Dextroamphetamine (Dexedrine)

What it treats

Dextroamphetamine is approved by the U.S. Food and Drug Administration for ADHD in children and adults, and for narcolepsy. The main use in current practice is ADHD.

Dextroamphetamine sits alongside Adderall (mixed amphetamine salts), lisdexamfetamine (Vyvanse), and the methylphenidate-family drugs (methylphenidate, dexmethylphenidate) as the standard stimulant options. For most people, one of these works well. Choosing between them is about response, side effects, and formulation fit rather than any inherent superiority of one over another.

How it works

Dextroamphetamine is a stimulant. In the brain, dopamine and norepinephrine help with attention and self-control. Dextroamphetamine increases both, in two ways. It slows their reuptake, and it also causes cells to release more of them. That combination raises signaling in the parts of the brain most involved with attention and impulse control.

Because the change happens quickly, dextroamphetamine works the day you take it, not weeks later like an antidepressant.

Receptor mechanism (detail)

Dextroamphetamine both releases dopamine and norepinephrine and blocks their reuptake at the dopamine and norepinephrine transporters (DAT and NET). That release effect is what distinguishes amphetamine-class stimulants from methylphenidate, which is a reuptake blocker without meaningful release action. Some patients respond more cleanly to one class than the other, and the receptor difference is why.

Potency and typical dosing pattern

Ranges are typical framework only, not a prescription for any individual.

• Immediate-release (IR): 5 mg once or twice daily starting, titrated to 5 to 10 mg two or three times daily. Total 5 to 40 mg per day divided.
• Extended-release capsules (Dexedrine Spansule): 5 to 30 mg once in the morning.

Dextroamphetamine's half-life is roughly 10 to 12 hours. That is longer than pure l-amphetamine, which is one reason d-amphetamine dominates ADHD prescribing.

Safety monitoring

• Baseline and periodic blood pressure, heart rate, weight, and cardiac history, including family history of sudden cardiac death.
• Sleep, appetite, mood at each visit.
• Growth in children and adolescents. Height and weight at each visit.
• Schedule II controlled substance. Assess for misuse, diversion, and appropriate storage.
• Do not combine with MAOIs (hypertensive crisis).
• Cardiac history. Serious pre-existing structural heart disease warrants careful evaluation before starting.
• Pregnancy. Potential risks discussed with prescriber.

What to expect

Common side effects

• Reduced appetite, one of the most common effects.
• Trouble sleeping, especially with late-in-the-day dosing.
• Headache and dry mouth.
• Faster heartbeat.
• Feeling jittery, restless, or anxious.
• Irritability or low mood as a dose wears off (rebound).

If a side effect is bothersome or doesn't settle, that's a conversation for the prescriber, not a reason to stop on your own.

Serious side effects and warnings

Boxed warning. Stimulant ADHD medications, including dextroamphetamine, carry an FDA boxed warning about potential for misuse, abuse, and addiction. Dextroamphetamine is a Schedule II controlled substance, the category for medications that have a recognized medical use and a high potential for misuse. Used as prescribed and monitored by a clinician, it has a long record as an effective ADHD treatment.

• Cardiovascular effects. Stimulants raise heart rate and blood pressure. For most people this is modest, but caution is needed for anyone with serious heart disease.
• Worsening anxiety or agitation.
• Psychotic symptoms. Rare, but new hallucinations or unusual paranoid thoughts warrant urgent prescriber contact.
• Slowed growth in children. Height and weight are monitored over time.
• Substance use history. A prescriber will factor this in when deciding on a stimulant.
• Circulation problems in fingers and toes (Raynaud's-like), occasional.

Sexual side effects

Dextroamphetamine isn't a notable cause of sexual side effects. Some people experience changes in libido in either direction. If a change occurs, it's worth mentioning to a prescriber.

Weight, appetite, and sleep

Reduced appetite is common and can lead to weight loss. In children, stimulants can slightly slow growth, so height and weight are tracked. Practical steps help: a good breakfast before the medication takes effect, and food available when appetite returns later in the day.

Sleep is the other thing to plan around. Dextroamphetamine can make it harder to fall asleep, so late-day doses are usually avoided. A prescriber may adjust dose or formulation if sleep is disrupted.

Starting and dosing basics

This section is general background, not a dosing instruction for any individual. The right dose is a decision for a prescriber.

Dextroamphetamine comes as immediate-release tablets (Dexedrine, also generic) and long-acting capsules (Dexedrine Spansule). A related medication, lisdexamfetamine (Vyvanse), is a prodrug that is converted to dextroamphetamine in the body, giving smoother onset and duration.

Missed doses and interactions

If a dose is missed, take it when remembered unless it's late in the day, since a late dose can disrupt sleep. Don't double up.

Because dextroamphetamine is Schedule II, prescriptions cannot be refilled the usual way. A new prescription is needed each time, which means planning ahead. The rules for prescribing controlled substances, including through telehealth, are stricter and can vary by state.

The key interaction: do not combine with MAOI antidepressants. Other stimulants and medications that raise blood pressure need prescriber attention. Give every prescriber and pharmacist the full medication list.

Stopping and tapering

Dextroamphetamine doesn't require a long taper the way some psychiatric medications do. Coordinating stopping with a prescriber is still the safer path. Some people notice tiredness or low mood for a short time after stopping, which usually passes. ADHD symptoms are likely to return, so timing and follow-up matter.

Pregnancy and breastfeeding

Individual circumstances matter, and the decision belongs with a clinician. The balance depends on how much ADHD affects daily functioning and safety, and the specific pregnancy situation. Anyone pregnant, planning a pregnancy, or breastfeeding should talk it through with their prescriber.

Cost and generic availability

Dextroamphetamine has been generic for many years and is inexpensive as immediate-release tablets. The extended-release capsule form (Dexedrine Spansule) is available generically and is more variable in cost. Most insurance plans cover it.

Common questions

How is dextroamphetamine different from Adderall? Adderall is a mixture of amphetamine salts, roughly 3 parts d-amphetamine to 1 part l-amphetamine. Dextroamphetamine is pure d-amphetamine. Some people notice differences in effect, side effects, or duration between the two.

How is it different from Vyvanse? Vyvanse (lisdexamfetamine) is a prodrug: it's dextroamphetamine attached to an amino acid, and it doesn't become active until the body cleaves them apart. That gives smoother onset and duration and lower misuse potential.

How fast does it work? Quickly, often within about an hour of the first dose.

Is it addictive? It has a potential for misuse and is a Schedule II controlled substance. Used as prescribed and monitored by a clinician, it has a long record as an effective ADHD treatment. Risk is higher with misuse.

Why can't I get a refill like a regular prescription? Schedule II medications require a new prescription each time.

Questions to ask your prescriber

• What are we hoping this treats, and how will we know it's working?
• Should we start with a short-acting or long-acting form?
• Which side effects should I expect, and which ones should I call about?
• How will refills work, since I need a new prescription each time?
• If we decide to stop it later, how would we do that?

Sources

This guide draws on current prescribing information and public health references and current as of June 8, 2026. It is reviewed for clinical accuracy and updated as guidance changes.

• U.S. Food and Drug Administration. Dextroamphetamine (Dexedrine) prescribing information.
• MedlinePlus, U.S. National Library of Medicine. Dextroamphetamine.
• National Institute of Mental Health. Mental health medications.
• American Academy of Pediatrics. ADHD Clinical Practice Guideline.
• American Psychiatric Association. Practice guidance on ADHD in adults.