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Adderall Xr Generic Name & Formulations
Legal Class
CII
General Description
Mixed salts of a single-entity amphetamine product (each cap contains equal parts dextroamphetamine saccharate, dextroamphetamine sulfate, amphetamine aspartate monohydrate, amphetamine sulfate); 5mg, 10mg, 15mg, 20mg, 25mg, 30mg; ext-rel caps.
Pharmacological Class
CNS stimulant.
How Supplied
Caps—100; Tabs—contact supplier.
Manufacturer
Adderall Xr Indications
Indications
Attention deficit hyperactivity disorder.
Adderall Xr Dosage and Administration
Adult
Swallow whole or may sprinkle contents of caps on applesauce; do not chew beads. Avoid afternoon doses; give upon awakening. >17yrs: 20mg once daily in the AM. Severe renal impairment (GFR 15–<30mL/min/1.73m2): 15mg once daily in the AM. ESRD (GFR <15mL/min/1.73m2): not recommended. Switching from Adderall immediate-release: give total daily dose of immediate-release once daily in the AM.
Children
Swallow whole or may sprinkle contents of caps on applesauce; do not chew beads. <6yrs: not studied. Avoid afternoon doses; give upon awakening. 6–12yrs: initially 10mg once daily in the AM, may increase by 5mg or 10mg per day at weekly intervals; max 30mg/day; with severe renal impairment: max 20mg/day. 13–17yrs: initially 10mg once daily in the AM; may increase to 20mg/day after 1 week. Severe renal impairment (GFR 15–<30mL/min/1.73m2): 5mg once daily in the AM. ESRD (GFR <15mL/min/1.73m2): not recommended. Switching from Adderall immediate-release: give total daily dose of immediate-release once daily in the AM.
Adderall Xr Contraindications
Contraindications
Advanced arteriosclerosis. Symptomatic cardiovascular disease. Moderate to severe hypertension. Hyperthyroidism. Glaucoma. History of drug abuse. Agitation. During or within 14 days of MAOIs. Hypersensitivity to sympathomimetics.
Adderall Xr Boxed Warnings
Boxed Warning
Abuse and dependence.
Adderall Xr Warnings/Precautions
Warnings/Precautions
High potential for abuse and dependence (monitor). Increased risk of sudden death, stroke, and MI; assess for presence of cardiac disease before initiating (eg, family history, physical exam). Avoid in known structural cardiac abnormalities, cardiomyopathy, serious arrhythmias, coronary artery disease, and other cardiac problems. Pre-existing psychotic disorder. Bipolar disorder; screen for risk before initiation. Consider discontinuing if new psychotic/manic symptoms occur. Monitor for new or worsening aggressive behavior or hostility. Seizure disorder. Monitor for serotonin syndrome; discontinue if occurs. Evaluate for tics or Tourette's syndrome prior to therapy. Peripheral vasculopathy, including Raynaud's phenomenon; monitor for digital changes. Monitor growth (esp. children), BP, HR. Renal impairment. Write ℞ for smallest practical amount. Reevaluate periodically. Pregnancy. Nursing mothers: not recommended.
Adderall Xr Pharmacokinetics
See Literature
Adderall Xr Interactions
Interactions
See Contraindications. Hypertensive crisis with MAOIs (including linezolid, IV methylene blue). Increased risk of serotonin syndrome with serotonergic drugs (eg, SSRIs, SNRIs, TCAs, triptans, fentanyl, lithium, tramadol, tryptophan, busprione, St. John's wort), CYP2D6 inhibitors (eg, paroxetine, fluoxetine, quinidine, ritonavir); consider alternatives; if needed, initiate with lower doses and monitor. Potentiated by urinary alkalinizers (eg, sodium bicarbonate, acetazolamide); avoid. Antagonized by acidifiers (eg, ascorbic acid). May potentiate TCAs, sympathomimetics, norepinephrine, meperidine; adjust dose or use alternatives. May antagonize adrenergic blockers, antihistamines, antihypertensives, phenobarbital, phenytoin, veratrum alkaloids, ethosuximide. Monitor effects with concomitant PPIs.
Adderall Xr Adverse Reactions
Adverse Reactions
Anorexia, insomnia, abdominal pain, emotional lability, vomiting, nervousness, nausea, fever, weight loss; also Adults: dry mouth, headache, anxiety, agitation, dizziness, tachycardia, diarrhea, asthenia, UTIs, prolonged erections; hypertension, visual disturbances.
Adderall Xr Clinical Trials
See Literature
Adderall Xr Note
Not Applicable
Adderall Xr Patient Counseling
See Literature
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