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Adderall XR

(AD-er-all X-R)

For the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy

Disclaimer

The content on this page is not medical advice and should be used for informational purposes only. Always consult your health care provider or pharmacist to determine what medication and dosage are right for you.

Last updatedJuly 27, 2021

Adderall XR

Adderall XR (extended release) is a central nervous system stimulant that may help increase attention and decrease impulsiveness and hyperactivity in people with ADHD, ages 3 years and older.

Adderall XR is also approved to treat narcolepsy, which causes overwhelming daytime sleepiness and a sudden urge to fall asleep.

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Generic name

Dextroamphetamine and amphetamine
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Rx or OTC

Available by prescription only. Adderall XR is a controlled substance.

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Black box warning

  • Adderall XR is a controlled substance with a high potential for abuse.
  • Taking amphetamines for prolonged periods of time may lead to drug dependence and must be avoided.
  • Adderall XR is prescribed sparingly to help reduce the chance of using it recreationally or distributing it to others.
  • Misuse of amphetamines may cause sudden death and serious cardiovascular adverse events.
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When & How

  • Take one pill in the morning when you wake up.
  • Can be taken with or without food.
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Do’s

  • Take exactly as prescribed by your doctor.
  • You will be started with the lowest dose possible to reduce the risk of side effects. The dose may be increased depending on your response after one week.
  • Adderall XR should be part of a total treatment program for ADHD that may include other approaches (psychological, educational, and social support).
  • Be sure to schedule appointments with your doctor on a regular basis so that you do not run out of medication. This prescription is not refillable.
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Don’ts

  • Do not take before bed—you may have trouble falling asleep.
  • Should not be given to children younger than 3 years old.
  • If you are pregnant, talk to your doctor about the potential risks.
  • Do not suddenly stop taking Adderall XR without checking with your doctor.
  • Never take Adderall XR unless your doctor has prescribed it for you.
  • Do not sell, give away, or let anyone else take your medication.
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Discuss with your doctor

  • If you are taking any other medications and supplements
  • If you have any heart problems, ask your doctor if it’s safe to take Adderall XR.
  • If you have any signs of heart problems (such as chest pain, shortness of breath, or fainting) while taking it
  • Any side effects that bother you or do not go away
  • Have any new mental symptoms (such as abnormally excited mood, restlessness, irritability, anxiety, hostility) or if any mental symptoms suddenly get worse while on Adderall XR
  • If you have tics or Tourette’s syndrome (Adderall XR may worsen these symptoms)
  • If you take medications for depression (including MAOIs), blood pressure, seizures, blood thinning, cold or allergies (medications that contain decongestants), or for stomach acid
  • If you or anyone in your family has a history of excessive alcohol use, drug abuse, or prescription drug abuse
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What is Adderall XR?

Adderall XR (extended release) is a central nervous system stimulant that may help increase attention and decrease impulsiveness and hyperactivity in people with ADHD, ages 3 years and older.

Adderall XR is also approved to treat narcolepsy, in which people tend to fall asleep whenever they are in relaxing surroundings. It is only for people ages 12 and older.

Adderall XR works by increasing the availability of brain neurotransmitters norepinephrine and dopamine in your central nervous system connections.

It is available by prescription only and is a controlled substance.

Similar drugs to Adderall XR

Other amphetamines similar to Adderall XR include:

  • Methylphenidate (Metadate CD, Ritalin LA, Ritalin SR, Concerta, Daytrana)
  • Dextroamphetamine (Dexedrine ER )
  • Dexmethylphenidate (Focalin XR)
  • Lisdexamfetamine (Vyvanse)

Side effects

Disclaimer

Medications may affect individuals differently. Usage of any medication may include side effects and other interactions. Here is a list of known common side effects and interactions. This list is not exhaustive -- there may be other side effects or interactions for this medication that are not listed here. In some cases, the likelihood of side effects or interactions may increase depending on dosage. It’s important to keep in mind that in extreme cases, other serious side effects, even death, may occur. Always consult your health care provider or pharmacist to determine what medication and dosage is right for you.

