A blue pill imprinted with E 111 is a generic formulation of Dextroamphetamine Mixed Salts / Amphetamine Mixed Salts (commonly known as generic Adderall). Manufactured primarily by Sandoz Pharmaceuticals (and formerly Sandoz/Eon Labs), it is a central nervous system (CNS) stimulant available by prescription only.
Because it contains amphetamines, it is classified as a Schedule II controlled substance in the United States due to its high potential for abuse, dependence, and addiction.
Pill Identification
Characteristic Specification
- Imprint Code –
E 111 - Active Ingredients – Dextroamphetamine Saccharate, Amphetamine Aspartate, Dextroamphetamine Sulfate, Amphetamine Sulfate
- Strength – 10 mg (or 7.5 mg depending on manufacturer variant; 10 mg is most common)
- Drug Class – Central Nervous System (CNS) Stimulant
- Color – Blue
- Shape – Round or Oval
- Formulation – Immediate-Release (IR)
- Note: Pill colors and exact shapes can vary slightly based on the drug manufacturer. Always verify unknown medications with a pharmacist before consumption.
Indications & Medical Uses
The E 111 tablet is FDA-approved for the treatment of:
- Attention Deficit Hyperactivity Disorder (ADHD): Helps increase attention span, decrease impulsivity, and reduce hyperactivity in children and adults.
- Narcolepsy: Helps reduce excessive daytime sleepiness and uncontrollable sleep attacks.
Mechanism of Action
Amphetamine and dextroamphetamine work by stimulating the central nervous system to increase brain activity in areas that control attention and behavior.
- Neurotransmitter Reuptake Inhibition: It inhibits the reuptake of dopamine and norepinephrine into the presynaptic neuron, increasing their concentration in the synaptic cleft.
- Promoted Neurotransmitter Release: It stimulates the direct release of dopamine and norepinephrine from storage vesicles into the synapse.
- Therapeutic Effect: Higher levels of dopamine improve reward processing, motivation, and motor control, while increased norepinephrine enhances alertness, energy, and focused execution.
Dosage & Administration
Dosage varies widely based on individual patient response, age, and condition.
- Administration: Taken orally, usually once or twice daily. Immediate-release (IR) formulations typically act within 30 to 60 minutes and last between 4 to 6 hours.
- Timing: The first dose is generally taken upon waking. If a second dose is prescribed, it should be taken in the early afternoon to prevent severe insomnia at night.
- Titration: Doctors typically start patients on the lowest effective dose (e.g., 5 mg or 10 mg daily) and gradually increase it based on therapeutic response and tolerance.
- Missed Dose: Take as soon as remembered, but skip if it is late afternoon or evening to avoid sleep disruption. Do not double the dose.
Side Effects
Common Side Effects
- Cardiovascular: Elevated heart rate (tachycardia), increased blood pressure, palpitations.
- Gastrointestinal: Decreased appetite, dry mouth (xerostomia), stomach pain, weight loss, nausea.
- Neurological/Psychiatric: Insomnia, restlessness, anxiety, irritability, headaches, dizziness.
Severe Side Effects (Seek Immediate Medical Care)
- Cardiovascular Events: Chest pain, shortness of breath, fainting (syncope).
- Psychiatric Symptoms: New or worsening psychosis, hallucinations (seeing or hearing things that aren’t there), paranoia, or extreme aggression.
- Circulatory Changes: Coldness, numbness, pain, or color changes in fingers or toes (Raynaud’s phenomenon).
- Serotonin Syndrome: High fever, severe muscle stiffness, seizures, or confusion (especially when combined with other serotonergic medications).
Precautions & Drug Interactions
- Cardiovascular Risk: Pre-existing heart conditions, structural heart defects, hypertension, or a history of arrhythmias increase the risk of sudden cardiac death or stroke.
- Psychiatric Conditions: May exacerbate underlying bipolar disorder, severe anxiety, or pre-existing psychotic disorders.
- Drug Interactions:
- MAO Inhibitors (MAOIs): Co-administration with or within 14 days of taking MAOIs (e.g., phenelzine, selegiline) is strictly contraindicated due to the risk of a severe, life-threatening hypertensive crisis.
- Serotonergic Drugs: SSRIs, SNRIs, and triptans combined with amphetamines can increase the risk of serotonin syndrome.
- Acidifying/Alkalinizing Agents: Gastrointestinal acidifying agents (like Vitamin C or fruit juices) lower amphetamine absorption, while alkalinizing agents (like sodium bicarbonate/antacids) increase absorption and prolong drug effects.
Black Box Warnings & Addiction Risk
- FDA BLACK BOX WARNING: HIGH POTENTIAL FOR ABUSE AND DEPENDENCE
- Abuse & Dependence: Amphetamines have a high potential for abuse, misuse, and psychological/physical dependence. Prolonged administration may lead to drug dependence and tolerance.
- Misuse: Often misused as a “study aid” or performance enhancer to increase wakefulness and stamina. Non-medical use can lead to serious cardiovascular events, addiction, severe depression, and chronic psychosis.
- Withdrawal: Abrupt cessation after prolonged high-dose use can cause severe fatigue, depression, sleep disturbances, and intense drug cravings.
- Pregnancy & Lactation: Should only be used during pregnancy if the potential benefit outweighs the potential risk to the fetus. Amphetamines pass into breast milk; breastfeeding while taking this medication is generally not recommended.