What You Should Know About Amphetamine/Dextroamphetamine IR Side Effects

Amphetamine/dextroamphetamine IR — the generic form of Adderall — is one of the most commonly prescribed medications for ADHD and narcolepsy. Like all medications, it comes with potential side effects. Most are mild and manageable, but some require immediate medical attention.

This guide covers the side effects you're most likely to experience, which ones are serious, and when you should contact your doctor.

What Is Amphetamine/Dextroamphetamine IR?

Amphetamine/dextroamphetamine IR is a Schedule II central nervous system (CNS) stimulant made up of mixed amphetamine salts. It works by increasing levels of dopamine and norepinephrine in the brain, which helps improve focus, attention, and impulse control. The "IR" stands for immediate-release, meaning it starts working within 30 to 60 minutes and lasts about 4 to 6 hours per dose. For more details, see our guide on what amphetamine/dextroamphetamine IR is and how it's used.

Common Side Effects

These side effects are reported frequently and are usually mild, especially during the first few weeks of treatment. Many improve as your body adjusts:

• Decreased appetite — One of the most common effects. You may not feel hungry, especially during the hours the medication is active.
• Insomnia or trouble sleeping — Particularly if you take your dose too late in the day.
• Dry mouth — Staying hydrated and chewing sugar-free gum can help.
• Headache — Often occurs when starting the medication or adjusting the dose.
• Nervousness or anxiety — Some people feel jittery or on edge, especially at higher doses.
• Stomach pain or nausea — Taking the medication with food may reduce this.
• Weight loss — Related to decreased appetite; more common in children.
• Dizziness — Usually mild and temporary.
• Increased heart rate — A slight increase is normal but should be monitored.
• Irritability or restlessness — May happen as the dose wears off (sometimes called the "crash").

If any of these side effects are persistent or bothersome, talk to your doctor. A dose adjustment or change in timing may help.

Serious Side Effects

These are less common but require prompt medical attention. Contact your doctor or seek emergency care if you experience any of the following:

• Chest pain, shortness of breath, or fainting — Could indicate a cardiovascular problem. Amphetamines can raise blood pressure and heart rate, and in rare cases have been associated with stroke and heart attack in adults.
• Signs of psychosis — Hallucinations (seeing or hearing things that aren't there), paranoia, or delusional thinking. This is rare but more likely at high doses.
• Mania or extreme mood changes — Unusually elevated mood, aggression, or erratic behavior.
• Peripheral vasculopathy — Numbness, pain, skin color changes, or unexplained wounds in fingers or toes. This includes Raynaud's phenomenon.
• Seizures — Especially in people with a history of seizures.
• Serotonin syndrome — If you're also taking serotonergic medications (like SSRIs or SNRIs), watch for symptoms such as agitation, rapid heart rate, high body temperature, muscle stiffness, and confusion. This is a medical emergency. Learn more about drug interactions with amphetamine/dextroamphetamine IR.
• Priapism — A prolonged, painful erection lasting more than 4 hours. This is rare but requires immediate treatment.

Side Effects in Specific Populations

Children and Adolescents

In addition to the side effects listed above, children may experience growth suppression with long-term use. Your child's doctor should monitor height and weight regularly. Temporary breaks from the medication ("drug holidays") during school vacations are sometimes used to allow catch-up growth.

Pregnant or Breastfeeding Women

Amphetamine/dextroamphetamine IR is a Pregnancy Category C medication. It may pose risks to the fetus, and infants born to mothers taking amphetamines may experience withdrawal symptoms. The medication also passes into breast milk, so breastfeeding is generally not recommended while taking it. Discuss the risks and benefits with your doctor.

Older Adults

Older adults may be more sensitive to cardiovascular side effects like increased blood pressure and heart rate. Dose adjustments and careful monitoring are important.

People with Heart Conditions

Amphetamine/dextroamphetamine IR carries a boxed warning about the risk of sudden death in people with pre-existing structural heart defects or other serious heart problems. Your doctor should evaluate your cardiac health before prescribing this medication.

How to Manage Common Side Effects

Here are practical tips for dealing with the most frequently reported side effects:

• Loss of appetite: Eat a good breakfast before your first dose. Have calorie-dense snacks available. Consider eating your main meal in the evening when the medication has worn off.
• Insomnia: Take your last dose at least 6 hours before bedtime. Your doctor may adjust your dosing schedule. Avoid caffeine in the afternoon.
• Dry mouth: Drink water throughout the day. Sugar-free gum or lozenges can stimulate saliva production.
• Headaches: Stay hydrated and maintain regular meals. Over-the-counter pain relievers like acetaminophen can help, but check with your pharmacist first.
• Anxiety or jitteriness: This may indicate your dose is too high. Talk to your doctor before making changes on your own.
• Crash or irritability: Some people experience a mood dip as the medication wears off. Your doctor may suggest a smaller "booster" dose in the afternoon or switching to an extended-release alternative.

Final Thoughts

Most people who take amphetamine/dextroamphetamine IR tolerate it well, especially once they find the right dose. Side effects like decreased appetite and mild insomnia are common but usually manageable. Serious side effects are rare — but knowing what to watch for can help you act quickly if something doesn't feel right.

Always keep your doctor informed about how you're feeling, and don't adjust your dose without their guidance. If you're having trouble finding this medication in stock, Medfinder can help you locate a pharmacy near you that has it available.