Comparative Pharmacology
Head-to-head clinical analysis: ADDERALL XR 15 versus JORNAY PM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ADDERALL XR 15 versus JORNAY PM.
ADDERALL XR 15 vs JORNAY PM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
ADDERALL XR contains a mixture of amphetamine salts, including dextroamphetamine and levoamphetamine. The mechanism of action involves increasing synaptic levels of dopamine and norepinephrine by inhibiting their reuptake and enhancing their release from presynaptic terminals, leading to CNS stimulation.
Methylphenidate is a central nervous system (CNS) stimulant. The mode of action in attention deficit hyperactivity disorder (ADHD) is not fully understood, but methylphenidate is thought to block the reuptake of norepinephrine and dopamine into the presynaptic neuron, increasing the levels of these neurotransmitters in the extraneuronal space.
Oral, 20-60 mg once daily in the morning; initial dose 20 mg once daily, titrated by 10-20 mg weekly based on tolerability and efficacy.
Initial: 20 mg orally once daily at bedtime; increase by 20 mg weekly as needed; max 100 mg/day.
None Documented
None Documented
The terminal elimination half-life of amphetamine in adults is approximately 10-13 hours; in children, it is slightly shorter (6-8 hours). For the l-amphetamine isomer, the half-life is 9-11 hours. The extended-release formulation provides a prolonged duration of effect due to a biphasic release profile.
The terminal elimination half-life of methylphenidate following JORNAY PM administration is approximately 4-5 hours. This relatively short half-life necessitates the delayed-release/extended-release formulation to provide a prolonged duration of effect.
Renal: approximately 90% of a dose is excreted in urine, with about 30% as unchanged amphetamine and the remainder as metabolites including deaminated and oxidized products; fecal excretion accounts for less than 10%.
Methylphenidate and its metabolites are primarily excreted in urine (approximately 90%) as metabolites (mainly ritalinic acid) with about 2% unchanged parent drug. Fecal excretion accounts for <1%.
Category C
Category C
CNS Stimulant
CNS Stimulant