Comparative Pharmacology
Head-to-head clinical analysis: ADDERALL XR 5 versus XELSTRYM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ADDERALL XR 5 versus XELSTRYM.
ADDERALL XR 5 vs XELSTRYM
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.
XELSTRYM (dextroamphetamine transdermal system) is a sympathomimetic amine that increases synaptic concentrations of dopamine and norepinephrine by inhibiting their reuptake and promoting their release from presynaptic terminals.
20 mg orally once daily in the morning
Initial: one 9-mg patch applied to the hip once daily; titrate weekly in 4.5-mg increments to desired effect; maximum dose: 18 mg/day.
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.
Mean terminal elimination half-life of dexmethylphenidate is approximately 2-3 hours in children and adolescents, with no significant accumulation at steady state; clinical effects correlate with plasma concentrations.
Renal (approximately 90% as unchanged drug and metabolites, with 30-40% as unchanged amphetamine), fecal (minimal, <5%)
Renal (90% as unchanged drug and metabolites, primarily dehydrodexmethylphenidate and inactive metabolites); minor biliary/fecal elimination (<5%)
Category C
Category C
CNS Stimulant
CNS Stimulant