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mixed amphetamine salts (dextroamphetamine/amphetamine)
Adderall · Adderall XR · Mydayis
CNS stimulant⚠ Unverified beta content
At a glance
- Class
- CNS stimulant (amphetamine; releases dopamine/norepinephrine); Schedule II
- Black box
- ⚠ Abuse, misuse, and addiction
- Key monitoring
- Blood pressure & heart rate
- Abuse / misuse / diversion risk
- Usual adult dose
- ADHD – IR tablets (age ≥6; label): Start 5 mg once or twice daily; ↑ 5 mg/day at weekly intervals; rarely need >40 mg/day
- Call provider / escalate if
- Chest pain, shortness of breath, fainting, or racing/irregular heartbeat • New hallucinations, paranoia, or manic symptoms (very high energy, little need for sleep) • Severe headache or very high blood pressure
Built-in explanation — generated offline from this app’s structured data (no AI, no network). Still unverified beta content.
What it is
- mixed amphetamine salts (dextroamphetamine/amphetamine) (Adderall, Adderall XR, Mydayis) — cNS stimulant (amphetamine; releases dopamine/norepinephrine); Schedule II.
- Used for: ADHD; Narcolepsy.
Usual adult dosing
- ADHD – IR tablets (age ≥6; label): Start 5 mg once or twice daily; ↑ 5 mg/day at weekly intervals; rarely need >40 mg/day (First dose on awakening; additional doses (1–2) at 4–6 h intervals. Avoid late-evening doses.)
- Narcolepsy – IR tablets: 5–60 mg/day in divided doses; ≥12 yrs start 10 mg/day, ↑ 10 mg weekly
- ADHD – Adderall XR (adults): 20 mg once daily in the morning (label starting dose) (Pediatrics 6–17: 10 mg once daily. Switching IR → XR at same total daily dose per label.)
Boxed warning
- Abuse, misuse, and addiction: high potential for abuse and misuse, which can lead to substance use disorder including addiction; misuse can result in overdose and death (risk higher with higher doses or non-oral routes such as snorting/injection). Assess risk before prescribing, educate about safe storage/disposal, and reassess frequently during treatment.
Monitor
- Blood pressure & heart rate [Baseline, after dose changes, periodically]
- Abuse / misuse / diversion risk [Every visit; before refills]
Nursing priorities
- Baseline BP, HR, weight (height/growth in children), sleep, appetite.
- Cardiac history, family history of sudden death or ventricular arrhythmia.
- Give early in the day (last dose before ~6 pm) to limit insomnia, unless otherwise ordered.
- Check BP and pulse at baseline, after dose changes, and periodically; report sustained elevations.
- Monitor weight/appetite; offer meals before dose/high-calorie snacks as appropriate.
Major interactions
- MAOIs (incl. linezolid, IV methylene blue) – within 14 days: Hypertensive crisis – contraindicated.
- Serotonergic drugs (SSRIs, SNRIs, triptans, etc.): Increased risk of serotonin syndrome – start low and monitor.
Key teaching
- Take it exactly as prescribed, usually in the morning. Taking it late in the day can keep you awake.
- Never share it, sell it, or take extra – it can be misused and is dangerous in overdose. Keep it locked up and dispose of leftovers safely.
- It can lower your appetite, raise your heart rate and blood pressure, and make it hard to sleep. Eat regular meals and have your vitals checked.
Optional: AI explanation
Off by default. To enable, add your own API key in Settings (stored only on this device).
Boxed warning
- Abuse, misuse, and addiction: high potential for abuse and misuse, which can lead to substance use disorder including addiction; misuse can result in overdose and death (risk higher with higher doses or non-oral routes such as snorting/injection). Assess risk before prescribing, educate about safe storage/disposal, and reassess frequently during treatment.
Other serious warnings
- Serious cardiovascular reactions (sudden death reported with structural cardiac abnormalities)
- Increased BP/HR
- Psychiatric adverse reactions (psychosis, mania)
- Long-term growth suppression in children
- Peripheral vasculopathy incl. Raynaud’s
- Serotonin syndrome (esp. with serotonergic drugs / CYP2D6 inhibitors)
- Motor and verbal tics
- Contraindicated with MAOIs (or within 14 days)
Sources: FDA label (DailyMed): ADDERALL (DEXTROAMPHETAMINE SACCHARATE, AMPHETAM
- Blood pressure & heart rateWhen: Baseline, after dose changes, periodicallyReport sustained increases
- Abuse / misuse / diversion riskWhen: Every visit; before refills
- Weight / appetite (height & growth in children)When: Baseline and periodically
- Sleep / anxiety / psychiatric symptoms (mania, psychosis, tics)When: Every visit
Sources: FDA label (DailyMed): ADDERALL (DEXTROAMPHETAMINE SACCHARATE, AMPHETAM
Assessment
- Baseline BP, HR, weight (height/growth in children), sleep, appetite.
- Cardiac history, family history of sudden death or ventricular arrhythmia.
- Personal/family history of bipolar disorder, psychosis, tics/Tourette’s, substance use disorder.
