Adderall 7.5mg Tablets
WARNING: This drug has a high risk of misuse. This can lead to alcohol or drug use disorder. Misuse or abuse of this drug can lead to overdose or death. The risk is higher with higher doses or when used in ways that are not approved like snorting or injecting it. Do not give this drug to anyone else. This drug may also be habit-forming if taken for a long time. Do not take for longer than you have been told by your doctor. Use only as you were told. Tell your doctor if you have ever had alcohol or drug use disorder. You will be watched closely while taking this drug. Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets. Throw away unused or expired drugs as you have been told. @ COMMON USES: It is used to treat attention deficit problems with hyperactivity.It is used to treat narcolepsy.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Central Nervous System (CNS) Stimulant
Pharmacologic Class
Sympathomimetic Amine
Pregnancy Category
Category C
FDA Approved
Jan 1996
DEA Schedule
Schedule II
Overview
What is this medicine?
Adderall is a medication that contains two types of stimulant drugs, dextroamphetamine and amphetamine. It's used to treat attention-deficit/hyperactivity disorder (ADHD) by helping to improve focus, attention, and control over impulsive behavior. It's also used to treat narcolepsy, a condition that causes extreme daytime sleepiness.
How to Use This Medicine
Taking Your Medication Correctly
To get the most benefit from your medication, it's essential to follow your doctor's instructions carefully. Read all the information provided with your prescription, and make sure you understand the instructions before taking your medication. You can take this medication with or without food. However, take your last dose of the day at least 4 hours before bedtime to minimize any potential disruptions to your sleep.
Before using any over-the-counter (OTC) products, consult with your doctor, especially if they may increase your blood pressure. These products include cough and cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.
Storing and Disposing of Your Medication
To maintain the effectiveness and safety of your medication, store it at room temperature, protected from light, and in a dry place. Avoid storing your medication in a bathroom, as the moisture and temperature fluctuations can affect its potency. Keep all medications in a secure location, out of the reach of children and pets.
When disposing of unused or expired medication, do not flush it down the toilet or pour it down the drain unless instructed to do so by your pharmacist or healthcare provider. Instead, check with your pharmacist for guidance on the best way to dispose of your medication. You may also want to explore drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses, as this can increase the risk of side effects.
To get the most benefit from your medication, it's essential to follow your doctor's instructions carefully. Read all the information provided with your prescription, and make sure you understand the instructions before taking your medication. You can take this medication with or without food. However, take your last dose of the day at least 4 hours before bedtime to minimize any potential disruptions to your sleep.
Before using any over-the-counter (OTC) products, consult with your doctor, especially if they may increase your blood pressure. These products include cough and cold medications, diet pills, stimulants, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and certain natural products or aids.
Storing and Disposing of Your Medication
To maintain the effectiveness and safety of your medication, store it at room temperature, protected from light, and in a dry place. Avoid storing your medication in a bathroom, as the moisture and temperature fluctuations can affect its potency. Keep all medications in a secure location, out of the reach of children and pets.
When disposing of unused or expired medication, do not flush it down the toilet or pour it down the drain unless instructed to do so by your pharmacist or healthcare provider. Instead, check with your pharmacist for guidance on the best way to dispose of your medication. You may also want to explore drug take-back programs in your area.
What to Do If You Miss a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses, as this can increase the risk of side effects.
Lifestyle & Tips
- Take exactly as prescribed by your doctor, usually in the morning to avoid sleep problems.
- Avoid taking doses late in the day to prevent insomnia.
- Do not crush, chew, or break the tablet if it's an extended-release form (Adderall XR). Immediate-release tablets can be split if scored.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Avoid alcohol consumption while taking this medication.
- Maintain a healthy diet and regular sleep schedule.
- Do not share this medication with others, as it has a high potential for abuse.
Available Forms & Alternatives
Available Strengths:
- Adderall XR 30mg Capsules
- Adderall XR 20mg Capsules
- Adderall XR 10mg Capsules
- Adderall XR 15mg Capsules
- Adderall XR 5mg Capsules
- Adderall XR 25mg Capsules
- Adderall 10mg Tablets
- Adderall 30mg Tablets
- Adderall 20mg Tablets
- Adderall 15mg Tablets
- Adderall 5mg Tablets
- Adderall 12.5mg Tablets
- Adderall 7.5mg Tablets
Generic Alternatives:
Dosing & Administration
Adult Dosing
Standard Dose:
For ADHD: Initial 5 mg once or twice daily. For Narcolepsy: Initial 10 mg daily.
