Converting from Concerta 36mg to Adderall
Start Adderall XR at 10 mg once daily in the morning, then titrate by 5 mg weekly increments based on response, as there is no established direct dose equivalency between methylphenidate and amphetamine formulations. 1
Conversion Algorithm
Discontinue Concerta 36mg abruptly without tapering when switching to Adderall XR, as no washout period is required between stimulant medications. 1
Initial dosing:
- Begin Adderall XR at 10 mg once daily in the morning (not 36mg equivalent) 1
- This starting dose applies regardless of your previous Concerta dose 1
Titration schedule:
- Increase by 5 mg weekly increments until optimal symptom control is achieved 1
- Maximum dose is 50 mg daily 2, 1
- Expect immediate therapeutic effects within hours of the first dose, unlike non-stimulants which require weeks for benefit 1
Why No Direct Conversion Exists
The American College of Obstetricians and Gynecologists explicitly states there is no established direct dose equivalency between methylphenidate (Concerta) and amphetamine salts (Adderall). 1 This is because:
- These are different medication classes with distinct mechanisms and pharmacokinetics
- Individual response varies significantly between methylphenidate and amphetamine preparations 3
- Starting low and titrating ensures safety while finding the optimal dose for your specific response
Important Pharmacokinetic Differences
Food effects differ substantially between these medications:
- Concerta provides consistent methylphenidate exposure regardless of food intake 4
- Adderall XR shows markedly lower amphetamine concentrations when taken with high-fat meals, resulting in significantly reduced early drug exposure (p < 0.0001) 4
- Take Adderall XR consistently either with or without food to minimize day-to-day variation in symptom control 4
Common Pitfalls to Avoid
Do not assume dose equivalency. A common error is attempting to calculate a "conversion ratio" between Concerta 36mg and Adderall—no such validated conversion exists. 1 Always start at the recommended 10mg Adderall XR starting dose. 1
Monitor for differences in duration of action. While both are extended-release formulations, Concerta uses OROS technology for 12-hour coverage 5, whereas Adderall XR's duration may vary based on individual metabolism and food intake. 4