What You Should Know About Amphetamine/Dextroamphetamine XR Side Effects

Like any medication, Amphetamine/Dextroamphetamine XR (the generic form of Adderall XR) can cause side effects. Most are mild and improve as your body adjusts to the medication. But some are more serious and need medical attention right away.

This guide covers the most common side effects, the ones that require a doctor's call, and practical tips for managing them — so you know what to expect when starting or adjusting your dose.

What Is Amphetamine/Dextroamphetamine XR?

Amphetamine/Dextroamphetamine XR is a Schedule II stimulant prescribed primarily for ADHD in patients aged 6 and older. It contains a mix of four amphetamine salts in an extended-release capsule that works for up to 12 hours. For a deeper look at how it works, see our guide on the mechanism of action of Amphetamine/Dextroamphetamine XR.

Common Side Effects

These side effects are reported most frequently and are usually mild to moderate. They often improve within the first few weeks of treatment:

• Decreased appetite — This is the most commonly reported side effect. Many people notice they're simply not hungry, especially during the day when the medication is active.
• Insomnia or trouble falling asleep — Because the medication is a stimulant, it can interfere with sleep, particularly if taken too late in the day.
• Dry mouth — A frequent complaint. Staying hydrated and chewing sugar-free gum can help.
• Headache — Typically mild and may go away on its own.
• Weight loss — Often related to reduced appetite. More common in children and adolescents.
• Abdominal pain or stomach upset — Taking the medication with food (or sprinkling the beads on applesauce) may reduce stomach discomfort.
• Nervousness or anxiety — Some people feel jittery or on edge, especially at higher doses.
• Nausea — Usually temporary and more common when first starting the medication.
• Dizziness — May occur when standing up too quickly.
• Increased heart rate — A slight increase is normal, but significant changes should be reported to your doctor.

Serious Side Effects — When to Call Your Doctor

While rare, some side effects of Amphetamine/Dextroamphetamine XR are serious and require prompt medical attention. Call your doctor or go to the emergency room if you experience:

Heart-Related Symptoms

• Chest pain or tightness
• Shortness of breath
• Fainting or feeling like you might pass out
• Heart pounding or irregular heartbeat

Stimulant medications can raise blood pressure and heart rate. In rare cases, they've been linked to stroke, heart attack, and sudden cardiac death — particularly in people with pre-existing heart conditions. Your doctor should check your heart health before prescribing.

Psychiatric Symptoms

• New or worsening anxiety, agitation, or panic attacks
• Hallucinations (seeing or hearing things that aren't there)
• Paranoia or unusual suspiciousness
• Manic behavior — feeling extremely "up," talking fast, reckless behavior
• Aggression or hostility

These symptoms can occur even in people with no prior history of psychiatric illness. If you or a family member notices significant mood or behavior changes, contact your provider.

Circulation Problems

• Fingers or toes feeling numb, cold, or painful
• Skin color changes (pale, blue, or red) in fingers or toes
• Unexplained wounds on fingers or toes

This may indicate Raynaud's phenomenon or peripheral vasculopathy, a known but uncommon side effect of amphetamine medications.

Serotonin Syndrome

If you take Amphetamine/Dextroamphetamine XR with certain other medications (like SSRIs, SNRIs, or triptans), there's a risk of serotonin syndrome — a potentially life-threatening condition. Symptoms include:

• Agitation or restlessness
• Fast heartbeat
• Muscle twitching or stiffness
• High fever
• Diarrhea
• Loss of coordination

For more on risky combinations, read our guide to Amphetamine/Dextroamphetamine XR drug interactions.

Side Effects in Specific Populations

Children and Adolescents

Children may be more likely to experience appetite loss, weight loss, and slowed growth. The FDA recommends monitoring height and weight regularly in children taking stimulants. Some children also experience emotional lability — mood swings, crying more easily, or irritability — especially as the medication wears off in the evening.

Adults

Adults more commonly report dry mouth, insomnia, and increased anxiety. Sexual side effects (decreased libido) are sometimes reported but less well-studied.

Older Adults

Amphetamine/Dextroamphetamine XR should be used with caution in older adults due to higher risk of cardiovascular side effects and potential interactions with other medications.

Pregnancy and Breastfeeding

Amphetamine/Dextroamphetamine XR is not recommended during pregnancy as it may increase the risk of premature birth and low birth weight. It's also excreted in breast milk and should not be used while breastfeeding. Talk to your doctor about safer alternatives if you're pregnant or planning to become pregnant.

How to Manage Common Side Effects

Most side effects can be managed with simple adjustments. Here's what you can try:

• Loss of appetite: Eat a good breakfast before the medication kicks in. Have a larger dinner after it wears off. Keep high-calorie snacks handy.
• Insomnia: Take the medication as early in the morning as possible. Avoid caffeine in the afternoon. Practice good sleep hygiene — consistent bedtime, no screens before bed.
• Dry mouth: Drink plenty of water throughout the day. Sugar-free gum or lozenges can stimulate saliva production.
• Headaches: Stay hydrated and eat regularly. Over-the-counter pain relievers like acetaminophen are generally safe, but check with your doctor.
• Nervousness: If anxiety is significant, your doctor may lower your dose or try a different medication. For more on alternatives, see alternatives to Amphetamine/Dextroamphetamine XR.
• Stomach pain: Try taking the capsule with food or sprinkling the beads on applesauce as directed.

Never adjust your dose on your own. If side effects are bothering you, talk to your doctor before making changes.

Final Thoughts

Amphetamine/Dextroamphetamine XR is an effective medication for ADHD, but it's normal to experience some side effects, especially when you first start or change doses. Most common side effects are manageable and improve with time. The key is knowing which symptoms are normal and which ones mean you should pick up the phone and call your doctor.

If you're currently taking Amphetamine/Dextroamphetamine XR and need help finding it in stock, Medfinder can help you locate a pharmacy near you with availability.