Adderall (Dextroamphetamine and Amphetamine) - Oral

Warning:

The Food and Drug Administration (FDA) has issued a boxed warning for Adderall. Boxed warnings are the agency’s strongest warnings for serious and potentially life-threatening risks.

The boxed warning:

Adderall has a boxed warning from the FDA because of its high potential for abuse. Long-term use of this medication could cause abuse, misuse, and dependence. This may lead people to attempt to obtain Adderall illegally or use it for nonmedical purposes. Misuse of Adderall may cause serious cardiovascular (heart) problems, including sudden death.

What Is Adderall?

Adderall (dextroamphetamine and amphetamine) is an orally administered prescription drug used to treat attention deficit hyperactivity disorder (ADHD) in people 3 and older and narcolepsy in people 6 and older.

Adderall contains a mixture of two active ingredients: dextroamphetamine and amphetamine. These ingredients belong to a class of drugs called stimulants. Stimulants increase the activity of neurotransmitters (chemical messengers in the brain) called norepinephrine and dopamine.

This increased neurotransmitter activity is thought to result in improved attention and focus. In people with ADHD, stimulants can provide a calming effect. In narcolepsy (a disorder that causes excessive daytime sleepiness), stimulants help people stay awake and alert.

Administratively, Adderall comes as an immediate-release (IR) oral tablet. Comparatively, Adderall XR (a similar variation that shares the two primary ingredients, dextroamphetamine and amphetamine) comes as an extended-release (ER) capsule.

IR tablets allow a drug's ingredients to be rapidly absorbed into the bloodstream. In comparison, ER capsules provide a predesignated amount of medication that is designed to absorb more slowly into the bloodstream; they are typically taken once or twice per day.

The Drug Enforcement Administration (DEA) classifies Adderall and Adderall XR as Schedule II controlled substances. Schedule II drugs carry a high risk of misuse, abuse, and severe psychological or physical dependence.

Because of these serious risks, healthcare providers and individual consumers of the drug should reassess the risks and benefits of this treatment periodically.

This article highlights both Adderall as an IR tablet and Adderall XR as an ER capsule.

Drug Facts

Generic Name: Dextroamphetamine and amphetamine

Brand Name(s): Adderall, Adderall XR

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Central nervous system (CNS) stimulant 

Available Generically: Yes

Controlled Substance: Schedule II

Active Ingredients: Dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate

Dosage Form(s): IR tablet (Adderall), ER capsule (Adderall XR)

What Is Adderall Used For?

The Food and Drug Administration (FDA) approved Adderall to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Specifically, Adderall IR tablets are FDA-approved to treat:

  • ADHD in adults and children ages 3 and older
  • Narcolepsy in adults and children ages 6 and older

Adderall XR is FDA-approved to treat ADHD in adults and children 6 and older.

For ADHD, evidence suggests that Adderall should be used as part of a comprehensive treatment approach that includes cognitive behavioral therapy (CBT), education, and other supportive measures.

How to Take Adderall

Adderall is taken by mouth, with or without food. Adderall IR tablets are typically prescribed two to three times a day, with the first dose upon waking and the following doses four to six hours apart. Avoid taking the last dose four to six hours before bedtime, as it could cause insomnia.

In comparison, Adderall XR capsules should be taken only in the morning. You can take them with or without food.

Storage

Store Adderall or Adderall XR at room temperature. Keep the drug in a child-resistant container, out of reach of children and pets. Do not store it in a bathroom.

Additionally, this medication has a very high abuse potential, so it is best to keep your Adderall in a secured location where others cannot access it.

Before traveling with Adderall, check in advance for restrictions on it where you are going. You may need to bring specific documentation with you, as this drug is considered illegal in some countries.

Off-Label Uses

Adderall has been prescribed off-label for several uses. 

In off-label prescribing, a healthcare provider may prescribe a drug for a purpose outside of its FDA-approved uses if they determine the potential benefits outweigh the risks for a person.

In some cases, healthcare providers may prescribe Adderall or Adderall XR off-label for the following uses. In other cases, people may be misusing the drug for these purposes.

While off-label prescribing is at the discretion of the provider, it is important to carefully consider the drug’s potential for dependence, drug addiction, and possible severe side effects.

How Long Does Adderall Take to Work?

You should notice a difference in your ADHD or narcolepsy symptoms within one to two hours after taking a dose of Adderall or Adderall XR. If you do not notice an improvement, talk to your healthcare provider. They may adjust your dosage or treatment plan.

What Are the Side Effects of Adderall?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Commonly shared side effects associated with the use of Adderall and Adderall XR may include:

Severe Side Effects

The FDA has issued a boxed warning for Adderall. Boxed warnings are the agency’s strongest warnings for serious and potentially life-threatening risks.

The boxed warning:

Adderall has a boxed warning from the FDA because of its high potential for abuse. Long-term use of this medication could cause abuse, misuse, and dependence. This may lead people to attempt to obtain Adderall illegally or use it for nonmedical purposes.