- Current meds (MAOIs within 14 days are contraindicated), supplements, caffeine/energy-drink use.
Interventions
- Give early in the day (last dose before ~6 pm) to limit insomnia, unless otherwise ordered.
- Check BP and pulse at baseline, after dose changes, and periodically; report sustained elevations.
- Monitor weight/appetite; offer meals before dose/high-calorie snacks as appropriate.
- Controlled substance (CII): count/store/dispense per facility policy; watch for diversion, misuse, or requests for early refills.
- Screen each visit for new anxiety, agitation, psychosis or manic symptoms.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Chest pain, shortness of breath, fainting, or racing/irregular heartbeat
- New hallucinations, paranoia, or manic symptoms (very high energy, little need for sleep)
- Severe headache or very high blood pressure
- Signs of misuse: taking extra doses, running out early, crushing/snorting
- Fingers or toes that turn pale, blue, cold or painful (peripheral vasculopathy)
- Erection lasting more than 4 hours
- Agitation, fever, sweating, tremor, muscle stiffness (serotonin syndrome, esp. with serotonergic drugs)
- Severe weight loss or inability to eat
Sources: FDA label (DailyMed): ADDERALL (DEXTROAMPHETAMINE SACCHARATE, AMPHETAM · General nursing drug reference conventions (e.g., Davis Drug Guide / L
- Decreased appetite, weight loss
- Insomnia
- Dry mouth
- Headache
- Increased heart rate / blood pressure
- Anxiety, irritability, restlessness
- Nausea, abdominal pain
- Sexual side effects
Sources: FDA label (DailyMed): ADDERALL (DEXTROAMPHETAMINE SACCHARATE, AMPHETAM
- MAOIs (incl. linezolid, IV methylene blue) – within 14 days MajorHypertensive crisis – contraindicated.
- Serotonergic drugs (SSRIs, SNRIs, triptans, etc.) MajorIncreased risk of serotonin syndrome – start low and monitor.
- CYP2D6 inhibitors (e.g., fluoxetine, paroxetine, bupropion)Increased amphetamine exposure and serotonin-syndrome risk.
- Acidifying agents (vitamin C, fruit juices, some GI/urinary acidifiers)Lower amphetamine levels/efficacy.
- Alkalinizing agents (sodium bicarbonate, some antacids)Increase amphetamine levels (label: avoid).
- AntihypertensivesMay decrease antihypertensive effect.
Sources: FDA label (DailyMed): ADDERALL (DEXTROAMPHETAMINE SACCHARATE, AMPHETAM
- Take it exactly as prescribed, usually in the morning. Taking it late in the day can keep you awake.
- Never share it, sell it, or take extra – it can be misused and is dangerous in overdose. Keep it locked up and dispose of leftovers safely.
- It can lower your appetite, raise your heart rate and blood pressure, and make it hard to sleep. Eat regular meals and have your vitals checked.
- Do not take it with, or within 14 days of, certain depression medicines called MAOIs. Tell every provider and pharmacist what you take.
- Avoid too much caffeine and energy drinks.
- Tell your provider about chest pain, fainting, strange thoughts, or if your fingers/toes turn pale or blue.
Sources: General nursing drug reference conventions (e.g., Davis Drug Guide / L
Indications
- ADHD
- Narcolepsy (immediate-release tablets)
Dosing
- ADHD – IR tablets (age ≥6; label): Start 5 mg once or twice daily; ↑ 5 mg/day at weekly intervals; rarely need >40 mg/dayFirst dose on awakening; additional doses (1–2) at 4–6 h intervals. Avoid late-evening doses.
- Narcolepsy – IR tablets: 5–60 mg/day in divided doses; ≥12 yrs start 10 mg/day, ↑ 10 mg weekly
- ADHD – Adderall XR (adults): 20 mg once daily in the morning (label starting dose)Pediatrics 6–17: 10 mg once daily. Switching IR → XR at same total daily dose per label.
Sources: FDA label (DailyMed): ADDERALL (DEXTROAMPHETAMINE SACCHARATE, AMPHETAM
Prescriber-oriented details; limited in this beta.
titration
- IR: weekly 5 mg increments; XR: weekly titration to effect.
renal Adjustment
- Adderall XR: severe renal impairment – lower dose (adults 15 mg/day); ESRD not recommended (XR label).
Sources: FDA label (DailyMed): ADDERALL (DEXTROAMPHETAMINE SACCHARATE, AMPHETAM
- Verified
- No – unverified beta
- Last reviewed
- 2026-10-29 (drafted; not clinician-reviewed)
- FDA label (DailyMed): ADDERALL (DEXTROAMPHETAMINE SACCHARATE, AMPHETAMINE ASPARTATE, DEXTROAMPHETAMINE SULFATE, AMPHETAMINE SULFA…
- General nursing drug reference conventions (e.g., Davis Drug Guide / Lexicomp nursing) - summarized from standard practice; NOT line-by-line verified
Reviewer notes – please double-check
- IR tablet dosing is from the Adderall IR label; XR/Mydayis differ – verify per product.
- Boxed warning updated by FDA (2023) to “Abuse, Misuse, and Addiction” for CNS stimulants.