ADHD Treatments- MPR

ADHD Treatments

ADHD TREATMENTS
Generic	Brand		Strength	Form	Dose
Stimulants
amphetamine	Adzenys XR-ODT¹	CII	3.1mg, 6.3mg, 9.4mg, 12.5mg, 15.7mg, 18.8mg	ext-rel ODT	<6yrs: Not established. 6–17yrs: initially 6.3mg once daily in the AM; increase in increments of 3.1mg or 6.3mg at weekly intervals; max 18.8mg/day (6–12yrs) or max 12.5mg/day (13–17yrs). ≥18yrs: 12.5mg once daily in the AM.
	Dyanavel XR¹	CII	2.5mg/mL	ext-rel oral susp	<6yrs: Not established. ≥6yrs: initially 2.5mg or 5mg once daily in the AM; may increase by 2.5mg–10mg/day every 4–7 days; max 20mg/day.
	Dyanavel XR¹	CII	5mg, 10mg, 15mg, 20mg	ext-rel tabs
amphetamine sulfate	Evekeo	CII	5mg, 10mg	tabs	<3yrs: Not recommended. 3–5yrs: initially 2.5mg daily, may increase by 2.5mg/day at weekly intervals. ≥6yrs: initially 5mg once or twice daily; may increase by 5mg/day at weekly intervals; max 40mg/day. Avoid late PM doses; give first dose upon awakening and additional doses (1–2) 4–6hrs apart.
amphetamine sulfate	Evekeo ODT	CII	5mg, 10mg, 15mg, 20mg	ODT	<6yrs: Not established. 6–17yrs: initially 5mg once in the AM or twice daily; give additional dose after 4–6hrs if needed. Titrate in increments of 5mg at weekly intervals; usual max 40mg/day. ≥18yrs: use other forms.
dextroamphetamine sulfate	—	CII	2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg, 30mg	tabs	<3yrs: Not recommended. 3–5yrs: initially 2.5mg once daily; may increase by 2.5mg at weekly intervals. ≥6yrs: initially 5mg 1–2 times daily; may increase by 5mg at weekly intervals; usual max 40mg/day. Avoid late PM doses; give first dose upon awakening and additional doses (1–2) 4–6hrs apart.
	Dexedrine Spansule	CII	5mg, 10mg, 15mg	sust-rel caps	<6yrs: Not recommended. ≥6yrs: initially 5mg 1–2 times daily; may increase by 5mg/day at weekly intervals; usual max 40mg/day.
	Zenzedi	CII	2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg, 30mg	tabs	<3yrs: Not recommended. 3–5yrs: initially 2.5mg once daily, may increase by 2.5mg/day at weekly intervals. ≥6yrs: initially 5mg once or twice daily; may increase by 5mg/day at weekly intervals; usual max 40mg/day. Avoid late PM doses; give first dose upon awakening and additional doses (1–2) 4–6hrs apart.
dexmethylphenidate HCl	Focalin	CII	2.5mg, 5mg, 10mg	tabs	<6yrs: Not established. ≥6yrs: initially 2.5mg twice daily ≥4hrs apart; may increase by 2.5–5mg weekly; max 20mg/day. Switching from racemic methylphenidate: give ½ of total daily racemic methylphenidate dose.
dexmethylphenidate HCl	Focalin XR²	CII	5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg	ext-rel caps (containing IR and del-rel beads)	<6yrs: Not established. 6–17yrs: initially 5mg once daily in the AM; may increase by 5mg weekly; max 30mg/day. ≥18yrs: initially 10mg once daily in the AM; may increase by 10mg weekly; max 40mg/day. Switching from racemic methylphenidate: give ½ of total daily racemic methylphenidate dose. Switching from dexmethylphenidate IR: give same total daily dose.
lisdexamfetamine dimesylate	Vyvanse	CII	10mg, 20mg, 30mg, 40mg, 50mg, 60mg, 70mg (caps only)	caps², chew tabs	<6yrs: Not established. ≥6yrs: initially 30mg once daily in the AM. May adjust in increments of 10mg or 20mg at weekly intervals; max 70mg/day.
methamphetamine HCl	Desoxyn	CII	5mg	tabs	<6yrs: Not established. ≥6yrs: initially 5mg 1–2 times daily; may increase in increments of 5mg at weekly intervals until response achieved. Usual range: 20–25mg daily in 2 divided doses.
methylphenidate	Cotempla XR-ODT³	CII	8.6mg, 17.3mg, 25.9mg	ext-rel ODT	<6yrs: Not established. 6–17yrs: initially 17.3mg once daily in the AM. May titrate in increments of 8.6–17.3mg weekly; max 51.8mg/day. Discontinue if no improvement seen after dose adjustment over 1 month.
