Comparative Pharmacology
Head-to-head clinical analysis: ADDERALL 30 versus XELSTRYM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ADDERALL 30 versus XELSTRYM.
ADDERALL 30 vs XELSTRYM
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.
XELSTRYM (dextroamphetamine transdermal system) is a sympathomimetic amine that increases synaptic concentrations of dopamine and norepinephrine by inhibiting their reuptake and promoting their release from presynaptic terminals.
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: one 9-mg patch applied to the hip once daily; titrate weekly in 4.5-mg increments to desired effect; maximum dose: 18 mg/day.
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.
Mean terminal elimination half-life of dexmethylphenidate is approximately 2-3 hours in children and adolescents, with no significant accumulation at steady state; clinical effects correlate with plasma concentrations.
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%.
Renal (90% as unchanged drug and metabolites, primarily dehydrodexmethylphenidate and inactive metabolites); minor biliary/fecal elimination (<5%)
Category C
Category C
CNS Stimulant
CNS Stimulant