amphetamine salt combo XR (adderall XR)
Adderall XR is the extended-release version of dextroamphetamine and amphetamine salt combo. It's a stimulant used to treat attention deficit-hyperactivity disorder (ADHD) in people 6 years and older. It comes as a capsule that you take once a day in the morning. The prescriber can adjust the dosage depending on how well it helps you focus and if you have side effects that bother you. These side effects can include low appetite, stomach pain, and trouble sleeping. It's a controlled substance because of its high risk of misuse and dependency. Adderall XR is available as a brand-name medication and a generic.
What is Adderall XR?
What is Adderall XR used for?
Attention deficit-hyperactivity disorder (ADHD) in people ages 6 years and older
How Adderall XR works
Adderall XR is a stimulant medication. It's not exactly known how it works to help with ADHD. But researchers think it raises the level of chemicals in your brain called norepinephrine, dopamine, and serotonin. These chemicals are thought to help you pay attention and focus.
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What are the risks and warnings for Adderall XR?
Adderall XR can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk of misuse and addiction
Risk factors: History of substance or alcohol use disorder | Taking more Adderall XR than prescribed
Adderall XR has a high risk that it could be misused, which can be very dangerous. Misusing this medication can cause serious side effects. This can include fast heart rate, high blood pressure, aggression, and even thoughts of hurting yourself or others. It can also lead to addiction or a life-threatening overdose.
To stay safe, take Adderall XR exactly as prescribed to you. Don't change the dose or how often you take it without talking to your prescriber first. Speak with your prescriber if you're worried about this risk.
Risks to people with serious heart conditions
There have been reports of sudden death in people with heart problems who take stimulants, including Adderall XR. Before starting this medication, let your prescriber know if you have any heart issues. This can include coronary artery disease (CAD) or heart rhythm problems (arrhythmia). It can also include problems with the structure of your heart. Your prescriber can make sure Adderall XR is safe for you to take.
Higher blood pressure and faster heart rate
Stimulants like Adderall XR can make your blood pressure and heart rate go up. Blood pressure can go up by an average of 2 mmHg to 4 mmHg. And, heart rate might be faster by an average of 3 to 6 beats per minute.
Tell your prescriber if you have high blood pressure or a history of a fast heart rate. They can check that Adderall XR is safe for you. Let your care team know if your blood pressure is higher than usual or if you feel your heart racing.
Strange thoughts or behaviors
Risk factors: History of psychotic episodes or other manic psychiatric conditions | Personal or family history of depression | Family history of suicide or bipolar disorder
Stimulants like Adderall XR can sometimes cause changes in thoughts or behaviors. This can include being aggressive, acting recklessly, or having too much energy. Some people might start to see or hear things that aren't there (hallucinations). And others might start to believe things that aren't true.
Although rare, this can happen in people who've never had these problems before. But these symptoms can be worse or be more likely to happen if you already have a mental health condition like psychosis, manic episodes, or bipolar disorder. Your prescriber will check your risk before you start taking Adderall XR.
If you start acting in a strange way or have unusual thoughts, let your prescriber know. You might need to stop taking Adderall XR.
Slow growth in children
Stimulants like Adderall XR have been linked to weight loss in children. They've also been linked to slower growth (in both height and weight). Your child's primary care provider will measure their height and weight often. If your child isn't growing as expected, the primary care provider might recommend taking a break from the medication.
Talk to your child's primary care provider or prescriber if you notice your child has lost a lot of weight. Also speak with the prescriber if you're worried about your child's growth. Adderall XR isn't approved or recommended for children younger than 6 years of age.
Seizures
Risk factors: History of seizures | High risk of seizures
Although rare, stimulants like Adderall XR might make seizures happen more easily. The risk is higher if you've had seizures before. If you have a seizure, get medical attention right away. You'll probably have to stop taking Adderall XR.
Problems with blood flow in the arms and legs, including Raynaud's phenomenon
Stimulants including Adderall XR have been linked to problems with blood flow in the arms and legs. An example is Raynaud's phenomenon, which can affect blood flow to your fingers and toes.
