FDA Maximum Dose for Adderall
The FDA-approved maximum daily dose for Adderall (mixed amphetamine salts) is 40 mg per day for children and adolescents, and while the same 40 mg limit is stated in the Physician's Desk Reference, clinical practice guidelines note that adults may require doses up to 60 mg per day to cover a longer functional day. 1, 2
Age-Specific Maximum Doses
Children and Adolescents
- Maximum total daily dose: 40 mg 1
- Children weighing less than 25 kg should not receive single doses greater than 10 mg of amphetamine 1
- The PDR explicitly states 40 mg as the maximum for amphetamines 1
Adults
- Standard maximum: 40 mg per day (per FDA labeling) 2
- Clinical practice maximum: Up to 60 mg per day 1
- Some adult patients have been treated with total daily doses up to 0.9 mg/kg or 65 mg for amphetamines in clinical studies 1
Important Clinical Context
The consensus from clinical practice is that doses may exceed PDR-recommended upper limits on rare occasions 1. Expert guidelines often limit the upper range to a total daily dose of 40 mg of amphetamine when given in multiple doses throughout the day 1.
When Higher Doses Are Used in Adults
If prescribing above 40 mg/day in adults:
- Clearly document that symptoms could not be controlled at lower doses 1
- Verify the higher doses are not producing side effects (weight loss, blood pressure increase, or agitation) 1
- Monitor closely for signs of tolerance 1
- Adults may need more frequent dosing to cover a longer functional day, which can result in higher total daily doses 1
Critical Caveat
If the top recommended dose does not help, more is not necessarily better 1. A change in medication or addition of environmental/psychosocial interventions may be required rather than continued dose escalation 1.
Monitoring Requirements
When using any dose of Adderall: