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

Maximum Dose for Adderall (Amphetamine and Dextroamphetamine)

The maximum recommended daily dose of Adderall for adults is 50 mg per day. 1, 2

FDA-Approved Dosing Guidelines

• The FDA-approved dosing information states that amphetamines should be administered at the lowest effective dosage and dosage should be individually adjusted 3
• For adults with ADHD, the recommended starting dose is 10 mg once daily in the morning 1
• Dose titration should occur in 5 mg weekly increments based on response and tolerability 1, 2
• Late evening doses should be avoided because of the resulting insomnia 3

Maximum Dose Considerations

• While older prescribing information indicated a maximum of 40 mg daily 1, more recent guidelines support a maximum daily dose of 50 mg for adults 1, 2
• The American Academy of Child and Adolescent Psychiatry recommends not exceeding 50 mg per day for adults with ADHD 2, 1
• If the maximum dose of 50 mg does not provide adequate symptom control, experts recommend considering alternative treatments rather than exceeding this dose 2, 1

Monitoring During Dose Adjustments

• Blood pressure and pulse should be checked regularly, as amphetamines increase systolic blood pressure by approximately 1.93 mmHg and diastolic blood pressure by 1.84 mmHg 4
• Heart rate typically increases by about 3.71 beats per minute with amphetamine use 4
• Dose titration should be done gradually, with reassessment after each increase for both therapeutic effects and side effects 2
• Follow-up appointments are recommended at least monthly until symptoms are stabilized 2

Special Considerations

• Older adults may be more sensitive to both therapeutic and adverse effects of stimulants due to age-related changes in pharmacokinetics 2
• A more conservative titration schedule (increasing by 5 mg every 2 weeks instead of weekly) may be appropriate for older adults 2
• When the maximum dose is reached without adequate symptom control, consider:
  • Switching to a different stimulant formulation 2
  • Adding a non-stimulant medication like atomoxetine 2
  • Reevaluating the diagnosis and considering comorbid conditions 2

Common Pitfalls to Avoid

• Starting at too high a dose, which can lead to unnecessary side effects and decreased medication adherence 1
• Failing to systematically assess both benefits and side effects during titration 1
• Not allowing sufficient time between dose increases to evaluate response 1
• Continuing to increase the dose beyond maximum recommendations when not effective 1
• Overlooking the importance of morning administration to minimize sleep disturbances 1

In your specific case, the prescribed range of 45-60 mg daily exceeds the maximum recommended dose of 50 mg at the upper end. While 45 mg is within guidelines, 60 mg exceeds current recommendations and may increase the risk of side effects without providing additional therapeutic benefit.