Raynaud's phenomenon can cause your fingers and toes to change color from pale, to blue, to red. They can also feel cold, numb, or painful. These symptoms happen with changes in how much blood gets to your fingers and toes. Most times, symptoms are mild and happen occasionally. But in rare cases, it can lead to other problems like sores or tissue damage.
Tell your care team if you have any of these symptoms while taking Adderall XR. Usually, they get better after your prescriber lowers your dose or after you stop the medication.
Serotonin syndrome
Risk factors: Taking monoamine oxidase inhibitors (MAOI) within 14 days of Adderall XR | Taking other medications that raise serotonin levels in your brain
There's a risk of a rare but serious problem called serotonin syndrome if you take Adderall XR with some other medications. This problem happens when there's too much serotonin in the brain.
Medications that can make serotonin syndrome more likely are those that raise serotonin levels in the brain. Examples include antidepressants, MAOIs, and migraine medications called triptans. Tell your care teams about all the medications you take or plan to take. They can help keep you safe and make changes if needed.
Get medical help right away if you have signs of serotonin syndrome. These include a fast heart rate, sweating, stiff muscles, high fever, changes in behavior, and confusion.
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What are the side effects of Adderall XR?
Common Side Effects
- Low appetite
- Trouble sleeping
- Stomach pain
- Dry mouth
- Low appetite
- Trouble sleeping
- Headache
- Feeling nervous
- Weight loss
Other Side Effects
- Nausea
- Vomiting
- Indigestion
- Weakness
- Dizziness
- Feeling irritable, agitated, or distressed
- Anxiety
- Fast heart rate
Serious Side Effects
- Changes in thoughts or behaviors: manic episodes, hallucinations, delusional thinking
- Serotonin syndrome: fast heart rate, fever, sweating, muscle stiffness or spasms, confusion
- Seizure
- Allergic reaction: rash; hives; trouble breathing; swelling of face, lips, tongue, or throat
Source: DailyMed
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The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Increase in blood pressure
- Irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea, which may be signs of serotonin syndrome
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- Prolonged or painful erection
- Raynaud syndrome—cool, numb, or painful fingers or toes that may change color from pale, to blue, to red
- Seizures
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Dry mouth
- Headache
- Loss of appetite with weight loss
- Nausea
- Stomach pain
- Trouble sleeping
Pros and cons of Adderall XR
Pros
Only taken once a day
Starts working within 45 minutes and lasts for up to 12 hours
Can open capsules and mix contents with applesauce if you have trouble swallowing pills whole
Cons
Has a risk of misuse and dependency
A controlled medication, so there are special requirements for getting the prescription filled
Can cause withdrawal symptoms if you stop the medication too suddenly
Not the best choice for people with heart conditions
Pharmacist tips for Adderall XR
Take Adderall XR once a day in the morning. Avoid taking it in the afternoon because it can make you have trouble sleeping.
You can take Adderall XR with or without food. But try not to eat or drink too many acidic things. This includes fruit juice, citrus fruits, and other foods with vitamin C. They might make Adderall XR not work as well.
If you have a hard time swallowing the Adderall XR capsule whole, you can open it and sprinkle all the contents onto applesauce. Make sure to swallow all of the medication and applesauce right away without chewing. Don't save it for later.
Drink coffee or other caffeinated drinks in moderation while taking Adderall XR. Caffeine is a stimulant, just like the medication. This means it can cause similar side effects, like high blood pressure, nervousness, and trouble sleeping. Talk to your care team about other ways to stay awake if you start to feel tired.
Avoid alcohol while taking Adderall XR. Alcohol can make your ADHD worse. Drinking alcohol with stimulants can also lead to dangerous side effects, including alcohol poisoning and heart problems.
Avoid driving the first few days after you start Adderall XR and after your dose changes until you know how the medication affects you. Adderall XR might cause blurry vision and affect how well you see.