Common side effects

  • Stomach ache
  • Decreased appetite
  • Nervousness
  • Insomnia
  • Headache
  • Dry mouth

Serious side effects include (seek urgent medical care)

  • Sudden death in patients who have heart problems or heart defects
  • Stroke and heart attack in adults
  • Increased blood pressure and heart rate
  • New or worse behavior and thought problems
  • New or worse bipolar illness
  • New or worse aggressive behavior or hostility
  • New psychotic symptoms in children and teenagers (such as hearing voices, believing things that are not true, acting suspicious)
  • New manic symptoms in children and teenagers
  • Circulation problems in fingers and toes (they may feel numb, cool, painful, or may change color from pale to blue, to red)

Full list of side effects

Cardiovascular

  • Palpitations
  • Tachycardia
  • Increased blood pressure
  • Sudden death
  • Heart attack
  • Stroke
  • Circulation problems in fingers and toes

Central Nervous System

  • Nervousness
  • Insomnia
  • Headache
  • Psychotic episodes
  • Overstimulation
  • Restlessness
  • Irritability
  • Euphoria
  • Dyskinesia
  • Dysphoria
  • Depression
  • Tremor
  • Tics
  • Aggression
  • Anger
  • Excessive talkativeness or wordiness
  • Chronic skin picking

Eye Disorders

  • Vision blurred
  • Dilation of the pupil of the eye

Gastrointestinal

  • Dry mouth
  • Unpleasant taste
  • Stomachache
  • Diarrhea
  • Constipation
  • Decreased appetite leading to unintended weight loss
  • Anorexia

Allergic

  • Urticaria
  • Rash
  • Hypersensitivity reactions including swelling and anaphylaxis
  • Serious skin rashes, including Stevens-Johnson syndrome and toxic epidermal necrolysis.

Endocrine

  • Impotence
  • Decreased libido
  • Frequent or prolonged erections

Skin

  • Hair loss

Musculoskeletal

  • Rhabdomyolysis

Long-term complications

  • Adderall XR has a high potential for abuse and it may become habit-forming.
  • Children taking Adderall XR regularly may have a temporary slowing in growth rate (on average, a total of about 2 cm less growth in height and 2.7 kg less growth in weight over 3 years).
  • There have been isolated reports of cardiomyopathy (enlarged heart) associated with chronic amphetamine use.

Safety notes

  • Adderall XR is a controlled substance, which means there is an increased risk of dependence, abuse, and accidental overdose.
  • If you take too much Adderall XR (or overdose), call your doctor or poison control center right away, or get emergency treatment.
  • It should not be taken by people with heart abnormalities or other serious heart problems, as it may cause heart attack, stroke, or other serious heart event.
  • May cause a small increase in blood pressure. You may need to have your heart rate and blood pressure checked regularly.
  • Amphetamines, like Adderall XR, can impair your ability to drive or use heavy machinery.
  • When first starting Adderall XR, monitor the circulation of your hands and feet. There is a risk for Raynaud's phenomenon. Look for these symptoms: fingers or toes may feel painful, cool, numb, change in color, or be sensitive to cold or hot temperatures. Symptoms improve when stopping the drug or reducing the dosage.
  • Adderall XR may worsen symptoms in people with bipolar disorder, psychosis, and aggression.
  • Serotonin syndrome, a potentially life-threatening reaction, may occur when Adderall XR is taken along with other drugs that affect the serotonergic neurotransmitter systems such as monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John’s wort.
  • Adderall XR may cause allergic reactions, including serious skin rashes, angioedema (swelling), and anaphylaxis.
  • Adderall XR has not been studied in the geriatric population.

What else you should know

  • This extended-release version of Adderall is only taken once daily, which reduces the chances of missed doses. It also provides a more steady dose throughout the day to avoid peaks and valleys.

Adderall XR interactions

Disclaimer

Medications may affect individuals differently. Usage of any medication may include side effects and other interactions. Here is a list of known common side effects and interactions. This list is not exhaustive -- there may be other side effects or interactions for this medication that are not listed here. In some cases, the likelihood of side effects or interactions may increase depending on dosage. It’s important to keep in mind that in extreme cases, other serious side effects, even death, may occur. Always consult your health care provider or pharmacist to determine what medication and dosage is right for you.

Tell your doctor if you are taking any of these medications or supplements

These medications may have moderate to severe side effects. Talk to your doctor before taking them with Adderall XR:

  • Monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping MAOIs. These include isocarboxazid (Marplan),  phenelzine (Nardil), selegiline (Emsam), and tranylcypromine (Parnate)
  • Medications for depression
  • Antihistamines, used for allergies
  • Blood pressure medications
  • Phenytoin, a medication used to prevent seizures
  • Medications for heartburn or reflux, both prescription and over the counter
  • St. John’s wort

Tell your doctor if you have any of these pre-existing conditions

  • Advanced arteriosclerosis, symptomatic cardiovascular disease, or moderate to severe hypertension
  • Hyperthyroidism
  • Known hypersensitivity or reaction to other stimulant drugs
  • Glaucoma
  • Agitated states
  • A history of drug abuse
  • In patients known to be hypersensitive to amphetamine, or other components of Adderall XR. Allergic reactions such as swelling and anaphylactic reactions have been reported in patients treated with other amphetamine products
  • A history of seizures
  • Pregnant or nursing

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