Comparative Pharmacology
Head-to-head clinical analysis: ADDERALL 20 versus CONCERTA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ADDERALL 20 versus CONCERTA.
ADDERALL 20 vs CONCERTA
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Adderall 20 is a combination of amphetamine and dextroamphetamine, which are central nervous system stimulants. They increase the levels of norepinephrine and dopamine in synaptic clefts by inhibiting their reuptake and promoting their release from presynaptic neurons.
Methylphenidate is a central nervous system (CNS) stimulant. It blocks the reuptake of norepinephrine and dopamine into presynaptic neurons, increasing their levels in the synaptic cleft. It also acts as a dopamine agonist by stimulating the release of dopamine from storage sites.
Initial: 5 mg orally once or twice daily; may increase by 5 mg increments at weekly intervals. Usual effective dose: 20-40 mg/day divided into 1-2 doses. Maximum: 40 mg/day (immediate-release); 60 mg/day (extended-release).
18-72 mg orally once daily in the morning, starting at 18-36 mg/day and titrating in 18 mg increments weekly; maximum 72 mg/day.
None Documented
None Documented
d-Amphetamine: 10-13h; l-Amphetamine: 13-16h. Clinical steady-state reached in 2-3 days.
Terminal elimination half-life of methylphenidate from CONCERTA is approximately 3.5 hours (range 2.5-5.5 hours) in adults; in children, mean half-life is 3-4 hours. The extended-release formulation provides a prolonged clinical effect due to the OROS delivery system, not prolonged half-life.
Renal: ~90% unchanged; ~10% as deaminated metabolites; fecal <5%.
Primarily renal (77%-87% as unchanged drug and metabolites); metabolic elimination accounts for 13%-23%, with minor biliary excretion (<2%).
Category C
Category C
CNS Stimulant
CNS Stimulant