Maximum Daily Dosage of Dexedrine

Regulatory Maximum Dose

The American Academy of Child and Adolescent Psychiatry recommends a maximum total daily dose of 40 mg per day for dextroamphetamine, with some patients being treated with up to 0.9 mg/kg or 40 mg, whichever is lower, for adults and older adolescents 1, 2
For adults and older adolescents, the maximum daily dose should not exceed 40 mg, with the American Academy of Child and Adolescent Psychiatry reinforcing this as the regulatory standard for amphetamines 2

When prescribing both Dexedrine Spansule and immediate-release Dexedrine, the American Academy of Child and Adolescent Psychiatry suggests adding the morning and noon doses together to determine the Spansule dose, then adding a separate immediate-release dose in the afternoon if needed, with a maximum total daily dose of 40 mg 1
The dosing approach may involve prescribing Dexedrine Spansule 20 mg in the morning, and adding immediate-release Dexedrine 5-10 mg in the early afternoon if needed, with the total daily dose not exceeding 40 mg 1, 2

If considering exceeding 40 mg/day, the American Academy of Child and Adolescent Psychiatry recommends clearly documenting that symptoms could not be controlled at lower doses, higher doses are not producing side effects, and the patient should be monitored for signs of tolerance 1, 2
Approximately 90% of patients respond when both stimulant classes are tried sequentially, so if the 40 mg/day maximum does not provide adequate symptom control, consider switching to an alternative stimulant rather than further dose escalation 1, 2

The American Academy of Child and Adolescent Psychiatry recommends assessing blood pressure and pulse, height and weight, and side effects, particularly insomnia, anorexia, irritability, and cardiovascular symptoms, at each visit 1, 2

Do not exceed 40 mg/day without exceptional documentation and justification, and do not add afternoon doses that defeat the purpose of using sustained-release formulations, according to the American Academy of Child and Adolescent Psychiatry 1, 2
Titrate doses in 5 mg increments at weekly intervals, and avoid advancing doses too quickly, as recommended by the American Academy of Child and Adolescent Psychiatry 3