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Amphetamine: Mixed Amphetamine Salts/Dextroamphetamine/Lisdexamfetamine

Brand names:

Adderall® (mixed amphetamine salts) – immediate release

  • Tablets: 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, 30 mg

Adderall XR® (mixed amphetamine salts) – extended release

  • Capsules: 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg

Dexedrine® (dextroamphetamine) – immediate release

  • Tablets: 5 mg

  • Elixir: 1 mg/mL

Dexedrine Spansules® (dextroamphetamine) – sustained release

  • Capsules: 5 mg, 10 mg, 15 mg

Vyvanse® (lisdexamfetamine)

  • Capsules: 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, 70 mg

Generic name: amphetamine (am FET a meen)

Medication class: Amphetamine, central nervous system (CNS) stimulant

All FDA black box warnings are at the end of this fact sheet. Please review before taking this medication.

What are Adderall®, Dexedrine®, Vyvanse® and what do they treat?

Amphetamine, mixed amphetamine salts, dextroamphetamine, and lisdexamfetamine are prescription medications that are used to treat individuals with attention-deficit hyperactivity disorder (ADHD). These medications are also known as stimulants.

Symptoms of ADHD interfere with an individual’s ability to function at school or work or in social settings and include:

  • Inattention (e.g., making careless mistakes, losing things necessary for tasks)

  • Hyperactivity (e.g., inability to sit still)

  • Impulsivity (e.g., interrupting or intruding on others)

Hyperactivity is less common in adults. A person may have severe inattention without hyperactivity or impulsivity.

Stimulants are used in addition to non-medication treatments to manage ADHD symptoms.

What is the most important information I should know about Adderall®, Dexedrine®, Vyvanse®?

Although some symptoms may improve within days of starting stimulants, it may take several weeks before you notice the full benefits of the medication.

Are there specific concerns about Adderall®, Dexedrine®, Vyvanse® and pregnancy?

If you are planning on becoming pregnant, notify your healthcare provider to best manage your medications. People living with ADHD who wish to become pregnant face important decisions. There is very little information available regarding the risks of stimulants in pregnancy when taken as prescribed for ADHD. Abuse of stimulants (i.e., taking without a prescription or taking more than prescribed) has been associated with premature delivery, low birth weight, and neonatal withdrawal symptoms. Untreated ADHD may be associated with increased risk of substance use. It is important to discuss the risks and benefits of treatment with your doctor and caregivers.

Stimulants are not recommended with breastfeeding according to the American Academy of Pediatrics. Stimulants may concentrate in breast milk and have negative effects on the infant.

What should I discuss with my healthcare provider before taking Adderall®, Dexedrine®, Vyvanse®?

  • Symptoms of your condition that bother you the most

  • If you have thoughts of suicide or harming yourself

  • If you experience side effects from your medications, discuss them with your provider. Some side effects pass with time, but others may require changes in the medication.

  • Any other psychiatric or medical problems you have, including heart disease

  • All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have

  • Other non-medication treatment you are receiving, such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication.

  • If you are pregnant, plan to become pregnant, or are breast-feeding

  • If you drink alcohol or use drugs

How should I take Adderall®, Dexedrine®, Vyvanse®?

Stimulants are usually taken 1 to 2 times per day with or without food.

  • Tablets (Dexedrine®, Adderall®): Swallow the tablets whole. Chewing the tablets gives an unpleasant taste and can irritate the mouth and throat.

  • Sprinkle capsules (Adderall XR®, Dexedrine Spansule®): Swallow whole or sprinkle onto food, such as applesauce or pudding and eat immediately. Do not chew sprinkle capsules or contents.

  • Long-acting capsules (Vyvanse®): Swallow whole or open capsule and mix contents with water. Use all of the powder from the capsule. Drink entire glass of water right away after mixing.

  • Liquid (Dexedrine®): Measure with a dosing spoon or oral syringe which you can get from your pharmacy

The dose of stimulant medication is variable. Only your healthcare provider can determine the correct dose for you.

Use a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking you medication.

What happens if I miss a dose of Adderall®, Dexedrine®, Vyvanse®?

