Adderall XR vs. IR: How Are They Different?

Medically reviewed by Alex Yampolsky, PharmD

There are two formulations of Adderall: Adderall extended-release (XR) and Adderall immediate-release (IR).

Adderall IR (dextroamphetamine/amphetamine), the immediate-release form of Adderall, is used to treat attention deficit hyperactivity disorder (ADHD) and a sleep disorder called narcolepsy.

Adderall XR (mixed salts of a single-entity amphetamine product), on the other hand, is used to treat only ADHD.

They both work by altering the levels of certain chemicals in the brain that help improve attention and reduce impulsiveness and hyperactivity in people with ADHD. Adderall XR and Adderall IR have the same active ingredient but differ in their formulations and how long they last.

This article compares the similarities and differences between Adderall IR and Adderall XR.

Adderall XR vs. IR: What Are the Differences?

Extended-release or "XR" medications release a drug slowly into the body over a period of time. Immediate-release or “IR” medications, on the other hand, release a drug into your body right away.

Adderall IR is a short-acting formulation that generally lasts for about four to six hours. It is usually prescribed to be taken two to three times a day to provide symptom relief throughout the day.

Adderall XR is a long-acting formulation that lasts for about 10–12 hours. It is designed to provide symptom relief throughout the day with a single dose, making it more convenient by reducing the need for multiple daily doses.

The following table highlights the main similarities and differences between Adderall IR and Adderall XR.

Dosing for Adderall XR vs. IR

Adderall IR is available in tablets. Dosage recommendations for Adderall depend on the individual's age and condition:

• For children ages 3–5 with ADHD, a starting dose of 2.5 milligrams (mg) is recommended, with weekly increases (by 2.5 mg) if necessary.

• For children 6 years and older, a starting dose of 5 mg once or twice a day is recommended, with weekly increases up to a maximum of 40 mg per day.

• For narcolepsy, the recommended dosage range is 5–60 mg daily.

Adderall should be taken with or without food first thing in the morning followed by additional doses every four to six hours. Avoid taking it late in the evening to prevent trouble sleeping.

Adderall XR is available in capsules. When starting or switching to Adderall XR, your healthcare provider may start with 10 mg (adolescents) or 20 mg (adults) once daily and adjust the dosage weekly as needed. Capsules can be swallowed whole with water or other liquids. It can be taken with or without food.

If you or your child cannot swallow the capsule, open it and sprinkle the medicine inside over a spoonful of applesauce. Swallow all of the applesauce and medicine mixture without chewing immediately. Follow with a drink of water or other liquid.

Use all medicine as directed on your prescription label and read all medication guides.

Side Effects and Safety

Because Adderall IR and Adderall XR both have the same active ingredient, users may experience similar side effects with both medications.

The following listed side effects are common when taking both Adderall IR and Adderall XR:

• Anorexia

• Central nervous system reactions, such as agitation, restlessness, tic exacerbation, trouble sleeping, dizziness, and nervousness

• Decreased appetite

• Dry mouth

• Fatigue/weakness

• Fever

• Gastrointestinal disturbances, such as diarrhea, constipation, nausea or vomiting, indigestion (dyspepsia), and stomach pain

• Heart-related problems, such as increased blood pressure or heart rate and heart palpitations

• Infection

• Mental health changes, such as mood swings, anxiety, and depression

• Sexual side effects, such as erectile dysfunction and changes to sex drive (libido)

• Visual disturbances

• Weight loss

Severe Side Effects

The following side effects of Adderall IR and Adderall XR can be severe and potentially life-threatening.

• Abuse or dependency

• Aggressive behavior

• Allergic reactions

• Heart complications, such as high blood pressure, heart attack, or stroke

• Erections lasting longer than four hours

• Growth suppression in children

• Psychiatric reactions, such as mania or psychosis

• Raynaud phenomenon (a condition in which your fingers turn blue and/or white when exposed to cold)

• Rhabdomyolysis (a condition characterized by the breakdown of muscles)

• Seizures

• Serious skin disorders, such as Stevens-Johnson syndrome or toxic epidermal necrolysis

• Withdrawal symptoms if abruptly stopped

Tell your healthcare provider immediately if you notice the emergence or worsening of any of these side effects.

Risk of Abuse and Misuse

Adderall IR and Adderall XR are both Schedule II controlled substances due to their high potential for abuse, dependence, and addiction.

Adderall IR and Adderall XR are habit-forming medications. Both have boxed warnings, the Food and Drug Administration's (FDA) strictest safety warning, because of its high potential for abuse and misuse. Improper use of stimulants like Adderall can lead to overdose and death.

Tell your healthcare provider if you have had problems with substance use disorder in the past.

Interactions

Be sure your healthcare provider knows if you also take:

• Other stimulant medications

• Selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs)

• Opioids

• Tricyclic antidepressants

• Migraine medications

• St. John's wort

Drugs that affect serotonin levels, like SSRIs and SNRIs, may interact with Adderall and cause a serious condition called serotonin syndrome.

Seek medical attention immediately if you have symptoms of serotonin syndrome, such as:

• Agitation

• Hallucinations

• Fever

• Sweating

• Shivering

• Fast heart rate

• Muscle stiffness

• Twitching

• Loss of coordination

• Nausea or vomiting

• Diarrhea

Do not use Adderall IR and Adderall XR if you have taken a monoamine oxidase inhibitor (MAOI) in the past 14 days.

Who Should Take Adderall XR vs. IR?

Your healthcare provider will determine whether taking Adderall XR or IR is best based on your or your child’s individual needs. They may consider key factors such as the severity and frequency of symptoms, your or your child’s daily routine, and response to different formulations.

Adderall XR is a longer-acting formulation designed to relieve symptoms for up to 12 hours. This can be beneficial for individuals who need to maintain focus and concentration throughout the day because it helps to prevent the need for an additional dose during school or work hours.

In contrast, Adderall IR is an immediate-release formulation designed to provide symptom relief for up to six hours. This can be beneficial for individuals who need more flexibility in their dosing schedule or who experience side effects with Adderall XR.

Communicate any concerns or side effects to your healthcare provider so that they can make any necessary adjustments to your medication regimen.

Related: Comparing Vyvanse vs. Adderall

Summary

There are two formulations of Adderall: Adderall XR and Adderall IR. Both are taken for treating ADHD, while Adderall IR is additionally taken for treating narcolepsy.

The active ingredient is the same in both medications, but they differ in how long they last in the body. Adderall XR is long-acting, while Adderall IR is short-acting. Your healthcare provider will choose between IR or XR formulation depending on your or your child’s needs.

Both medications may cause side effects, some of which can be severe and potentially life-threatening, so follow all dosage recommendations and report any side effects to your healthcare provider.

Read the original article on Verywell Health.