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Adderall IR and XR Fact Sheet

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Medication Name (brand): 
Adderall IR and XR
Medication Name (clinical): 
mixed amphetamine and dextroamphetamine
Manufacturer: 

Shire; IR (immediate release) version available as generic since 2003, XR marketing exclusivity expires 2009.

Indications: 
  • Attention Deficit Hyperactivity Disorder in children and adolescents

  • Narcolepsy

Mechanism: 

Blocks reuptake of norepinephrine and dopamine

Dosing: 
  • IR: Supplied as 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, and 30 mg breakable tablets. Start at 5 mg BID (usually Q 6 hours), increase gradually as tolerated. Maximum recommended dose 40 mg daily, but some patients may require 60 mg QD or more.

  • XR: Supplied as 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, and 30 mg capsules (not breakable).Start at 10 mg QAM and increase gradually as tolerated. Maximum recommended dose 30 mg daily, but some patients may require 60 mg QD. Adderall XR lasts about 8 hours in most people. Some patients require BID dosing for coverage into the evening.

Side Effects: 
  • Most common are decreased appetite, weight loss, tics, and nausea.

  • All stimulants are required to carry a warning about the possibility of sudden death, primarily in children with pre-existing cardiac abnormalities.

  • Risk of stimulant abuse and diversion (Schedule II controlled substance).

  • Growth suppression, usually mild, is possible with all stimulants.

  • Pregnancy Category C.

Drug-drug Interactions: 

Avoid in combination with MAOIs.

Pharmokinetics: 
  • Metabolized by the liver.

  • IR Lasts 4-6 hours.

  • XR lasts 8-10 hours.

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