Titration Plan from Adderall ER 30 mg to 60 mg
The recommended titration plan for increasing Adderall ER from 30 mg to 60 mg is to increase by 10 mg increments weekly until reaching the target dose of 60 mg daily, with careful monitoring for side effects at each dose level. 1
Titration Schedule
- Week 1: Continue current dose of 30 mg Adderall ER daily
- Week 2: Increase to 40 mg Adderall ER daily
- Week 3: Increase to 50 mg Adderall ER daily
- Week 4: Reach target dose of 60 mg Adderall ER daily
Rationale for Gradual Titration
The FDA label for amphetamine products recommends that "amphetamines should be administered at the lowest effective dosage and dosage should be individually adjusted" 1. This gradual titration approach:
- Allows for assessment of therapeutic benefit at each dose level
- Minimizes risk of adverse effects
- Follows standard clinical practice for stimulant titration
- Stays within the maximum recommended daily dose of 60 mg 2
Monitoring During Titration
At each dose increase, monitor for:
- Blood pressure and heart rate (stimulants can increase both)
- Weight and appetite (common side effects include decreased appetite)
- Sleep quality (avoid late evening doses due to insomnia risk) 1
- Mood changes and irritability
- Effectiveness in symptom control
Important Considerations
Maximum daily dose: The maximum recommended daily dose of Adderall is 60 mg per day 1, so the target dose is at the upper limit of the recommended range.
Timing of administration: Administer the extended-release formulation in the morning to minimize sleep disturbances 1.
Potential side effects: Common side effects include insomnia, decreased appetite, weight loss, and increased heart rate/blood pressure 3. These should be monitored closely as the dose increases.
Contraindications: Avoid this titration in patients with uncontrolled hypertension, active coronary disease, hyperthyroidism, glaucoma, severe anxiety, or history of drug abuse 2.
Drug interactions: Be aware that vitamin C and citrus can decrease absorption and accelerate elimination of amphetamines 3. Advise avoiding vitamin C or citrus consumption within 1 hour before and after taking Adderall.
When to Adjust the Titration Plan
If bothersome adverse reactions appear (e.g., significant insomnia, anorexia, or cardiovascular effects), reduce the dose or slow the titration schedule 1.
If inadequate symptom control occurs at any dose level, consider proceeding to the next dose increase sooner, while still monitoring carefully for side effects.
If side effects become intolerable or dangerous (severe hypertension, cardiac arrhythmias, or significant psychiatric symptoms), discontinue the titration and reassess treatment options.
This titration plan follows established guidelines for stimulant medication management while prioritizing patient safety and symptom control.