What are comparable Attention Deficit Hyperactivity Disorder (ADHD) medications to Mydayis (amphetamine and dextroamphetamine)?

Comparable ADHD Medications to Mydayis

For patients requiring an alternative to Mydayis (mixed amphetamine salts extended-release), other amphetamine-based stimulants such as Adderall XR, Vyvanse (lisdexamphetamine), or Dexedrine (dextroamphetamine) are the most comparable options based on their similar mechanism of action and efficacy profiles. 1

Comparable Amphetamine-Based Alternatives

Extended-Release Options

• Adderall XR: Contains the same 3:1 ratio of dextroamphetamine to levoamphetamine as Mydayis but with a shorter duration (12 hours vs. 16 hours for Mydayis) 2
• Vyvanse (lisdexamphetamine): A prodrug that converts to dextroamphetamine in the body, providing smooth release over 10-14 hours
• Dexedrine Spansules (dextroamphetamine): Extended-release dextroamphetamine capsules lasting 8-10 hours

Immediate-Release Options

• Adderall IR (mixed amphetamine salts): Same active ingredients as Mydayis but requires multiple daily dosing
• Dexedrine IR (dextroamphetamine): Pure dextroamphetamine requiring multiple daily dosing

Efficacy Considerations

Amphetamine-based stimulants are highly effective for ADHD treatment, with studies showing:

• 42% reduction in ADHD symptoms with mixed amphetamine salts 3
• 70% response rate (defined as ≥30% reduction in symptoms) 3
• Significant improvement in core ADHD symptoms (SMD = -0.72; 95% CI -0.87 to -0.57) 4

Recent meta-analyses suggest amphetamines may be the preferred therapy for adults with ADHD 5, making these alternatives particularly appropriate for adult patients previously on Mydayis.

Dosing Considerations

When switching from Mydayis to another amphetamine-based medication:

• Start at a lower dose and titrate up weekly
• Typical starting doses:
  • Adderall XR: 10 mg once daily
  • Vyvanse: 30 mg once daily
  • Dexedrine Spansules: 5-10 mg once daily

Maximum daily doses should generally not exceed:

• Adderall XR: 40-50 mg daily
• Vyvanse: 70 mg daily
• Dexedrine: 40 mg daily 1

Non-Amphetamine Alternatives

If amphetamine-based medications are contraindicated or poorly tolerated:

Methylphenidate-Based Options

• Concerta, Ritalin LA, Aptensio XR: Extended-release methylphenidate formulations
• Focalin XR: Extended-release dexmethylphenidate

Non-Stimulant Options

• Atomoxetine (Strattera): Norepinephrine reuptake inhibitor
• Viloxazine (Qelbree): Recently approved non-stimulant
• Guanfacine XR (Intuniv) or Clonidine XR (Kapvay): Alpha-2 adrenergic agonists
• Bupropion: Off-label option with moderate efficacy 5, 1

Clinical Considerations When Switching

1. Duration of action: Mydayis provides 16-hour coverage; other medications may require additional dosing for similar coverage
2. Timing of administration: Morning dosing is typical for extended-release formulations
3. Tolerability: Monitor for common side effects (decreased appetite, insomnia, increased heart rate/blood pressure)
4. Efficacy monitoring: Use standardized ADHD rating scales to assess response 1

Common Pitfalls to Avoid

• Inadequate dose titration: Insufficient dosing is a common reason for treatment failure
• Premature discontinuation: Allow 4-6 weeks at optimal dose before determining efficacy
• Neglecting comorbidities: Anxiety, depression, or substance use disorders may require additional treatment 1
• Overlooking duration of coverage: If switching from Mydayis (16-hour coverage), patients may need supplemental immediate-release medication for adequate symptom control throughout the day

For patients with comorbid mood or anxiety disorders, combination therapy may be necessary, as studies show amphetamines primarily address ADHD symptoms while medications like paroxetine better target mood/anxiety symptoms 6.