Comparative Pharmacology
Head-to-head clinical analysis: CONCERTA versus DEXTROSTAT.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CONCERTA versus DEXTROSTAT.
CONCERTA vs DEXTROSTAT
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Methylphenidate is a central nervous system (CNS) stimulant. It blocks the reuptake of norepinephrine and dopamine into presynaptic neurons, increasing their levels in the synaptic cleft. It also acts as a dopamine agonist by stimulating the release of dopamine from storage sites.
Dextroamphetamine is a central nervous system stimulant that promotes release of dopamine and norepinephrine from presynaptic neurons, and inhibits their reuptake, thereby increasing synaptic concentrations of these neurotransmitters.
18-72 mg orally once daily in the morning, starting at 18-36 mg/day and titrating in 18 mg increments weekly; maximum 72 mg/day.
5-60 mg orally per day in divided doses, typically 5-10 mg 2-3 times daily, maximum 60 mg/day.
None Documented
None Documented
Terminal elimination half-life of methylphenidate from CONCERTA is approximately 3.5 hours (range 2.5-5.5 hours) in adults; in children, mean half-life is 3-4 hours. The extended-release formulation provides a prolonged clinical effect due to the OROS delivery system, not prolonged half-life.
Terminal elimination half-life is approximately 10-13 hours in adults, 6-8 hours in children. Extended duration allows once-daily dosing in some patients.
Primarily renal (77%-87% as unchanged drug and metabolites); metabolic elimination accounts for 13%-23%, with minor biliary excretion (<2%).
Primarily renal (approximately 90% as unchanged drug and metabolites); minor biliary/fecal elimination (<10%).
Category C
Category C
CNS Stimulant
CNS Stimulant