Comparative Pharmacology
Head-to-head clinical analysis: QUILLICHEW ER versus XELSTRYM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: QUILLICHEW ER versus XELSTRYM.
QUILLICHEW ER vs XELSTRYM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
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, titrate by 10 mg weekly to maximum 60 mg/day (methylphenidate component).
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 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.
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.
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.
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