What is the maximum recommended dose for Adderall (amphetamine and dextroamphetamine)?

Maximum Recommended Dose for Adderall (Amphetamine and Dextroamphetamine)

The maximum recommended daily dose of Adderall for adults is 50 mg per day, according to FDA labeling, with dosage individually adjusted based on patient response and tolerability. 1

Dosing Guidelines

Adults with ADHD

• Starting dose: 5-10 mg daily 2
• Titration: Increase in 5-10 mg increments at weekly intervals 3
• Maximum daily dose: 50 mg daily 1, 2
• Alternative maximum calculation: Up to 0.9 mg/kg for dextroamphetamine/amphetamine combinations 3
• Dosing schedule: Usually divided into 2 daily doses, with first dose upon awakening and additional doses at 4-6 hour intervals 1

Special Considerations

• Late evening doses should be avoided due to resulting insomnia 1
• Higher total daily doses in adults may be required because adults need more dosings to cover a longer day 3
• If using doses higher than standard recommendations, clinicians should document that symptoms could not be controlled at lower doses and that higher doses are not producing side effects 3

Titration Process

1. Begin with 5 mg once or twice daily 1
2. Increase by 5-10 mg at weekly intervals 3
3. Schedule follow-up 1-2 weeks after dose increases to assess efficacy and side effects 2
4. Continue titration until optimal symptom control is achieved or side effects become problematic
5. Monitor for signs of tolerance with continued use 3

Monitoring During Treatment

• Regular assessment of vital signs, particularly blood pressure 2
• Monitoring for common side effects:
  • Insomnia
  • Appetite changes
  • Weight loss
  • Agitation
  • Increased blood pressure 3, 2

Important Cautions

• Exceeding maximum recommended doses increases cardiovascular and neuropsychiatric risks 2
• Concurrent use of multiple stimulant formulations is not recommended except when "sculpting" dosing for coverage throughout the day 2
• Absolute contraindications include:
  • Previous sensitivity to stimulants
  • Glaucoma
  • Symptomatic cardiovascular disease
  • Hyperthyroidism
  • Hypertension
  • Concurrent use of MAOIs
  • History of psychosis or mania 2

Clinical Efficacy

• Clinical trials have demonstrated efficacy at various doses:
  • One study found a mean effective dose of 10.77 mg/day (0.14 mg/kg/day) in adult responders 4
  • Another study used an average dose of 54 mg/day (in 2 daily doses) with 70% of subjects showing significant improvement 5

Remember that while the maximum recommended dose is 50 mg daily, the goal is to find the lowest effective dose that adequately controls symptoms while minimizing side effects.