Comparative Pharmacology
Head-to-head clinical analysis: METHYLIN versus XELSTRYM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: METHYLIN versus XELSTRYM.
METHYLIN vs XELSTRYM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Methylphenidate is a central nervous system stimulant. It blocks the reuptake of dopamine and norepinephrine into presynaptic neurons, increasing their concentrations in the synaptic cleft.
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.
10 mg orally twice daily, administered 4-6 hours apart; doses may be adjusted in 5-10 mg increments weekly up to 60 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
2-4 hours (short elimination half-life, requiring multiple daily dosing; immediate-release: 3-4 hours, extended-release: 3-6 hours)
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: 90% (mainly as metabolites, 30-50% as unchanged drug); fecal: <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