What is the difference between amphetamine-dextroamphetamine (Adderall) 10mg and dextroamphetamine-amphetamine (Dexedrine) extended release (ER) 15mg?

From the Guidelines

The primary difference between amphetamine-dextroamphetamine 10mg and dextroamp-amphet ER 15mg lies in their formulation, with the former being an immediate-release and the latter an extended-release, impacting their duration of action and dosing frequency. The immediate-release formulation of amphetamine-dextroamphetamine 10mg starts working within 30 minutes, with its effects lasting approximately 4-6 hours, necessitating multiple daily doses 1. In contrast, the extended-release formulation, dextroamp-amphet ER 15mg, releases the medication gradually over a period of 10-12 hours, allowing for once-daily dosing. Key points to consider include:

• The difference in release mechanisms: immediate-release vs. extended-release
• Duration of action: 4-6 hours for immediate-release vs. 10-12 hours for extended-release
• Dosing frequency: multiple times a day for immediate-release vs. once daily for extended-release
• Dosage: 10mg for immediate-release vs. 15mg for extended-release, reflecting the extended duration of action for the latter Both formulations contain the same active ingredients, a mixture of amphetamine salts, and are indicated for the treatment of ADHD and narcolepsy. However, the extended-release formulation may offer advantages in terms of convenience and potentially smoother medication levels throughout the day, with fewer peaks and valleys. It is crucial for patients to adhere to their doctor's instructions regarding the timing and administration of these medications, given the differences in their pharmacokinetic profiles and the potential for varying side effects, such as decreased appetite, sleep disturbances, and increased blood pressure and pulse 1.

From the FDA Drug Label

CLINICAL PHARMACOLOGY Amphetamines are non-catecholamine, sympathomimetic amines with CNS stimulant activity. DESCRIPTION A single-entity amphetamine product combining the neutral sulfate salts of dextroamphetamine and amphetamine, with the dextro isomer of amphetamine saccharate and d, l-amphetamine aspartate monohydrate. EACH TABLET CONTAINS 5 mg 7.5 mg 10 mg 12.5 mg 15 mg 20 mg 30 mg Dextroamphetamine Saccharate 1.25 mg 1.875mg 2.5 mg 3.125mg 3.75 mg 5 mg 7.5 mg Amphetamine Aspartate Monohydrate 1. 25 mg 1.875mg 2.5 mg 3.125mg 3.75 mg 5 mg 7.5 mg Dextroamphetamine Sulfate, USP 1.25 mg 1.875mg 2.5 mg 3.125mg 3.75 mg 5 mg 7.5 mg Amphetamine Sulfate, USP 1.25 mg 1.875mg 2.5 mg 3.125mg 3.75 mg 5 mg 7.5 mg Total Amphetamine Base Equivalence 3.13 mg 4.7 mg 6.3 mg 7.8 mg 9.4 mg 12.6 mg 18. 8 mg

The main differences between amphetamine-dextroamphetamine 10mg and dextroamphetamine-amphetamine ER 15mg are:

• Dosage: amphetamine-dextroamphetamine 10mg contains 10mg of the active ingredients, while dextroamphetamine-amphetamine ER 15mg contains 15mg of the active ingredients, but with a different composition of the amphetamine salts.
• Composition: amphetamine-dextroamphetamine 10mg contains dextroamphetamine sulfate, while dextroamphetamine-amphetamine ER 15mg contains a combination of dextroamphetamine saccharate, amphetamine aspartate monohydrate, dextroamphetamine sulfate, and amphetamine sulfate.
• Release mechanism: The label does not explicitly describe the release mechanism of the 10mg formulation, while the 15mg formulation is described as an extended-release (ER) formulation 2. The amphetamine base equivalence for the 10mg and 15mg formulations are not directly comparable, as the label does not provide the amphetamine base equivalence for the 10mg formulation. However, for the 15mg formulation, the total amphetamine base equivalence is 9.4mg 2.

From the Research

Difference between Amphetamine-Dextroamphetamine 10mg and Dextroamphetamine ER 15mg

• The main difference between amphetamine-dextroamphetamine 10mg and dextroamphetamine ER 15mg lies in their composition and dosage form.
• Amphetamine-dextroamphetamine 10mg is a combination of amphetamine and dextroamphetamine, whereas dextroamphetamine ER 15mg is an extended-release formulation of dextroamphetamine only 3.
• The extended-release formulation of dextroamphetamine ER 15mg is designed to release the medication slowly over time, providing a longer duration of action compared to the immediate-release formulation of amphetamine-dextroamphetamine 10mg 4.
• In terms of efficacy, both medications have been shown to be effective in reducing the severity of ADHD symptoms, but the extended-release formulation of dextroamphetamine ER 15mg may provide a more sustained release of the medication, leading to improved symptom control throughout the day 4.
• The side effect profiles of the two medications may also differ, with amphetamine-dextroamphetamine 10mg potentially causing more side effects due to its combination of amphetamine and dextroamphetamine, whereas dextroamphetamine ER 15mg may have a more favorable side effect profile due to its extended-release formulation 5, 6.

Key Points to Consider

• The choice between amphetamine-dextroamphetamine 10mg and dextroamphetamine ER 15mg should be based on individual patient needs and medical history.
• Patients should be monitored closely for side effects and efficacy when switching between these two medications.
• The extended-release formulation of dextroamphetamine ER 15mg may be a better option for patients who require a longer duration of action and more sustained symptom control throughout the day 4.
• Further research is needed to fully understand the differences between these two medications and their effects on ADHD symptoms and side effects 3, 7.