Comparative Pharmacology
Head-to-head clinical analysis: ADDERALL 30 versus QUILLICHEW ER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ADDERALL 30 versus QUILLICHEW ER.
ADDERALL 30 vs QUILLICHEW ER
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Adderall contains mixed amphetamine salts that increase synaptic levels of dopamine and norepinephrine by inhibiting their reuptake and promoting release from presynaptic terminals.
Quillichew ER contains methylphenidate, a central nervous system (CNS) stimulant. The mechanism of action in ADHD is not fully understood, but it is thought to block the reuptake of norepinephrine and dopamine into the presynaptic neuron, increasing their availability in the extraneuronal space.
Initial: 5 mg orally once or twice daily; increase by 5 mg increments weekly; usual maintenance: 20-30 mg daily in divided doses; maximum: 40 mg/day
Initial 20 mg orally once daily, titrate by 10 mg weekly to maximum 60 mg/day (methylphenidate component).
None Documented
None Documented
Terminal elimination half-life: d-amphetamine 10-13 hours, l-amphetamine 13-15 hours; in adults (children: 6-8 hours). The longer half-life allows for once-daily dosing.
The terminal elimination half-life of methylphenidate is approximately 3-4 hours in children and 3.5-5 hours in adults. For QuilliChew ER, the extended-release formulation provides a prolonged absorption phase, with an effective duration of action of up to 12 hours.
Approximately 30-40% of a dose is excreted unchanged in urine; the remainder is metabolized primarily by oxidative deamination and aromatic hydroxylation. Biliary/fecal elimination accounts for less than 5%.
QuilliChew ER (methylphenidate extended-release chewable tablet) is primarily eliminated via renal excretion as metabolites (60-80%) and unchanged drug (approx. 10%). Hepatic metabolism accounts for the remainder. Fecal elimination is minimal.
Category C
Category C
CNS Stimulant
CNS Stimulant