methylphenidate	Daytrana	CII	10mg/9hrs, 15mg/9hrs, 20mg/9hrs, 30mg/9hrs	transdermal patch	<6yrs: Not established. 6–17yrs: initially apply one 10mg patch to hip 2hrs before desired effect, remove 9hrs after application; may remove earlier if shorter duration of effect or late day side effects appear. May titrate dose at 1wk intervals. ≥18yrs: Not applicable.
methylphenidate HCl	—	CII	5mg, 10mg, 20mg	tabs	<6yrs: Not established. 6–17yrs: initially 5mg twice daily before breakfast and lunch. Increase gradually by 5–10mg per week if needed; max 60mg/day. ≥18yrs: 10–60mg daily in 2–3 divided doses preferably 30–45mins before meals.
			2.5mg, 5mg, 10mg	chew tabs
			10mg, 20mg	ext-rel tabs⁵	Adults and Children: May use ER tabs in place of IR tabs when the 8hr dose of methylphenidate ER corresponds to the titrated 8hr dose of methylphenidate IR. Max 60mg/day.
	Aptensio XR²	CII	10mg, 15mg, 20mg, 30mg, 40mg, 50mg, 60mg	ext-rel caps	<6yrs: Not established. ≥6yrs: 10mg once daily in the AM. May titrate dose in weekly increments of 10mg/day; max 60mg/day. Discontinue if no improvement after dose adjustment over 1 month.
	Concerta⁵	CII	18mg, 27mg, 36mg, 54mg	ext-rel tabs	<6yrs: Not established. Methylphenidate-naive: 6–12yrs: initially 18mg once daily in the AM, max 54mg/day; 13–17yrs: initially 18mg once daily in the AM, max 72mg/day or 2mg/kg/day (whichever is less). 18–65yrs: initially 18mg or 36mg/day; max 72mg/day. Switching from methylphenidate 5mg 2 or 3 times daily: initially Concerta 18mg once daily. Switching from methylphenidate 10mg 2 or 3 times daily: initially Concerta 36mg once daily. Switching from methylphenidate 15mg 2 or 3 times daily: initially Concerta 54mg once daily. Switching from methylphenidate 20mg 2 or 3 times daily: initially Concerta 72mg once daily. For all: may adjust in 18mg/day increments at 1wk intervals; max 54mg/day for children; max 72mg/day for adolescents and adults.
	Jornay PM^1,2	CII	20mg, 40mg, 60mg, 80mg, 100mg	ext-rel caps	<6yrs: Not established. ≥6yrs: initially 20mg once daily at 8PM (may adjust between 6:30PM–9:30PM). May titrate in 20mg increments weekly; daily dose >100mg: not recommended. Discontinue if no improvement seen after 1 month.
	Metadate CD²	CII	10mg, 20mg, 30mg, 40mg, 50mg, 60mg	ext-rel caps (containing IR and ext-rel beads)	<6yrs: Not established. 6–15yrs: initially 20mg once daily before breakfast; may increase weekly by 10–20mg/day; max 60mg/day.
	Methylin	CII	5mg/5mL, 10mg/5mL	oral soln	<6yrs: Not established. 6–17yrs:initially 5mg twice daily before breakfast and lunch. Increase gradually by 5–10mg per week if needed; max 60mg/day. ≥18yrs: 10–60mg daily in 2–3 divided doses preferably 30–45mins before meals.
	Quillichew ER¹	CII	20mg, 30mg, 40mg	ext-rel chew tabs	<6yrs: Not established. ≥6yrs: initially 20mg once daily in the AM. May titrate dose in 10mg, 15mg, or 20mg increments. Doses >60mg: not recommended. Discontinue if no improvement seen after dose adjustment over 1 month.
	Quillivant XR^1,4	CII	5mg/mL	ext-rel oral susp	<6yrs: Not established. ≥6yrs: initially 20mg once daily in the AM. May increase by 10–20mg per week if needed; max 60mg/day. Discontinue if no improvement seen after dose adjustment over 1 month.
	Ritalin	CII	5mg, 10mg, 20mg	tabs	<6yrs: Not established. 6–17yrs: initially 5mg twice daily before breakfast and lunch. May increase by 5–10mg weekly; max 60mg/day. ≥18yrs: give in 2–3 divided doses preferably 30–45mins before meals. Usual dose: 20–30mg/day. Max 60mg/day.
