Originally Posted by RetroHousewife
Adderall IS amphetamine
salts, and SWIM
believes 30mg is the highest they prescribe.
I don't think he was questioning whether Adderall
was mixed amphetamine salts...
The FDA maximum recommended dose of Adderall
is 40 mg
, the FDA has not established a maximum recommended dose for adults. I've attached ADDERALL® (CII)
, downloaded from the FDA's website.
The FDA maximum recommended dose of Adderall XR
is 30 mg
; for adults, the FDA only recommends a starting dose
of 20 mg
. However, it is also noted:
Originally Posted by MEDICATION GUIDE ADDERALL XR CII
Patients Currently Using ADDERALL® - Based on bioequivalence data, patients taking divided doses of immediate-release ADDERALL®, for example twice a day, may be switched to ADDERALL XR® at the same total daily dose taken once daily. Titrate at weekly intervals to appropriate efficacy and tolerability as indicated.
So if a child had been prescribed to the maximum recommended daily dose of 40mg immediate-release Adderall, the doctor should prescribe 40mg Adderall XR (two 20mg capsules taken at the same time, since Adderall XR is not supplied in 40mg capsules). If this dose proves effective and tolerable, then the child may remain on the 40mg dose despite the maximum recommended dose of 30mg for the Adderall XR formulation in children. I've also attached the ADDERALL XR® (CII) Medication Guide
, also found on the FDA's website.
For Adults with ADHD, I've personally known people who've been prescribed to 40mg Adderall XR + 40mg Adderall IR daily, for a total effective dose of 80mg per day. My impression is that most doctors would initially try to honor 30mg/day as a maximum for Adderall XR in adults, but will more easily consider up to 60mg/day. I have heard of Adults using 120mg/day. In such cases, treatment probably reached 60mg Adderall XR per day and then the patient complained that the effects wore off too quickly, so the doctor would prescribe an additional 60mg instant-release to be taken in the afternoon. Such cases are common enough that Shire pharmaceuticals developed SPD465, a tripple-release version of Adderall XR for an intended 16-hour duration of effectiveness. I believe Shire abandoned this formulation in favor it's lisdexamfetamine (Vyvanse) formulation; I suspect the SPD465 formulation is further complicated by the more recent Teva/Barr/Shire business. This
is Shire's press release for their submission of the NDA for SPD465, and from what I can tell, the FDA approved the NDA, so now I suppose Teva probably has the rights and could start marketing this medication...