Dose Range:
5 - 40 mg
Condition-Specific Dosing:
ADHD:
Initial 5 mg once or twice daily; may increase by 5 mg weekly to a maximum of 40 mg/day (divided doses).
Narcolepsy:
Initial 10 mg daily; may increase by 10 mg weekly to a maximum of 60 mg/day (divided doses).
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
ADHD (6-12 years): Initial 5 mg once or twice daily; may increase by 5 mg weekly to a maximum of 30 mg/day (divided doses). ADHD (3-5 years): Initial 2.5 mg daily; may increase by 2.5 mg weekly to a maximum of 10 mg/day (single or divided doses).
Adolescent:
ADHD (13-17 years): Initial 5 mg once or twice daily; may increase by 5 mg weekly to a maximum of 40 mg/day (divided doses).
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; consider lower doses.
Moderate:
Use with caution; consider lower doses.
Severe:
Use with caution; consider lower doses. Contraindicated in end-stage renal disease.
Dialysis:
Not recommended; amphetamines are not significantly removed by dialysis.
Hepatic Impairment:
Mild:
No specific dose adjustment provided; use with caution.
Moderate:
No specific dose adjustment provided; use with caution.
Severe:
No specific dose adjustment provided; use with caution.
Pharmacology
Mechanism of Action
Amphetamines are non-catecholamine sympathomimetic amines that exert their therapeutic effect by increasing the release of norepinephrine and dopamine from presynaptic nerve terminals in the brain and by blocking the reuptake of these monoamines into the presynaptic neuron. This leads to increased concentrations of norepinephrine and dopamine in the synaptic cleft.
Pharmacokinetics
Absorption:
Bioavailability:
Approximately 75% (oral)
Tmax:
Approximately 2-3 hours (for immediate-release formulation)
FoodEffect:
Food can delay absorption but does not significantly affect the extent of absorption.
Distribution:
Vd:
Approximately 3-5 L/kg
ProteinBinding:
Approximately 15-26%
CnssPenetration:
Yes
Elimination:
HalfLife:
Dextroamphetamine: 10-13 hours; Levoamphetamine: 9-11 hours (pH-dependent)
Clearance:
Highly dependent on urinary pH; increased in acidic urine, decreased in alkaline urine.
ExcretionRoute:
Renal
Unchanged:
Approximately 30-50% (dependent on urinary pH)
Pharmacodynamics
OnsetOfAction:
30-60 minutes (immediate-release)
PeakEffect:
2-3 hours (immediate-release)
DurationOfAction:
4-6 hours (immediate-release)
Safety & Warnings
BLACK BOX WARNING
Amphetamines have a high potential for abuse. Administration of amphetamines for prolonged periods of time may lead to drug dependence. Misuse of amphetamines may cause sudden death and serious cardiovascular adverse events.
