Can Adderall (amphetamine and dextroamphetamine) cause liver damage?

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Last updated: April 25, 2025View editorial policy

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From the Guidelines

Adderall can potentially cause liver damage, though it's relatively uncommon with normal prescribed use. Adderall (mixed amphetamine salts) is primarily metabolized by the liver, and in rare cases, it may lead to elevated liver enzymes or more serious liver injury, especially at high doses or with long-term use 1. People with pre-existing liver conditions should use Adderall with caution and under close medical supervision. The risk of liver damage increases with misuse, such as taking higher than prescribed doses or using the medication without a prescription. Signs of potential liver problems while taking Adderall include yellowing of the skin or eyes (jaundice), dark urine, light-colored stools, persistent nausea, abdominal pain, or unusual fatigue. If you experience these symptoms while taking Adderall, you should contact your healthcare provider immediately. Regular liver function monitoring may be recommended for those on long-term Adderall therapy, particularly if there are other risk factors for liver disease such as alcohol use, obesity, or hepatitis 1.

Some key points to consider:

  • Adderall is metabolized by the liver, and high doses or long-term use can increase the risk of liver damage 1.
  • Pre-existing liver conditions, such as fatty liver disease or hepatitis, can increase the risk of liver damage from Adderall 1.
  • Misuse of Adderall, such as taking higher than prescribed doses or using the medication without a prescription, can increase the risk of liver damage.
  • Regular liver function monitoring may be recommended for those on long-term Adderall therapy, particularly if there are other risk factors for liver disease 1.
  • It is essential to be aware of the potential risks and to discuss any concerns with a healthcare provider.

In terms of specific guidance, the most recent and highest-quality study on the topic is from 2020, which highlights the importance of careful monitoring and management of liver function in patients taking Adderall, particularly those with pre-existing liver conditions or other risk factors for liver disease 1.

From the Research

Adderall and Liver Damage

  • Adderall, a medication used to treat attention-deficit/hyperactivity disorder (ADHD), has been reported to cause acute liver injury in rare cases 2.
  • A case study published in 2013 described a 55-year-old woman who developed acute liver failure while taking Adderall for ADHD, highlighting the need for careful use in individuals with underlying liver conditions 2.
  • Another study published in 2018 analyzed reports of liver damage associated with methylphenidate, a different medication used to treat ADHD, and found that while liver damage was possible, it was unlikely in most cases 3.
  • Amphetamine, an ingredient in Adderall, has been known to cause hepatotoxicity, particularly when used recreationally or in high doses 4, 5.
  • A case study published in 2021 reported the successful use of N-acetylcysteine in treating acute liver failure caused by amphetamine ingestion, highlighting the potential for hepatoprotective agents in managing liver damage 5.
  • An older study published in 1984 documented hepatic dysfunction due to intravenous abuse of methylphenidate hydrochloride, demonstrating the potential for liver injury with non-standard use of ADHD medications 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Adderall induced acute liver injury: a rare case and review of the literature.

Case reports in gastrointestinal medicine, 2013

Research

Liver abnormalities in drug and substance abusers.

Best practice & research. Clinical gastroenterology, 2013

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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