If you miss a dose of stimulant, take it as soon as you remember if it is still early in the day. Do not take a missed dose after 5:00 PM, as this may interfere with sleep. Do not take a missed dose of extended-release capsules after 2:00 PM, as this may interfere with sleep. Discuss missed doses with your healthcare provider. Do not double your next dose or take more than what is prescribed.

What should I avoid while taking Adderall®, Dexedrine®, Vyvanse®?

Avoid drinking alcohol or using illegal drugs while you are taking this medication. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.

What happens if I overdose with Adderall®, Dexedrine®, Vyvanse®?

If an overdose occurs call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.

A specific treatment to reverse the effects of stimulants does not exist.

What are the possible side effects of Adderall®, Dexedrine®, Vyvanse®?

Common Side Effects

  • Upset stomach, loss of appetite, insomnia, and mild anxiety

Rare Side Effects

Contact your healthcare provider if any of the following occur while taking stimulants:

  • Significant increases in blood pressure or heart rate, shortness of breath, fatigue

  • Severe anxiety, panic attacks, mania, hallucinations, paranoia or delusions

Serious Side Effects

Misuse of amphetamine medications may cause sudden death and serious cardiovascular adverse events. Amphetamine medications should be avoided in individuals who have a heart defect (structural abnormality), uncontrolled high blood pressure, or other disorder of heart.

Are there any risks for taking Adderall®, Dexedrine®, Vyvanse® for long periods of time?

Stimulants are Schedule II controlled substances. There is a risk of physical and/or emotional dependence (addiction) when they are taken for long periods of time.

Although treatment with stimulant medications can slow growth, many studies have shown that these changes are small. Children may catch up with growth over time; therefore, it should not be a concern for most children. Height, weight, and eating habits should be discussed before treatment starts and regularly during treatment. If you are concerned about your child’s growth, discuss other possible treatments with your child’s doctor.

What other medications interact with Adderall®, Dexedrine®, Vyvanse®?

Medications used to treat depression can interact with amphetamine medications resulting in serious reactions including high body temperature, high blood pressure, and seizures (convulsions). Tell your healthcare provider if you are beginning or have recently discontinued any of these medications.

Stimulants should not be taken with or within 2 weeks of monoamine oxidase inhibitor antidepressants (MAOIs), including phenelzine (Nardil®), Tranylcypromine (Parnate®), selegiline (Emsam®), and isocarboxazid (Marplan®) or the antibiotic linezolid (Zyvox®). Taking stimulants with or within 2 weeks of MAOIs can result in seizures, fever or dangerously high blood pressure that can lead to death.

The following medications may increase the levels and/or effects of amphetamine medications:

  • Increase levels: Antacids (e.g., sodium bicarbonate, calcium carbonate [Tums®]), acetazolamide

  • Increase side effects: Atomoxetine (Strattera®), caffeine, phenylephrine, fluoxetine (Prozac®), bupropion (Wellbutrin®), venlafaxine (Effexor®), duloxetine (Cymbalta®), Modafinil (Provigil®), and armodafinil (Nuvigil®)

The following foods/medications may decrease the levels and effects of amphetamine medications: ascorbic acid (vitamin C), acidic beverages (e.g., orange juice, grapefruit juice)

Stimulant medications may decrease the effects of blood pressure medications.

How long does it take for Adderall®, Dexedrine®, Vyvanse® to work?

Although you may experience beneficial effects from stimulants within a few days of starting the medication, it often takes several weeks to get the full effect of the medication. Your healthcare provider may also need to gradually adjust the dose to find the dose that works best for you.

Provided by the College of Psychiatric and Neurologic Pharmacists

(January 2013)

Summary of Black Box Warnings

Sudden Cardiac Death

Misuse of amphetamines may cause sudden death or serious cardiovascular adverse events.

Dependence

Amphetamines have a high potential for abuse. Prolonged use of amphetamines may lead to drug dependence. Particular attention should be paid to the possibility of subjects obtaining amphetamines for non-therapeutic use or distribution to others. They should be prescribed or dispensed sparingly.

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