What is the recommended dosage conversion from Adderall (amphetamine and dextroamphetamine) 10mg Immediate Release (IR) to Adderall (amphetamine and dextroamphetamine) Extended Release (ER)?

Conversion from Adderall 10mg IR to Adderall ER

When converting from Adderall 10mg IR to Adderall XR (extended-release), use the same total daily dose: if taking 10mg IR twice daily (20mg total), convert to 20mg XR once daily in the morning; if taking only a single 10mg IR dose, convert to 10mg XR once daily. 1, 2, 3

Conversion Principles

The bioavailability and pharmacokinetic profiles of Adderall XR are designed to be comparable to the immediate-release formulation when matched for total daily dose 3, 4:

• Adderall XR 20mg once daily is bioequivalent to Adderall IR 10mg twice daily 3, 4
• The XR formulation contains immediate-release pellets that deliver half the dose upon ingestion, and delayed-release pellets that release the remaining half approximately 4 hours later 3
• This dual-release mechanism provides approximately 12 hours of symptom coverage with a single morning dose 3

Specific Conversion Scenarios

If currently taking 10mg IR twice daily (total 20mg/day):

• Convert to Adderall XR 20mg once daily in the morning 1, 2, 3

If currently taking a single 10mg IR dose:

• Convert to Adderall XR 10mg once daily in the morning 1, 2

If currently taking 10mg IR three times daily (total 30mg/day):

• Convert to Adderall XR 30mg once daily in the morning 1, 2

Administration Timing

• Always administer XR formulation in the morning to minimize sleep disturbances 1, 2
• The extended-release formulation eliminates the need for in-school or afternoon doses, improving adherence 2

Monitoring After Conversion

After converting to the XR formulation, assess the following parameters 1, 2:

• Target ADHD symptoms using standardized rating scales when possible 1
• Blood pressure and pulse at baseline and follow-up visits 1, 2
• Common side effects including insomnia, anorexia, headaches, social withdrawal, tics, and weight loss 1
• Weight at each visit to monitor for appetite suppression 1, 2
• For adults, check blood pressure and pulse quarterly 1, 2

Titration After Conversion

If symptom control is inadequate after conversion 1, 2:

• Increase by 5mg weekly increments based on clinical response and tolerability 1, 2
• Allow at least one week between dose increases to properly evaluate response 1, 2
• Maximum recommended daily dose is 40-50mg for both formulations 1, 5, 2

Critical Pitfalls to Avoid

• Do not crush or open XR capsules, as this destroys the sustained-release mechanism and can result in dangerous immediate release of the full dose 5
• Do not exceed maximum recommended doses (50mg daily) when symptom control is inadequate—instead, consider switching to an alternative medication 1, 5, 2
• Do not administer XR formulation in the afternoon or evening, as this will cause sleep disturbances 1, 2
• Do not assume identical clinical response after conversion—some patients may require dose adjustment due to individual pharmacokinetic differences 1

Special Considerations

• The XR formulation has reduced abuse potential compared to immediate-release formulations due to its extended-release properties 2
• Once-daily dosing improves adherence by eliminating the need to remember multiple doses throughout the day 2
• The XR capsule contents can be sprinkled in applesauce if swallowing is difficult, and this administration method is bioequivalent to taking the intact capsule 4