Concerned About A Friend Taking Adderall XR Capsules The Wrong Way

In our latest question and answer, the pharmacist discusses how to properly take Adderall XR capsules and what happens if they are chewed.

Question

I have a good friend of mine who abuses Adderall. He takes 25mg XR usually after lunch at work. I have noticed that when he finishes eating his lunch, he takes his daily medication and openly breaks open the capsule and takes all the medication at one time. Normally after about an hour or so he seems not himself, almost sedated, and lethargic, and sometimes it is hard to have a normal conversation with him. After about an hour, this subsides and then he seems to be ok. As a friend, can you explain what may be going on? I feel strongly about approaching him and maybe if I knew more about this, I could deter him from taking his medication the improper way. Thanks.

Asked by John On Oct 20, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Oct 20, 2022
Last updated Apr 26, 2024

Key points

  • Adderall XR capsules contain numerous small drug-containing beads, that release the drug in two phases (immediate and delayed-release).
  • While Adderall XR capsules can safely be opened, and the beads mixed with food or a liquid, they should never be crushed or chewed as doing so will cause the entire dose to be released at once, increasing the risk of side effects.

Answer

Thanks for reaching out! In your question, it isn't entirely clear what your friend is doing after the Adderall XR capsules are opened, and whether or not there is anything to be concerned about in regard to how they are taking the drug.

Are they simply swallowing the contents of the Adderall XR capsule or are they chewing the contents?

We've written a number of answers about Adderall XR and it is perfectly fine to open the capsules and mix the contents with food or liquid and take it that way. One of our previous answers on the subject can be found here.

Adderall XR capsules contain a number of small drug-containing beads, and the actual outer capsule simply holds the beads together in place. It does not really influence how the drug is absorbed or works. Below is an image of Adderall XR capsules, and inside, you can see the small drug-containing beads:

Adderall Inside Capsule drug containing beads

There are two types of beads contained in Adderall XR.

One type of bead is designed to release the drug immediately upon dosing, and the other beads release the drug a few hours later to prolong the duration of action.

In fact, one Adderall XR capsule per day is designed to mimic taking two immediate-release Adderall tablets dosed four hours apart (i.e., Adderall XR 20mg is equivalent to Adderall immediate-release 10mg twice a day). You can see this illustrated in the below chart:

Adderall XR Concentration Graph

The chart above shows blood (plasma) concentrations of Adderall XR 10mg per day, and Adderall (immediate-release) 20mg per day (dosed 4 hours apart), to be essentially the same.

What Happens If You Chew The Drug-Containing Beads In Adderall XR Capsules?

It is important that when opening Adderall XR, the beads contained inside the capsule are not crushed, chewed, or otherwise altered before taking. They must be taken intact. If mixed with food or water, they must be consumed immediately, and not stored for later use.

If the beads are crushed, chewed, etc..., the entire dose will be released at once, instead of over a period of time as intended. This is considered 'dose-dumping' and will essentially cause a higher dose than intended to be ingested, increasing the risk of side effects, which include:

  • Increased heart rate
  • Sweating
  • Muscle spasms/tremors
  • Increased blood pressure
  • Anxiety
  • Irritability
  • Euphoria
  • Delirium
  • Emotional lability
  • Confusion
  • Difficulty concentrating

What you describe happening to your friend (being overly lethargic for a little bit) could be a side effect of too high a dose of amphetamine, or it could be just the effect the medication has on them.

Even though Adderall XR is a stimulant, it's certainly not uncommon that people can feel 'spacey' or 'zombie-like' on the drug, especially if a high dose is taken. It's very tough to say if this is just how the medicine affects them, or if it is due to too high a dose (it should be noted that lowering the dosage generally helps to relieve this side effect).

So, going back to your question, whether or not your friend is abusing Adderall XR depends on how they are taking it.

If their doctor prescribed them Adderall XR 25mg to be taken once daily, opening a capsule and mixing the beads with something (or just putting it in the mouth and immediately swallowing) is safe and would be following the doctor's prescription.

If they are chewing the beads before swallowing, they would not be taking the drug as directed as would be resulting in a higher blood concentration of amphetamine than intended (and a greater risk of side effects). It is also certainly possible that if your friend is chewing them, they just don't know that you are not supposed to do that.

Final Words

I hope you found this answer helpful and that it has some information you can use for your friend.

Your first step would be to find out if they are taking Adderall XR the correct way, and if not, educate them on how to properly take the drug or if they are intentionally abusing it, provide the support they need.

References

  • Adderall XR Prescribing Information, AccessFDA
  • Amphetamines: pharmacology, abuse and addiction, PubMed
  • Neuropsychiatric Adverse Effects of Amphetamine and Methamphetamine, PubMed
  • Amphetamine, PubMed
  • Potential Adverse Effects of Amphetamine Treatment on Brain and Behavior: A Review, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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