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you experience any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood pressure, including:
+ Severe headache or dizziness
+ Passing out
+ Changes in eyesight
Signs of a urinary tract infection (UTI), such as:
+ Blood in the urine
+ Burning or pain when passing urine
+ Frequent or urgent need to pass urine
+ Fever
+ Lower stomach pain or pelvic pain
Erectile dysfunction or changes in sex interest
Seizures
Trouble controlling body movements or sounds (e.g., humming, throat clearing, yelling, or making loud noises)
Restlessness
Changes in eyesight
Prolonged or frequent erections
Changes in skin color (pale, blue, gray, purple, or red) on hands, feet, or other areas
Numbness, pain, tingling, or cold feeling in hands or feet
Sores or wounds on fingers or toes
Muscle pain or weakness, dark urine, or trouble passing urine
Important Heart-Related Warnings
If you have a heart problem or defect, or if a family member has an abnormal heartbeat or died suddenly, inform your doctor. Seek medical help immediately if you experience any signs of heart problems, such as:
Chest pain
Abnormal heartbeat
Shortness of breath
Severe dizziness or passing out
Other Possible Side Effects
Like all medications, this drug may cause side effects in some people. While many individuals may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Feeling nervous and excitable
Headache
Trouble sleeping
Constipation, diarrhea, stomach pain, upset stomach, vomiting, or decreased appetite
Dizziness, tiredness, or weakness
Dry mouth
Bad taste in mouth
* Weight loss
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you experience any of the following symptoms, contact your doctor or seek medical attention immediately:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high blood pressure, including:
+ Severe headache or dizziness
+ Passing out
+ Changes in eyesight
Signs of a urinary tract infection (UTI), such as:
+ Blood in the urine
+ Burning or pain when passing urine
+ Frequent or urgent need to pass urine
+ Fever
+ Lower stomach pain or pelvic pain
Erectile dysfunction or changes in sex interest
Seizures
Trouble controlling body movements or sounds (e.g., humming, throat clearing, yelling, or making loud noises)
Restlessness
Changes in eyesight
Prolonged or frequent erections
Changes in skin color (pale, blue, gray, purple, or red) on hands, feet, or other areas
Numbness, pain, tingling, or cold feeling in hands or feet
Sores or wounds on fingers or toes
Muscle pain or weakness, dark urine, or trouble passing urine
Important Heart-Related Warnings
If you have a heart problem or defect, or if a family member has an abnormal heartbeat or died suddenly, inform your doctor. Seek medical help immediately if you experience any signs of heart problems, such as:
Chest pain
Abnormal heartbeat
Shortness of breath
Severe dizziness or passing out
Other Possible Side Effects
Like all medications, this drug may cause side effects in some people. While many individuals may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:
Feeling nervous and excitable
Headache
Trouble sleeping
Constipation, diarrhea, stomach pain, upset stomach, vomiting, or decreased appetite
Dizziness, tiredness, or weakness
Dry mouth
Bad taste in mouth
* Weight loss
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Chest pain, shortness of breath, or fainting (seek immediate medical attention)
- New or worsening aggression, hostility, or irritability
- New or worsening psychotic symptoms (e.g., hearing voices, seeing things that aren't there, paranoia)
- Manic symptoms (e.g., unusually elevated mood, racing thoughts, decreased need for sleep)
- Unexplained numbness, pain, or discoloration in fingers or toes
- Unexplained seizures
- Blurred vision
- Severe headache
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including the symptoms that occurred.
A family history of certain health conditions, including:
+ Blood vessel disease
+ High blood pressure
+ Heart structure problems or other heart-related issues
+ Tourette's syndrome or tics
Your medical history, particularly if you have:
+ Glaucoma
+ Agitation
+ Anxiety
+ Overactive thyroid
+ A history of drug abuse
+ A history of stroke
Kidney disease, as this may affect how your body processes the medication
Current or recent use of certain medications, including:
+ Acetazolamide
+ Sodium bicarbonate
+ Certain antidepressants or Parkinson's disease medications taken within the last 14 days, such as:
- Isocarboxazid
- Phenelzine
- Tranylcypromine
- Selegiline
- Rasagiline (note: taking these medications with this drug can lead to very high blood pressure)
+ Linezolid or methylene blue
If you are breast-feeding, as this medication is not recommended during breast-feeding
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist to ensure safe use. Do not start, stop, or change the dose of any medication without consulting your doctor first.
It is essential to inform your doctor about the following conditions to ensure safe treatment:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including the symptoms that occurred.
A family history of certain health conditions, including:
+ Blood vessel disease
+ High blood pressure
+ Heart structure problems or other heart-related issues
+ Tourette's syndrome or tics
Your medical history, particularly if you have:
+ Glaucoma
+ Agitation
+ Anxiety
+ Overactive thyroid
+ A history of drug abuse
+ A history of stroke
Kidney disease, as this may affect how your body processes the medication
Current or recent use of certain medications, including:
+ Acetazolamide
+ Sodium bicarbonate
+ Certain antidepressants or Parkinson's disease medications taken within the last 14 days, such as:
- Isocarboxazid
- Phenelzine
- Tranylcypromine
- Selegiline
- Rasagiline (note: taking these medications with this drug can lead to very high blood pressure)
+ Linezolid or methylene blue
If you are breast-feeding, as this medication is not recommended during breast-feeding
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist to ensure safe use. Do not start, stop, or change the dose of any medication without consulting your doctor first.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. This will help ensure your safety and prevent potential interactions with other treatments.
