction or sleep aid
Anxiety/irritability:
- May need dose reduction
- Ensure adequate sleep and nutrition
- Consider switching to XR formulation
- Rule out anxiety disorder
Drug Holidays
Considerations:
- Some patients take breaks on weekends/holidays
- Pros: Reduces side effects, allows appetite recovery
- Cons: Symptom return, impact on daily functioning
- Discuss with doctor - individualized decision
Special Populations
Children:
- Approved for age 3+
- Lower doses for younger children
- Monitor growth carefully
- Regular follow-up essential
Adolescents:
- Higher abuse/diversion risk
- Address misuse concerns
- Long-acting formulations may improve compliance
- Driving concerns when starting treatment
Adults:
- Growing population of adults with ADHD
- May prefer long-acting for work
- Screen for substance abuse history
- Cardiovascular screening important
Pregnancy:
- Category C
- Limited human data
- Risk of premature birth and low birth weight
- Use only if benefit outweighs risk
- Not recommended during breastfeeding
Elderly:
- Higher cardiovascular risk
- Start with lower doses
- Monitor carefully for side effects
Non-Stimulant Alternatives
If stimulants not appropriate:
- Atomoxetine (Strattera)
- Guanfacine (Intuniv)
- Clonidine (Kapvay)
- Bupropion (off-label)
When to Contact Your Doctor
- Chest pain or palpitations
- Fainting or severe dizziness
- Shortness of breath
- Seizures
- Hallucinations or psychosis
- Severe mood changes or depression
- Thoughts of self-harm
- Prolonged erection
- Painful fingers or toes
- Tics developing
- Significant weight loss
- Signs of abuse or addiction
Storage and Disposal
- Store at room temperature
- Keep in secure, locked location
- Count pills periodically
- Don't share with others
- Dispose through drug take-back programs
- Never flush (environmental concerns)
Legal Considerations
- Schedule II controlled substance
- Requires new prescription each month (no refills)
- Pharmacies may require ID to pick up
- Traveling with medication: keep in original bottle
- Possession without prescription is illegal
Frequently Asked Questions
Medical Disclaimer: This information is for educational purposes only and should not be considered medical advice. Always consult with your healthcare provider before starting, stopping, or changing any medication. Your doctor can provide personalized recommendations based on your specific health condition and medical history.