Comparative Pharmacology
Head-to-head clinical analysis: JORNAY PM versus LISDEXAMFETAMINE DIMESYLATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: JORNAY PM versus LISDEXAMFETAMINE DIMESYLATE.
JORNAY PM vs LISDEXAMFETAMINE DIMESYLATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
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.
Initial: 20 mg orally once daily at bedtime; increase by 20 mg weekly as needed; max 100 mg/day.
30–70 mg orally once daily in the morning.
None Documented
None Documented
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.
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.
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%.
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