What are the side effects of Adderall (amphetamine and dextroamphetamine) ER 5 mg?

Side Effects of Adderall ER 5 mg

Adderall ER 5 mg causes common side effects including appetite loss, insomnia, cardiovascular changes (elevated blood pressure and heart rate), and gastrointestinal symptoms, with most effects being dose-dependent and manageable through timing adjustments or dose modifications. 1

Common Side Effects

Cardiovascular Effects

• Increased blood pressure and heart rate are expected effects, with amphetamines raising systolic blood pressure by approximately 2 mmHg and diastolic blood pressure by approximately 2 mmHg 2
• Palpitations and tachycardia occur commonly 1
• Regular monitoring of blood pressure and pulse is essential, especially during initial treatment and dose adjustments 3
• Isolated reports of cardiomyopathy have been associated with chronic amphetamine use 1

Central Nervous System Effects

• Insomnia is one of the most common side effects 4, 1
• Overstimulation, restlessness, and dizziness occur frequently 1
• Headache is commonly reported 4, 1
• Psychotic episodes can occur at recommended doses, though this is rare 1
• Other effects include euphoria, dyskinesia, dysphoria, and tremor 1
• Exacerbation of motor and phonic tics and Tourette's syndrome may occur 1

Gastrointestinal and Appetite Effects

• Appetite loss and weight loss are among the most common side effects 4, 1
• Dry mouth and unpleasant taste are frequent 1
• Diarrhea, constipation, and other gastrointestinal disturbances may occur 1
• Abdominal pain is commonly reported 4

Other Effects

• Urticaria (allergic reaction) 1
• Impotence and changes in libido 1
• Anxiety may develop 4

Growth Effects in Children

• Small decrements in growth velocity have been observed, particularly with higher and more consistently administered doses 4
• Effects on height are typically in the range of 1-2 cm and may diminish by the third year of treatment 4
• Weight should be monitored at each visit to assess for appetite suppression 3

Serious but Rare Side Effects

• Hallucinations and other psychotic symptoms are uncommon but significant adverse effects 4
• Sudden cardiac death in children on stimulant medication is extremely rare, with conflicting evidence on whether stimulants increase this risk 4
• Serious side effects in the general population occur at a rate of less than 1/10,000 4

Withdrawal Due to Adverse Effects

• Patients taking amphetamines are 2.69 times more likely to withdraw from treatment due to adverse effects compared to placebo, with an absolute risk increase of 4.3% 2

Management Strategies for Common Side Effects

For Appetite Loss

• Administer stimulants with meals 4
• Provide high-calorie drinks or snacks late in the evening when medication effects have worn off 4

For Insomnia

• Morning administration is recommended to minimize sleep disturbances 3
• Lower the last dose of the day or move it earlier 4
• Consider dose reduction if insomnia is problematic 3
• Distinguish whether sleep delay is due to medication side effect versus oppositional behavior or separation anxiety 4

For Cardiovascular Effects

• Regular monitoring of blood pressure and heart rate with dose adjustment or medication change if significant elevations occur 3
• Patients with pre-existing cardiovascular conditions require more careful monitoring 3

Important Monitoring Requirements

• Blood pressure and pulse should be monitored regularly, especially during initial titration 3
• Weight monitoring at each visit is essential 3
• Systematic evaluation of both therapeutic benefits and side effects should be conducted during treatment 3

Dosing Considerations

• Starting at too high a dose can lead to unnecessary side effects and decreased medication adherence 3
• The 5 mg dose represents a low starting dose, which helps minimize side effects while assessing therapeutic response 3