What Mydayis (mixed amphetamine salts extended‑release) dose is equivalent to a 30 mg dose of Adderall XR (mixed amphetamine salts extended‑release)?

Mydayis Dosing Equivalent to 30 mg Adderall XR

There is no established direct dose equivalency between Mydayis and Adderall XR, so start Mydayis at 12.5 mg once daily and titrate by 12.5 mg weekly increments based on clinical response, as both formulations contain identical mixed amphetamine salts but differ in their extended-release mechanisms and duration of action.

Evidence-Based Rationale for Lack of Direct Conversion

Pharmacokinetic Differences Between Formulations

• Adderall XR uses a dual-bead system that releases 50% of the dose immediately and 50% approximately 4 hours later, providing approximately 12 hours of symptom control 1
• Mydayis (triple-bead mixed amphetamine salts) employs a three-phase release mechanism designed for duration of action up to 16 hours, significantly extending coverage beyond Adderall XR 2
• The bioavailability and pharmacokinetic profiles differ substantially between these formulations despite containing the same 3:1 ratio of dextroamphetamine to levoamphetamine 1

Why Direct Milligram-for-Milligram Conversion Is Not Appropriate

• Different extended-release technologies produce distinct plasma concentration curves, making direct dose equivalency impossible to establish 3
• The triple-bead formulation in Mydayis creates a unique pharmacokinetic profile with extended duration that cannot be directly compared to the dual-bead Adderall XR system 2

Recommended Conversion Algorithm

Step 1: Initial Mydayis Dosing

• Discontinue Adderall XR 30 mg abruptly without tapering—no washout period is required when switching between amphetamine formulations 3, 4
• Initiate Mydayis at 12.5 mg once daily in the morning on the day after the last Adderall XR dose 2
• Starting at the lowest available Mydayis dose (12.5 mg) allows assessment of the patient's response to the extended 16-hour duration before escalating 2

Step 2: Titration Schedule

• Increase Mydayis by 12.5 mg weekly increments based on symptom control and tolerability, with maximum dose of 50 mg daily 5, 2
• Most patients previously on Adderall XR 30 mg will likely require Mydayis 25-37.5 mg for equivalent symptom control, though individual response varies 2
• Expect immediate therapeutic effects within 1.5 hours of the first Mydayis dose, as both are amphetamine-based stimulants with rapid onset 1, 3

Step 3: Assessment of Extended Duration

• Evaluate symptom control using the Time-Sensitive ADHD Symptom Scale (TASS) at 13-16 hours post-dose to assess whether the extended duration provides additional benefit 2
• The primary advantage of Mydayis over Adderall XR is coverage extending into late afternoon and early evening (up to 16 hours vs 12 hours) 2

Critical Monitoring Parameters

Weekly Assessment During Titration

• Evaluate ADHD symptom control weekly using standardized rating scales (ADHD-RS-IV) to guide dose adjustments 6, 2
• Assess both inattentive and hyperactive-impulsive symptom domains separately, as response may differ 6
• Monitor for treatment-emergent adverse effects including insomnia, decreased appetite, weight loss, dry mouth, and headache 2

Vital Signs and Safety Monitoring

• Record blood pressure, heart rate, and body weight at each visit during titration 6
• Most adverse events with Mydayis are mild to moderate in severity and consistent with amphetamine treatment 2

Common Pitfalls to Avoid

Pitfall 1: Assuming 1:1 Dose Equivalency

• Never assume that 30 mg Adderall XR equals 30 mg Mydayis—the extended-release mechanisms differ substantially, requiring individualized titration starting at lower doses 3, 2
• Starting too high increases risk of adverse effects without allowing assessment of the patient's response to the unique triple-bead formulation 2

Pitfall 2: Inadequate Trial Duration

• Allow at least 4-6 weeks at each Mydayis dose before concluding inadequate response, as full therapeutic benefit may take several weeks to manifest 6
• Premature dose escalation can lead to unnecessary adverse effects 6

Pitfall 3: Ignoring Extended Duration Benefits

• The key advantage of Mydayis is extended coverage into evening hours—specifically assess late-day symptom control (13-16 hours post-dose) to determine if this benefit is clinically meaningful for the patient 2
• Some patients may not require or benefit from 16-hour coverage and may be adequately managed with Adderall XR's 12-hour duration 1, 2

Pitfall 4: Overlooking Food Effects

• Adderall XR shows markedly lower amphetamine concentrations when taken with high-fat meals, resulting in significantly reduced early drug exposure 3
• Instruct patients to take Mydayis consistently either with or without food to maintain stable plasma levels 3

Expected Clinical Outcomes

Efficacy Timeline

• Initial symptom improvement should be evident within hours of the first dose, with maximal benefit typically achieved within 2-4 weeks at therapeutic dose 1, 2
• Mydayis demonstrated significantly greater improvement in ADHD-RS-IV total scores compared to placebo (p < 0.0001) in adult trials 2

Quality of Life Improvements

• Mydayis significantly improved all domains of the Adult ADHD Impact Module (AIM-A) measuring quality of life (p ≤ 0.01) 2
• Executive function improvements were demonstrated through significant reductions in Brown Attention-Deficit Disorder Scale (BADDS) total scores (p < 0.0001) 2