Comparative Pharmacology
Head-to-head clinical analysis: ADDERALL XR 20 versus LISDEXAMFETAMINE DIMESYLATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ADDERALL XR 20 versus LISDEXAMFETAMINE DIMESYLATE.
ADDERALL XR 20 vs LISDEXAMFETAMINE DIMESYLATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Adderall XR 20 is a combination of amphetamine enantiomers (dextroamphetamine and levoamphetamine). It increases synaptic levels of dopamine and norepinephrine by inhibiting their reuptake and promoting their release from presynaptic terminals.
Lisdexamfetamine is a prodrug of dextroamphetamine, which blocks the reuptake of norepinephrine and dopamine from the synaptic cleft and increases their release into the extraneuronal space.
20 mg orally once daily in the morning.
30–70 mg orally once daily in the morning.
None Documented
None Documented
Approximately 10-13 hours for d-amphetamine and 13-15 hours for l-amphetamine in adults; in children, 9-11 hours. The extended-release formulation provides a prolonged therapeutic effect masking shorter elimination.
Terminal elimination half-life of lisdexamfetamine is approximately 1 hour (prodrug conversion), while dextroamphetamine (active moiety) has a half-life of 10-12 hours in adults. In children, half-life is slightly shorter (9-11 hours). Clinically, once-daily dosing provides symptom control for ADHD.
Approximately 90% of an oral dose is excreted renally, with 30% as unchanged amphetamine and the remainder as metabolites (including hippuric acid, benzoic acid, and hydroxylated derivatives). Fecal/biliary excretion accounts for <10%.
Primarily renal: approximately 95% of the dose is excreted in urine, with about 70% as intact lisdexamfetamine, 20% as dextroamphetamine and its metabolites (hippuric acid, benzoic acid), and minimal biliary/fecal elimination (<5%).
Category C
Category C
CNS Stimulant
CNS Stimulant