Comparative Pharmacology
Head-to-head clinical analysis: ADDERALL XR 25 versus JORNAY PM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ADDERALL XR 25 versus JORNAY PM.
ADDERALL XR 25 vs JORNAY PM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Adderall XR is a combination of dextroamphetamine and amphetamine, which are non-catecholamine sympathomimetic amines that promote release of catecholamines (primarily dopamine and norepinephrine) from presynaptic nerve terminals and inhibit their reuptake, resulting in increased synaptic concentrations. This leads 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.
20-60 mg orally once daily in the morning; starting dose 20 mg, titrate weekly by 10-20 mg based on response and tolerability.
Initial: 20 mg orally once daily at bedtime; increase by 20 mg weekly as needed; max 100 mg/day.
None Documented
None Documented
Dextroamphetamine: 10-13 hours; levoamphetamine: 11-14 hours. Effective half-life supports once-daily dosing with extended duration.
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% (30-40% unchanged, remainder as metabolites); fecal: minimal (<2%) via biliary elimination.
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