When you first start taking this medication, be cautious when driving or performing tasks that require alertness and clear vision, as it may affect your ability to do so. Wait until you understand how this medication affects you before engaging in such activities.
Long-term or high-dose use of this medication can lead to tolerance, where the medication becomes less effective, and you may need higher doses to achieve the same effect. If you notice that the medication is not working as well as it used to, contact your doctor. Do not take more than the prescribed dose, as this can increase the risk of adverse effects.
Prolonged or regular use of this medication may cause dependence, and stopping it abruptly can lead to withdrawal symptoms. If you need to reduce the dose or stop taking this medication, consult your doctor, who will provide guidance on how to do so safely.
Before starting this medication, you may need to undergo heart tests to ensure it is safe for you to take. If you have any questions or concerns, discuss them with your doctor.
This medication may cause an increase in blood pressure. Monitor your blood pressure and heart rate as directed by your doctor, and have regular blood tests to check for any potential effects on your blood work.
It is crucial to inform all your healthcare providers and laboratory personnel that you are taking this medication, as it may affect the results of certain lab tests. Additionally, do not take antacids while taking this medication, as they may interact with it.
Some individuals taking this medication may experience changes in behavior or mood, such as altered thinking, anger, or hallucinations. If you or a family member have a history of mental health conditions, such as depression or bipolar disorder, or if a family member has committed suicide, inform your doctor. Seek immediate medical attention if you experience hallucinations, changes in behavior, or signs of mood changes, including depression, suicidal thoughts, nervousness, emotional instability, abnormal thinking, anxiety, or loss of interest in life.
This medication may increase the risk of seizures in some individuals, particularly those with a history of seizures. Discuss your risk with your doctor to determine if you are more susceptible to seizures while taking this medication.
A rare but potentially life-threatening condition called serotonin syndrome can occur if you take this medication with certain other drugs. Seek immediate medical attention if you experience symptoms such as agitation, balance problems, confusion, hallucinations, fever, abnormal heartbeat, flushing, muscle twitching or stiffness, seizures, shivering or shaking, excessive sweating, severe diarrhea, stomach upset, vomiting, or severe headache.
In some cases, this medication may affect growth in children and adolescents. Regular growth checks may be necessary, and different brands of this medication may be suitable for different age groups. Consult your doctor before giving this medication to a child.
It is recommended that you discuss the use of alcohol with your doctor while taking this medication. If you are pregnant or plan to become pregnant, inform your doctor, as you will need to weigh the benefits and risks of using this medication during pregnancy.
When you first start taking this medication, be cautious when driving or performing tasks that require alertness and clear vision, as it may affect your ability to do so. Wait until you understand how this medication affects you before engaging in such activities.
Long-term or high-dose use of this medication can lead to tolerance, where the medication becomes less effective, and you may need higher doses to achieve the same effect. If you notice that the medication is not working as well as it used to, contact your doctor. Do not take more than the prescribed dose, as this can increase the risk of adverse effects.
Prolonged or regular use of this medication may cause dependence, and stopping it abruptly can lead to withdrawal symptoms. If you need to reduce the dose or stop taking this medication, consult your doctor, who will provide guidance on how to do so safely.
Before starting this medication, you may need to undergo heart tests to ensure it is safe for you to take. If you have any questions or concerns, discuss them with your doctor.
This medication may cause an increase in blood pressure. Monitor your blood pressure and heart rate as directed by your doctor, and have regular blood tests to check for any potential effects on your blood work.
It is crucial to inform all your healthcare providers and laboratory personnel that you are taking this medication, as it may affect the results of certain lab tests. Additionally, do not take antacids while taking this medication, as they may interact with it.
Some individuals taking this medication may experience changes in behavior or mood, such as altered thinking, anger, or hallucinations. If you or a family member have a history of mental health conditions, such as depression or bipolar disorder, or if a family member has committed suicide, inform your doctor. Seek immediate medical attention if you experience hallucinations, changes in behavior, or signs of mood changes, including depression, suicidal thoughts, nervousness, emotional instability, abnormal thinking, anxiety, or loss of interest in life.
