Comparative Pharmacology
Head-to-head clinical analysis: QUILLIVANT XR versus XELSTRYM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: QUILLIVANT XR versus XELSTRYM.
QUILLIVANT XR vs XELSTRYM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Extended-release oral suspension formulation of methylphenidate, a central nervous system stimulant that inhibits the reuptake of dopamine and norepinephrine into presynaptic neurons, increasing their synaptic concentrations. The exact therapeutic effect in ADHD is unknown but is thought to involve dopaminergic and noradrenergic pathways in the prefrontal cortex.
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: 25 mg orally once daily in the morning; may increase weekly in 25 mg increments based on tolerability and response. Maximum: 75 mg once daily.
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
Approximately 4 hours; extended-release formulation provides therapeutic levels for ~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.
Primarily renal (approximately 60% as unchanged drug); fecal excretion accounts for <5%.
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