ADDERALL XR Dosage & Rx Info | Uses, Side Effects

Adderall Xr Generic Name & Formulations

Legal Class

CII

General Description

Mixed salts of a single-entity amphetamine product (each cap contains equal parts dextroamphetamine saccharate, dextroamphetamine sulfate, amphetamine aspartate monohydrate, amphetamine sulfate); 5mg, 10mg, 15mg, 20mg, 25mg, 30mg; ext-rel caps.

Pharmacological Class

CNS stimulant.

How Supplied

Caps—100; Tabs—contact supplier

Manufacturer

Takeda Pharmaceutical Company

Mechanism of Action

Amphetamines are non-catecholamine sympathomimetic amines with central nervous system (CNS) stimulant activity. The mode of therapeutic action in ADHD is not known.

Adderall Xr Indications

Indications

Attention deficit hyperactivity disorder.

Adderall Xr Dosage and Administration

Adult

Swallow whole or may sprinkle contents of caps on applesauce; do not chew beads. Avoid afternoon doses; give upon awakening. >17yrs: 20mg once daily in the AM. Severe renal impairment (GFR 15–<30mL/min/1.73m²): 15mg once daily in the AM. ESRD (GFR <15mL/min/1.73m²): not recommended. Switching from Adderall immediate-release: give total daily dose of immediate-release once daily in the AM.

Children

Swallow whole or may sprinkle contents of caps on applesauce; do not chew beads. <6yrs: not studied. Avoid afternoon doses; give upon awakening. 6–12yrs: initially 10mg once daily in the AM, may increase by 5mg or 10mg per day at weekly intervals; max 30mg/day; with severe renal impairment: max 20mg/day. 13–17yrs: initially 10mg once daily in the AM; may increase to 20mg/day after 1 week. Severe renal impairment (GFR 15–<30mL/min/1.73m²): 5mg once daily in the AM. ESRD (GFR <15mL/min/1.73m²): not recommended. Switching from Adderall immediate-release: give total daily dose of immediate-release once daily in the AM.

Adderall Xr Contraindications

Contraindications

During or within 14 days of MAOIs.

Adderall Xr Boxed Warnings

Boxed Warning

Abuse, misuse, and addiction.

Adderall Xr Warnings/Precautions

Warnings/Precautions

High potential for abuse, misuse, and addiction; assess patient’s risk before prescribing. Assess for presence of cardiac disease before initiating (eg, family history, physical exam). Avoid in known structural cardiac abnormalities, cardiomyopathy, serious arrhythmias, coronary artery disease, or other cardiac disease. Pre-existing psychotic disorder. Bipolar disorder. Screen for risk factors in developing manic episode prior to initiation. Consider discontinuing if new psychotic/manic symptoms occur. Monitor for seizures, serotonin syndrome; discontinue if occurs. Assess family history and evaluate for tics or Tourette’s syndrome before initiating; monitor for emergence or worsening, and discontinue if clinically appropriate. Peripheral vasculopathy, including Raynaud's phenomenon; monitor for digital changes. Monitor BP, HR, growth in children. Renal impairment. Write ℞ for smallest practical amount. Reevaluate periodically. Pregnancy. Nursing mothers: not recommended.

Adderall Xr Pharmacokinetics

Metabolism

Hepatic.

Elimination

Renal. Half-life: d-amphetamine: 10 hours (adults); 9-11 hours (children); l-amphetamine: 13 hours (adults); 11-14 hours (children).

Adderall Xr Interactions

Interactions

See Contraindications. Hypertensive crisis with MAOIs (including linezolid, IV methylene blue). Increased risk of serotonin syndrome with serotonergic drugs (eg, SSRIs, SNRIs, TCAs, triptans, fentanyl, lithium, tramadol, tryptophan, busprione, St. John's wort), CYP2D6 inhibitors (eg, paroxetine, fluoxetine, quinidine, ritonavir); consider alternatives; if needed, initiate with lower doses and monitor. Potentiated by urinary alkalinizers (eg, sodium bicarbonate, acetazolamide); avoid. Antagonized by acidifiers (eg, ascorbic acid). May potentiate TCAs, sympathomimetics, norepinephrine, meperidine; adjust dose or use alternatives. May antagonize adrenergic blockers, antihistamines, antihypertensives, phenobarbital, phenytoin, veratrum alkaloids, ethosuximide. Monitor effects with concomitant PPIs.

Adderall Xr Adverse Reactions

Adverse Reactions

Anorexia, insomnia, abdominal pain, emotional lability, vomiting, nervousness, nausea, fever, weight loss; also Adults: dry mouth, headache, anxiety, agitation, dizziness, tachycardia, diarrhea, asthenia, UTIs, prolonged erections; hypertension, visual disturbances.

Adderall Xr Clinical Trials

See Literature

Adderall Xr Note

Not Applicable

Adderall Xr Patient Counseling