This medication may increase the risk of seizures in some individuals, particularly those with a history of seizures. Discuss your risk with your doctor to determine if you are more susceptible to seizures while taking this medication.
A rare but potentially life-threatening condition called serotonin syndrome can occur if you take this medication with certain other drugs. Seek immediate medical attention if you experience symptoms such as agitation, balance problems, confusion, hallucinations, fever, abnormal heartbeat, flushing, muscle twitching or stiffness, seizures, shivering or shaking, excessive sweating, severe diarrhea, stomach upset, vomiting, or severe headache.
In some cases, this medication may affect growth in children and adolescents. Regular growth checks may be necessary, and different brands of this medication may be suitable for different age groups. Consult your doctor before giving this medication to a child.
It is recommended that you discuss the use of alcohol with your doctor while taking this medication. If you are pregnant or plan to become pregnant, inform your doctor, as you will need to weigh the benefits and risks of using this medication during pregnancy.
Overdose Information
Overdose Symptoms:
- Restlessness
- Tremor
- Hyperreflexia (overactive reflexes)
- Rapid breathing
- Confusion
- Hallucinations
- Panic states
- High fever (hyperpyrexia)
- Rhabdomyolysis (muscle breakdown)
- Arrhythmias (irregular heartbeats)
- Hypertension (high blood pressure) or hypotension (low blood pressure)
- Circulatory collapse
- Seizures
- Coma
What to Do:
If overdose is suspected, seek immediate medical attention. Call 911 or your local poison control center (e.g., 1-800-222-1222 in the US).
Drug Interactions
Contraindicated Interactions
- Monoamine Oxidase Inhibitors (MAOIs) (concurrent use or within 14 days of MAOI use)
- Linezolid
- Methylene blue (intravenous)
Major Interactions
- Serotonergic drugs (e.g., SSRIs, SNRIs, triptans, fentanyl, tramadol, St. John's Wort) - risk of serotonin syndrome
- Tricyclic Antidepressants (TCAs) - may increase amphetamine levels and potentiate cardiovascular effects
- Antihypertensives - amphetamines may reduce the hypotensive effect of these drugs
- Urinary Alkalinizers (e.g., sodium bicarbonate, acetazolamide, thiazide diuretics) - decrease amphetamine excretion, increasing levels and prolonging effects
- Urinary Acidifiers (e.g., ammonium chloride, ascorbic acid) - increase amphetamine excretion, decreasing levels and shortening effects
Moderate Interactions
- Antacids (e.g., aluminum hydroxide, magnesium hydroxide) - may increase amphetamine absorption
- Proton Pump Inhibitors (PPIs) - may increase amphetamine absorption
- Phenothiazines - may inhibit amphetamine effects
- Haloperidol - may inhibit amphetamine effects
Minor Interactions
- Caffeine - additive stimulant effects, increased risk of adverse cardiovascular effects
Monitoring
Baseline Monitoring
Blood Pressure (BP) and Heart Rate (HR)
Rationale: Amphetamines can cause increases in BP and HR; screen for pre-existing cardiovascular conditions.
Timing: Prior to initiation of therapy.
Height and Weight
Rationale: Monitor for growth suppression in children and adolescents.
Timing: Prior to initiation of therapy.
Psychiatric History (e.g., bipolar disorder, psychosis, tics)
Rationale: Amphetamines can exacerbate or induce psychiatric symptoms.
Timing: Prior to initiation of therapy.
Cardiac History (e.g., family history of sudden death, structural cardiac abnormalities)
Rationale: Screen for underlying cardiac conditions that may increase risk of sudden death.
Timing: Prior to initiation of therapy; ECG may be considered if clinically indicated.
Routine Monitoring
Blood Pressure (BP) and Heart Rate (HR)
Frequency: At each visit or at least every 3-6 months.
Target: Maintain within normal limits for age/sex.
Action Threshold: Significant or sustained increases warrant dose reduction or discontinuation.
Height and Weight
Frequency: Every 3-6 months in children and adolescents; annually in adults.
Target: Maintain appropriate growth trajectory/stable weight.
Action Threshold: Significant growth deceleration or weight loss may require dose adjustment or drug holiday.