	Ritalin LA²	CII	10mg, 20mg, 30mg, 40mg	ext-rel caps (containing IR and del-rel beads)	<6yrs: Not established. 6–12yrs: initially 20mg once daily in AM, may increase by 10mg weekly; max 60mg/day.
mixed dextro– amphetamine/ amphetamine salts	—	CII	5mg, 7.5mg, 10mg, 12.5mg, 15mg, 20mg, 30mg	scored tabs	<3yrs: Not recommended. 3–5yrs: initially 2.5mg once daily, may increase by 2.5mg/day weekly. ≥6yrs: initially 5mg 1–2 times daily, may increase by 5mg/day weekly; usual max 40mg/day in 2–3 divided doses. Avoid late PM doses; give first dose upon awakening and additional doses (1–2) 4–6hrs apart.
	Adderall XR²	CII	5mg, 10mg, 15mg, 20mg, 25mg, 30mg	ext-rel caps	<6yrs: Not studied. 6–12yrs: initially 10mg once daily upon awakening; may increase by 5mg/day or 10mg/day at weekly intervals; max 30mg/day. 13–17yrs: initially 10mg once daily upon awakening; may increase to 20mg/day after 1wk. ≥18yrs: 20mg once daily upon awakening. Switching from IR formulation: give total daily dose of IR tabs once daily in the AM.
	Mydayis^1,2	CII	12.5mg, 25mg, 37.5mg, 50mg	ext-rel caps	≤12yrs: Not established. 13–17yrs: initially 12.5mg once daily upon awakening; may increase by 12.5mg at weekly intervals; max 25mg/day. 18–55yrs: initially 12.5mg or 25mg once daily upon awakening; may increase by 12.5mg at weekly intervals; max 50mg/day.
serdexmethy– lphenidate/ dexmethyl– phenidate	Azstarys^1,2	CII	26.1mg/5.2mg, 39.2mg/7.8mg, 52.3mg/10.4mg	caps	<6yrs: Not established. 6–12yrs: initially 39.2mg/7.8mg once daily in the AM; may increase to 52.3mg/10.4mg per day or decrease to 26.1mg/5.2mg per day after 1 week depending on response and tolerability; max 52.3mg/10.4mg per day. ≥13yrs: initially 39.2mg/7.8mg once daily in the AM; may increase to 52.3mg/10.4mg per day after 1 week; max 52.3mg/10.4mg per day.
Nonstimulants
atomoxetine HCl	Strattera⁵	Rx	10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg	caps	<6yrs: Not established. Give once daily in the AM, or in 2 evenly divided doses (in AM and late afternoon/early PM). Acute: ≥6yrs (≤70kg): initially 0.5mg/kg/day; increase after at least 3 days to 1.2mg/kg/day; max 1.4mg/kg or 100mg/day (whichever is less); (>70kg): initially 40mg/day; increase after at least 3 days to 80mg/day, then after 2–4wks may increase to max 100mg/day. Maintenance: 6–15yrs: continue with same dose, reevaluate periodically.
clonidine HCl	Kapvay^1,5,6	Rx	0.1mg	ext-rel tabs	<6yrs: Not recommended. 6–17yrs: Individualize; titrate by response. Initially 0.1mg at bedtime for 1 week, then 0.1mg twice daily for 1 week, then 0.1mg in the AM and 0.2mg at bedtime for 1 week, then 0.2mg twice daily. Withdraw gradually; reduce by 0.1mg/day at 3–7 day intervals. ≥18yrs: Not recommended.
guanfacine	Intuniv^1,5,6,7	Rx	1mg, 2mg, 3mg, 4mg	ext-rel tabs	<6yrs: Not established. 6–17yrs: initially 1mg once daily; adjust in increments of no more than 1mg/week; target range: 0.05–0.12mg/kg/day (1–7mg/day). Doses >4mg/day: not evaluated in children (6–12yrs); doses >7mg/day: not evaluated in adolescents (13–17yrs). Withdraw gradually (by 1mg every 3–7 days). ≥18yrs: Not established.
viloxazine	Qelbree²	Rx	100mg, 150mg, 200mg	ext-rel caps	<6yrs: Not established. 6–11yrs: initially 100mg once daily; may titrate in increments of 100mg at weekly intervals based on response and tolerability; max 400mg/day. 12–17yrs: initially 200mg once daily; after 1 week, may increase in increments of 200mg based on response and tolerability; max 400mg/day. ≥18yrs: initially 200mg once daily; may titrate in increments of 200mg at weekly intervals, based on response and tolerability; max 600mg/day.
NOTES
Key: IR = immediate-release; ER = extended-release; ODT = orally disintegrating tabs ¹ Not interchangeable on a mg-per-mg basis. ² May swallow whole or sprinkle contents onto applesauce, yogurt, pudding (swallow immediately); do not crush, chew, or divide beads. ³ Place on tongue and allow to disintegrate; do not crush or chew. ⁴ Shake bottle for 10secs before use. ⁵ Swallow whole. ⁶ As monotherapy or adjunct to stimulant therapies. ⁷ Avoid with high-fat meals. (Rev. 2/2023)

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