Comparative Pharmacology
Head-to-head clinical analysis: LISDEXAMFETAMINE DIMESYLATE versus QUILLICHEW ER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LISDEXAMFETAMINE DIMESYLATE versus QUILLICHEW ER.
LISDEXAMFETAMINE DIMESYLATE vs QUILLICHEW ER
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Quillichew ER contains methylphenidate, a central nervous system (CNS) stimulant. The mechanism of action in ADHD is not fully understood, but it is thought to block the reuptake of norepinephrine and dopamine into the presynaptic neuron, increasing their availability in the extraneuronal space.
30–70 mg orally once daily in the morning.
Initial 20 mg orally once daily, titrate by 10 mg weekly to maximum 60 mg/day (methylphenidate component).
None Documented
None Documented
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.
The terminal elimination half-life of methylphenidate is approximately 3-4 hours in children and 3.5-5 hours in adults. For QuilliChew ER, the extended-release formulation provides a prolonged absorption phase, with an effective duration of action of up to 12 hours.
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%).
QuilliChew ER (methylphenidate extended-release chewable tablet) is primarily eliminated via renal excretion as metabolites (60-80%) and unchanged drug (approx. 10%). Hepatic metabolism accounts for the remainder. Fecal elimination is minimal.
Category C
Category C
CNS Stimulant
CNS Stimulant