Comparative Pharmacology
Head-to-head clinical analysis: ADDERALL XR 5 versus AZSTARYS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ADDERALL XR 5 versus AZSTARYS.
ADDERALL XR 5 vs AZSTARYS
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Adderall XR 5 contains a combination of amphetamine and dextroamphetamine, 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.
20 mg orally once daily in the morning
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
d-Amphetamine: 10-13 hours (adults), 11-14 hours (children); l-Amphetamine: 13-15 hours (adults). The prolonged terminal half-life of the extended-release formulation supports once-daily dosing.
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 (approximately 90% as unchanged drug and metabolites, with 30-40% as unchanged amphetamine), fecal (minimal, <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