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Suggest the dosage of Adderall XL?

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Addiction Medicine Specialist
Practicing since : 2002
Answered : 1486 Questions
My psychiatrist has had me on generic Adderall, 20mg, immediate release tabs, directed to take po tid prn ADHD. I have been on this dose just over a year now. My question is in regards to what she switched it to today - even confused my insurance (now requiring prior authorization), as well as my pharmacist; however, she is adiment this change is not an error, but the drug & form it comes in as as dosage and lifespan. New script written for: Adderall XL, 20mg, caps, directed as follows: three caps PO TID prn ADHD. I am just trying to figure out another opinion from a professional in this type of field to give me thought, facts, advice, information, etc. I was told by a pharmacy tech, she thought the XL WAS ONLY 1qd because it is long-acting (24hrs), another professional pointed out that it CAN be taken tid., but the most she suggested was bid (1po qam & 1po qhs) The reason for my psychoatrist making this change is because of the fact the type & dosage I was on is no longer effective- as of July 2013. What are your thoughts on this?
Posted Wed, 20 Nov 2013 in Mental Health
Answered by Dr. Preeti Parakh 53 minutes later
Brief Answer: Once daily. Detailed Answer: Hi, Welcome to Healthcare Magic! Ideally the extended release preparation of Adderall is taken once daily only. The XR preparation contains two types of beads which ensure that the drug release is maintained equally over the entire day. In my opinion, you should be taking 60 mgs of the extended release preparation once daily in the morning. No added benefit will accrue from dividing the dose three times. The 60 mg of XR preparation will be equivalent to 20 mg thrice daily dose of immediate release preparation but will provide steady levels of the drug in the body throughout the day. So you may find it more efficacious than the previous regimen. Even the package insert with the Adderall XR tab mentions that the dose is once daily. I suggest that you call your psychiatrist and politely tell her that you want to know why a medication that needs to be given once daily only is being prescribed thrice daily. It is possible that she has some special reason for doing so and will inform you in that case. Please do not take three tabs of 20 mg XR preparation three times a day, that is nine tabs per day. It can be XXXXXXX Hope this helps you. Please feel free to ask in case you need any clarifications. Best wishes. Dr Preeti Parakh MD Psychiatry
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