Can a 5 mg Immediate Release Adderall Be Cut in Half?
Yes, immediate-release Adderall tablets can be safely cut in half for dose titration and adjustment. 1
Clinical Rationale for Splitting IR Adderall
IR Adderall tablets are specifically designed to allow cutting for therapeutic dose adjustment when finding the optimal dose. 1 This practice is explicitly supported by clinical guidelines for several important scenarios:
- For older or frail patients, lower initial doses of 2.5 mg are recommended, which requires cutting a 5 mg tablet in half 1
- For gradual dose titration to minimize side effects, cutting IR tablets is an effective strategy 1
- For children weighing less than 25 kg, single doses generally should not exceed 15 mg, which may necessitate cutting tablets to achieve appropriate dosing 1
Critical Distinction: IR vs Extended-Release Formulations
Never cut or crush Adderall XR (extended-release) capsules or tablets, as this destroys the sustained-release mechanism and can result in dangerous immediate release of the full dose, leading to potential overdose and increased abuse potential. 1 This is a fundamental safety principle that applies to all extended-release preparations. 2, 3
The immediate-release formulation lacks the modified-release coating that would be compromised by splitting, making it safe to divide. 2
Practical Considerations
When cutting IR Adderall tablets:
- Use a tablet splitter rather than attempting to break by hand, as some older adults may struggle with manual splitting based on physical limitations 3
- Administer the split dose promptly after cutting to avoid any potential degradation 1
- Consult with your healthcare provider before making any dosing adjustments 1
Clinical Monitoring After Dose Adjustment
After splitting tablets and adjusting doses:
- Check blood pressure and pulse quarterly in adults on stimulants 1
- Assess efficacy using standardized ADHD rating scales when possible 1
- Monitor for both therapeutic effects and side effects before making further adjustments 4
Common Pitfall to Avoid
The most critical error is confusing immediate-release with extended-release formulations. While IR tablets can be safely split, splitting XR formulations is dangerous and should never be done. 1