Misuse of Adderall may cause serious cardiovascular problems, including sudden death.

The list below includes severe side effects reported with the use of Adderall or Adderall XR. It is very important to let your provider know immediately if you experience any of these.

If you feel the symptoms are life-threatening, call 911, as it might be a medical emergency.

Rarely, severe side effects and their symptoms may include:

  • Increased blood pressure or tachycardia (rapid heart rate)
  • Rhabdomyolysis: Extreme muscle pain, dehydration, confusion
  • Bowel ischemia: Abdominal pain, urgent bowel movements, blood in stool
  • Heart attack: Chest pain that travels from the left arm to the neck, shortness of breath, dizziness
  • Severe allergic reaction: Rash, hives, tongue or facial swelling, blistering or peeling skin, wheezing

Long-Term Side Effects

Long-term use of Adderall and Adderall XR increases the risk of drug dependence, misuse, and abuse.

Taking too much of this medication or taking it for long periods can result in serious heart problems, such as a heart attack, which can be fatal. 

This medication is meant for short-term use. When the drug was in clinical trials, it was not studied for long-term use.

You and your healthcare provider should often talk about how your Adderall treatment is helping your symptoms.

It is best to discuss whether it is still helpful or if it is causing side effects. You and your healthcare provider will weigh the potential risks against the benefits of long-term use.

Some evidence suggests that Adderall could also have a negative impact on growth and development in children with ADHD.

If your child takes Adderall, their healthcare provider will monitor their growth and development closely throughout treatment.

Report Side Effects

Adderall may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program online or by phone (800-332-1088).

Dosage: How Much Adderall Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For attention deficit hyperactivity disorder (ADHD):
    • For oral dosage form (Adderall XR® extended-release capsules):
      • Adults—20 milligrams (mg) once a day in the morning. Your doctor may adjust your dose as needed.
      • Children 13 to 17 years of age—At first, 10 mg once a day in the morning. Your doctor may adjust your dose as needed.
      • Children 6 to 12 years of age—At first, 10 mg once a day in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 30 mg per day.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.
    • For oral dosage form (Mydayis® extended-release capsules):
      • Adults—At first, 12.5 milligrams (mg) once a day in the morning right after you wake up. Your doctor may adjust your dose as needed. However, the dose is usually not more than 50 mg per day.
      • Children 13 to 17 years of age—At first, 12.5 mg once a day in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 25 mg per day.
      • Children younger than 13 years of age—Use and dose must be determined by your doctor.
    • For oral dosage form (Adderall® tablets):
      • Adults and children 6 years of age and older—At first, 5 milligrams (mg) given 1 or 2 times a day. Your doctor may adjust your dose as needed.
      • Children 3 to 5 years of age—At first, 2.5 mg once a day. Your doctor may adjust your dose as needed.
      • Children younger than 3 years of age—Use is not recommended.
  • For narcolepsy:
    • For oral dosage form (Adderall® tablets):
      • Adults and children 12 years of age and older—At first, 10 milligrams (mg) per day, divided and given into 2 doses. Your doctor may adjust your dose as needed.
      • Children 6 to 12 years of age—At first, 5 mg per day. Your doctor may adjust your dose as needed.
      • Children younger than 6 years of age—Use and dose must be determined by your doctor.

Modifications

Users should be aware of the following before beginning Adderall or Adderall XR:

Adaptive consumption: Adderall IR tablets may be cut in half, if necessary. The tablet is scored to make it easy to split.

If you have trouble swallowing pills, you may open an Adderall XR capsule and sprinkle the contents on applesauce, then swallow the mixture without chewing.

Older adults: You may need to use caution when taking Adderall or Adderall XR if you are 65 years or older, especially if you have other medical conditions. There is a lack of contemporary studies on Adderall's impact on older populations regarding efficacy and safety.

People with kidney or liver problems: People with kidney or liver problems should consult their healthcare provider, as there are no clinical trials that studied Adderall in people with kidney or liver conditions.

Pregnant people: Amphetamines should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. People who are pregnant should consult their healthcare provider for medical advice.

Those nursing: Amphetamines are present in human milk. Those taking amphetamines should be advised to refrain from nursing.

Missed Dose

If a dose is missed, take the medication at the next scheduled dose. Do not double up the dose or take your next dose early to make up for a missed dose.

Taking Adderall or Adderall XR too late in the day can result in trouble sleeping.

Overdose: What Happens If I Take Too Much Adderall?

Taking too much Adderall or Adderall XR may cause: 

What Happens If I Overdose on Adderall?

If you think you or someone else may have overdosed on Adderall, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Adderall, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your or your child's progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for any unwanted effects.

Do not take amphetamine and dextroamphetamine combination with a monoamine oxidase (MAO) inhibitor (eg, isocarboxazid [Marplan®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]). Do not start taking this medicine during the 2 weeks after you stop an MAO inhibitor. If you take them together or do not wait 2 weeks, you may develop confusion, agitation, headaches, restlessness, stomach or bowel symptoms, a sudden high body temperature, an extremely high blood pressure, or severe convulsions.