Not feeling hungry can be a common side effect of Adderall XR. Be sure to eat balanced meals when you can. Talk to your care team if you're worried about your nutrition.
Speak to your prescriber if you have tics or Tourette syndrome. Adderall XR might make these problems worse, so your prescriber can help you figure out the best plan for you.
Tell your prescriber and pharmacist about the medications you take or plan to take. They can make sure all your medications are safe for you. This is because Adderall XR can interact with some medications, which can be harmful. This can include antidepressants, blood pressure medications, and decongestants.
Take Adderall XR exactly how your prescriber tells you. Don't stop or change your dose without talking to them first. Stopping suddenly can cause withdrawal symptoms that can be uncomfortable. They can include feeling uneasy, feeling depressed, or having trouble sleeping. Your prescriber can help lower your dose to stop Adderall XR safely.
Accidentally taking too much Adderall XR can be very dangerous. It can lead to an overdose. This can look like restlessness, confusion, anxiety, depression, shaking, and heavy breathing. Be sure you and your loved ones know what an overdose could look like. Call 911 right away if this happens.
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Frequently asked questions about Adderall XR
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Adderall XR dosage forms
Typical dosing for Adderall XR
Age 6 to 12 years: The typical starting dose is 5 mg or 10 mg by mouth once a day in the morning. The maximum dose is 30 mg per day.
Age 13 to 17 years: The typical starting dose is 10 mg by mouth once a day in the morning.
Age 18 years and older: The typical dose is 20 mg by mouth once a day in the morning.
Your prescriber will adjust your dose based on how well it's helping your ADHD and if you have any side effects. Your dose might also change if you take a medication that interacts with Adderall XR or if you have severe kidney problems.
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How much does Adderall XR cost?
Adderall XR contraindications
Allergy to amphetamine products
Currently take or have taken a monoamine oxidase inhibitor (MAOI), linezolid (Zyvox), or methylene blue (ProvayBlue) in the last 14 days
What are alternatives to Adderall XR?
Attention deficit-hyperactivity disorder (ADHD) in people ages 6 years and older
Attention-deficit hyperactivity disorder (ADHD)
Attention-deficit hyperactivity disorder (ADHD) in people 6 years and older
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References
Best studies we foundAdvokat, C., et al. (2013). Attention-deficit hyperactivity disorder (ADHD) stimulant medications as cognitive enhancers. Frontiers in Neuroscience.
Centers for Disease Control and Prevention. (2025). Diagnosing tic disorders.
Department of Justice/Drug Enforcement Administration. (2024). Amphetamines.
Gamcsik, S. (2024). Stimulant versus non-stimulant treatment options for ADHD. American Association of Psychiatric Pharmacists.
Martin, D., et al. (2023). Amphetamine. StatPearls.
MedlinePlus. (2023). Neonatal abstinence syndrome.
MedlinePlus. (2025). Drug use and addiction.
Moran, L. V., et al. (2019). Psychosis with methylphenidate or amphetamine in patients with ADHD. The New England Journal of Medicine.
Nanda, A., et al. (2023). Adverse effects of stimulant interventions for attention deficit hyperactivity disorder (ADHD): A comprehensive systematic review. Cureus.
National Institute of Neurological Disorders and Stroke. (2025). Tourette syndrome.
Post, R. E., et al. (2012). Diagnosis and management of attention-deficit/hyperactivity disorder in adults. American Family Physician.
Shoptaw, S. J., et al. (2009). Treatment for amphetamine withdrawal. The Cochrane Database of Systematic Reviews.
Steingard, R., et al. (2019). New formulations of stimulants: An update for clinicians. Journal of Child and Adolescent Psychopharmacology.
Takeda Pharmaceuticals America, Inc. (2025). Adderall XR- dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate and amphetamine aspartate capsule, extended release [package insert]. DailyMed.
U.S. Food and Drug Administration. (2024). Some medicines and driving don’t mix.
Wolraich, M. L., et al. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics.
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