Comparative Pharmacology
Head-to-head clinical analysis: JORNAY PM versus XELSTRYM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: JORNAY PM versus XELSTRYM.
JORNAY PM vs XELSTRYM
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.
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.
Initial: 20 mg orally once daily at bedtime; increase by 20 mg weekly as needed; max 100 mg/day.
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
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.
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.
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%.
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