Comparative Pharmacology
Head-to-head clinical analysis: ADDERALL 5 versus AZSTARYS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ADDERALL 5 versus AZSTARYS.
ADDERALL 5 vs AZSTARYS
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Adderall 5 is a combination of dextroamphetamine and amphetamine, which are central nervous system stimulants. They increase the levels of dopamine and norepinephrine in the synaptic cleft by inhibiting their reuptake and promoting their release from presynaptic neurons.
AZSTARYS is a prodrug of dexmethylphenidate, a central nervous system stimulant. The exact mechanism of action in attention deficit hyperactivity disorder (ADHD) is unknown, but it is thought to block the reuptake of norepinephrine and dopamine into the presynaptic neuron, increasing their levels in the extraneuronal space.
Initial: 5 mg orally once or twice daily; increase by 5 mg increments at weekly intervals. Maximum: 40 mg/day in divided doses.
Initial: 39.2 mg oral once daily in the morning; titrate weekly by 19.6 mg increments as needed; maximum dose: 78.4 mg once daily.
None Documented
None Documented
Immediate-release: 9–11 hours (mean 10 hours for dextroamphetamine); extended-release: 10–13 hours. Terminal half-life may be prolonged with urinary pH >7.
Serdexmethylphenidate: 1.5 hours; dexmethylphenidate: 3.5 hours. The terminal half-life of total dexmethylphenidate after AZSTARYS is approximately 6.5 hours, supporting once-daily dosing.
Renal (90% as unchanged drug and metabolites; ~30% unchanged), minor fecal elimination (<5%).
Renal: 90% (primarily as metabolites, with 50-70% as the major metabolite (-)-phensuximide glucuronide). Fecal: <5%.
Category C
Category C
CNS Stimulant
CNS Stimulant