This medicine may cause serious heart or blood vessel problems. This may be more likely in patients who have a family history of heart disease. Check with your doctor right away if you or your child have chest pain, trouble breathing, fainting, or a fast, irregular heartbeat while using this medicine.

You or your child will also need to have your blood pressure and heart rate measured before starting this medicine and while you are using it. If you notice any change in your blood pressure, call your doctor right away. If you have questions about this, talk to your doctor.

Tell your doctor right away if you or your family notice any unusual changes in behavior, such as an increase in aggression, hostility, agitation, irritability, or suicidal thinking or behaviors. Also tell your doctor if you or your child have hallucinations or any unusual thoughts, especially if they are new or getting worse quickly.

This medicine may cause some people to feel a false sense of well-being or to become dizzy, lightheaded, or less alert than they are normally. It may also cause blurred vision or other vision problems. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

If you have been using this medicine for a long time and you think you may have become mentally or physically dependent on it, check with your doctor right away. Some signs of dependence may be:

  • A strong desire or need to continue using the medicine.
  • A need to increase the dose to receive the same effects.
  • Withdrawal effects after stopping the medicine such as mental depression, nausea or vomiting, stomach cramps or pain, trembling, or unusual tiredness or weakness.

This medicine may cause slow growth. If your child is using this medicine, the doctor will need to keep track of your child's height and weight.

This medicine may cause Raynaud phenomenon, which is a problem with blood circulation in the fingers or toes. Tell your doctor if you have tingling or pain, a cold feeling, paleness, or skin color changes in the fingers or toes, especially when exposed to cold temperatures. Call your doctor right away if you have unexplained sores or ulcers on your fingers or toes.

Before you have any medical tests, tell the medical doctor in charge that you are using this medicine. The results of some tests may be affected by this medicine.

This medicine may increase your risk of having seizures. This is more likely to occur in patients with a history of seizures or heart rhythm problems. Check with your doctor right away if this happens.

Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition, called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter (OTC)) medicines, herbal supplements (eg, St. John's wort), and especially those for appetite control, asthma, colds, cough, hay fever, allergies, or sinus problems.

What Are Reasons I Shouldn’t Take Adderall?

This medication is not safe for everyone. Your healthcare provider may not prescribe Adderall or Adderall XR if you have the following conditions or factors:

What Other Medications May Interact With Adderall?

Adderall and Adderall XR can interact with several other medications. The following list includes some of the most important interactions to know about but does not include all possible interactions.

It is very important to tell your provider and pharmacist about everything you take, including prescription drugs, over-the-counter medications, vitamins, dietary supplements, and herbal products.

Monoamine oxidase inhibitors (MAOIs) should not be taken with Adderall or Adderall XR or within 14 days. Doing so could result in sudden, extremely high blood pressure, known as a hypertensive crisis. Examples of MAOIs are Marplan (isocarboxazid), Nardil (phenelzine), Zyvox (linezolid), and Emsam (selegiline).

Also, the following drugs can raise the risk of side effects if taken with Adderall or Adderall XR:

Additionally, taking certain drugs together could lower the effectiveness of Adderall and Adderall XR. Examples include:

What Medications Are Similar?

Several medications are available that are similar to Adderall and Adderall XR. Examples of other stimulants used for ADHD include:

Examples of non-stimulant drugs that may be considered alternatives to Adderall for ADHD include:

Examples of other medications used to treat narcolepsy include:

Talk to your healthcare provider for more information on whether an alternative to Adderall is right for you.

Frequently Asked Questions

  • Does Adderall cause weight loss?

    It is possible that some people experience weight loss as a side effect of taking Adderall or Adderall XR. If this concerns you, talk to your healthcare provider about ways to maintain a healthy weight while taking this medication.

  • Will I need to take Adderall long term for ADHD?

    ADHD is often diagnosed in childhood. While some people outgrow the condition, others experience ADHD symptoms into adolescence and adulthood. Long-term use of Adderall carries risks for dependence and misuse, so this should be carefully evaluated by you and your healthcare provider.

  • How does Adderall work for ADHD?

    Adderall is a stimulant. It activates certain chemical messengers in your brain. This effect is thought to improve focus and attention in people with ADHD.

How Can I Stay Healthy While Taking Adderall?

While taking Adderall or Adderall XR, it is important for you and your healthcare provider to periodically reevaluate the benefits and risks of the medication.

Keep in mind that long-term use increases the risk of serious problems, such as drug dependence, misuse, and serious heart problems.

Besides taking ADHD or narcolepsy medication, the following tips may help you better manage the stresses of living with a health condition:

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Patricia Weiser, PharmD
Patricia Weiser, PharmD, is a licensed pharmacist and freelance medical writer. She has more than 14 years of professional experience.