amphetamine/dextroamphetamine

General information

• Class: Adjunctive therapy
• Common US brands: ADDERALL, ADDERALL XR, MYDAYIS
• Typical dose range: Doses are typically started low and titrated gradually based on functional improvement and tolerability. Immediate-release products often require BID dosing; extended-release products are typically once daily in the morning.
• Therapeutic drug monitoring not routinely recommended.
• Last reviewed: 2026-02-20

Dosing & forms

• Forms/strengths: Immediate-release tablets (often dosed 1–2 times daily).; Extended-release capsules/tablets (typically once daily in the morning; product-dependent).
• Frequency: Doses are typically started low and titrated gradually based on functional improvement and tolerability. Immediate-release products often require BID dosing; extended-release products are typically once daily in the morning.
• Typical range: Doses are typically started low and titrated gradually based on functional improvement and tolerability. Immediate-release products often require BID dosing; extended-release products are typically once daily in the morning.

Mechanism (brief)

CNS stimulant; increases dopamine and norepinephrine signaling via release and reuptake inhibition.

Metabolism & Half‑life

• Metabolism: CYP2D6 (partial), Oxidative deamination and other non-CYP pathways
• Half‑life: Single-dose mean 11 h; Single-dose range 9–14 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

Monitoring highlights

• Baseline and periodic blood pressure and heart rate (more often during titration).
• Track appetite and weight/BMI; revisit nutrition and meal timing if weight loss occurs.
• Monitor sleep onset and duration; adjust timing/formulation before adding sedatives.
• Monitor for anxiety, agitation, mood elevation, or hallucinations; stop/reassess if symptoms emerge.
• Review misuse/diversion risk and document safe storage counseling.

Sources

• Adderall (mixed amphetamine salts) prescribing information — DailyMed (2024)
• Adderall XR (mixed amphetamine salts extended-release) prescribing information — DailyMed (2025)
• Attention deficit hyperactivity disorder (NICE guideline NG87) — NICE (2018)
• Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents — Pediatrics (2019)
• Comparative efficacy and tolerability of medications for ADHD (systematic review and network meta-analysis) — Lancet Psychiatry (2018)