Psychiatric Status (e.g., mood, anxiety, psychosis, tics)
Frequency: At each visit.
Target: Stable mood, absence of new or worsening psychotic symptoms or tics.
Action Threshold: Emergence of new or worsening psychiatric symptoms warrants evaluation and potential discontinuation.
ADHD/Narcolepsy Symptom Control
Frequency: At each visit.
Target: Improved focus, reduced impulsivity/hyperactivity, improved wakefulness.
Action Threshold: Lack of efficacy or intolerable side effects warrants dose adjustment or alternative therapy.
Symptom Monitoring
- Chest pain
- Shortness of breath
- Syncope (fainting)
- Palpitations
- New or worsening aggression or hostility
- New or worsening psychotic symptoms (e.g., hallucinations, delusions)
- Manic symptoms (e.g., elevated mood, decreased need for sleep, racing thoughts)
- New or worsening tics
- Unexplained weight loss
- Blurred vision
Special Patient Groups
Pregnancy
Category C. Use during pregnancy should only be considered if the potential benefit justifies the potential risk to the fetus. Amphetamines may cause fetal harm, including growth restriction and premature birth. Neonatal withdrawal symptoms have been reported.
Trimester-Specific Risks:
First Trimester:
Limited data, but potential for congenital malformations cannot be entirely ruled out.
Second Trimester:
Potential for fetal growth restriction and premature birth.
Third Trimester:
Risk of neonatal withdrawal symptoms (e.g., agitation, feeding difficulties, tremor) if used near term.
Lactation
Amphetamines are excreted into breast milk. Due to the potential for serious adverse reactions in breastfed infants (e.g., irritability, poor feeding, sleep disturbances, weight loss), a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Infant Risk:
Moderate risk. Monitor infant for signs of agitation, insomnia, poor feeding, and weight loss.
Pediatric Use
Careful monitoring of growth (height and weight) is essential due to potential for growth suppression. Monitor for emergence or worsening of psychiatric symptoms (e.g., psychosis, mania, tics). Not recommended for children under 3 years of age.
Geriatric Use
Use with caution. Geriatric patients may be more sensitive to the adverse effects of amphetamines, particularly cardiovascular and psychiatric effects. Start with lower doses and titrate slowly.
Clinical Information
Clinical Pearls
- Adderall (immediate-release) typically has a duration of action of 4-6 hours, requiring multiple daily doses for sustained effect.
- To minimize insomnia, the last dose of Adderall IR should generally be taken at least 6 hours before bedtime.
- Acidic foods (e.g., citrus fruits, vitamin C) and urinary acidifiers can increase the excretion of amphetamines, potentially reducing their effectiveness. Conversely, alkaline foods or urinary alkalinizers can decrease excretion, increasing effects.
- Patients should be screened for pre-existing cardiac conditions and psychiatric disorders before initiating therapy.
- Regular monitoring of blood pressure, heart rate, and growth (in children) is crucial.
- Educate patients and caregivers about the high potential for abuse and dependence associated with amphetamines.
Alternative Therapies
- Methylphenidate (e.g., Ritalin, Concerta, Focalin)
- Lisdexamfetamine (Vyvanse)
- Atomoxetine (Strattera)
- Guanfacine extended-release (Intuniv)
- Clonidine extended-release (Kapvay)
- Bupropion (Wellbutrin - off-label for ADHD)
Cost & Coverage
Average Cost:
Varies widely (e.g., $30-$150) per 30 tablets
Generic Available:
Yes
Insurance Coverage:
Tier 2 or Tier 3 (preferred or non-preferred brand/generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication.
This medication is accompanied by a Medication Guide, which is a valuable resource that provides important information about your treatment. Please read this guide carefully and review it again whenever you receive a refill of your medication. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, pharmacist, or other healthcare provider for clarification.
In the event of a suspected overdose, it's crucial to seek immediate medical attention or contact your local poison control center. When reporting the incident, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.
This medication is accompanied by a Medication Guide, which is a valuable resource that provides important information about your treatment. Please read this guide carefully and review it again whenever you receive a refill of your medication. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, pharmacist, or other healthcare provider for clarification.
In the event of a suspected overdose, it's crucial to seek immediate medical attention or contact your local poison control center. When reporting the incident, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.