What is the standard dose for immediate release Adderall (amphetamine and dextroamphetamine) in adults?

Standard Dosing for Immediate Release Adderall in Adults

The standard starting dose for immediate release Adderall (amphetamine mixed salts) in adults is 5-10 mg daily, with titration up to a maximum of 50 mg daily. 1

Dosing Guidelines

• Initial dosing:

  • Start with 5-10 mg once daily in the morning 1
  • Alternative approach: 5 mg twice daily 2

• Titration:

  • Increase by 5 mg weekly increments 3, 1
  • Adjust dose to achieve maximum benefit with minimum side effects 1

• Maximum daily dose: Up to 50 mg daily 3, 1

• Typical effective dose range:

  • Average effective dose in clinical studies: 54 mg daily (administered in 2 daily doses) 4
  • Some patients may respond to lower doses (10-20 mg/day) 2

Administration Considerations

• Administer early in the day to minimize sleep disruption 1
• Divided dosing (twice daily) is common with immediate release formulation
• Effects begin within 30-60 minutes of administration
• Duration of action: 4-6 hours per dose for immediate release formulation

Monitoring and Safety

• During initial titration:

  • Weekly monitoring is recommended 1
  • Monitor vital signs, especially blood pressure and heart rate 1
  • Watch for common side effects: decreased appetite, insomnia, headache, irritability 5

• Regular monitoring should include:

  • Vital signs (blood pressure, heart rate)
  • Weight and appetite
  • Sleep patterns
  • Mood changes

Important Cautions

• Contraindications include:

  • Advanced cardiovascular disease
  • High blood pressure
  • Hyperthyroidism
  • Glaucoma
  • History of psychosis or mania
  • Active substance abuse 1

• Common side effects include:

  • Anorexia/decreased appetite (35.6%)
  • Headache (16.3%)
  • Insomnia (12%)
  • Abdominal pain (10.7%)
  • Weight loss (9.4%) 5

Clinical Pearls

• Approximately 70% of adults with ADHD show significant improvement with Adderall treatment 4
• Low-dose therapy (mean 10.77 mg/day) may be effective for some adults 2
• Medication effects cease when medication stops 1
• Patients with comorbid anxiety disorders may experience exacerbation of anxiety symptoms 2
• Consider combining medication with behavioral interventions for optimal outcomes 1

Remember that while these are standard dosing guidelines, clinical response and tolerability should guide the final dosing regimen, with the goal of achieving symptom control with minimal side effects.