How to Dose Attention-Deficit/Hyperactivity Disorder Medications Without a Grain of Salt

Dorothy Engelking, MSNeos Therapeutics, Inc.2940 N. Highway 360Grand Prairie, TX 75050 dengelking@neostx.com To the Editor: Many clinicians have asked why some stimulant medications for the treatment of attention-deficit/hyperactivity disorder (ADHD) with the same active moiety (often methylphenidate or amphetamine) differ in the labeled dosage. Comparison of Attention-Deficit/Hyperactivity Disorder Medications with a Salt or Nonsalt Form of the Active Ingredient Drug Active ingredient Salt amount (mg) Conversion factora Active moiety amount (mg) Methylphenidate Cotempla XR-ODT Methylphenidate — — 25.9 Ritalin LA Methylphenidate hydrochloride 30 86.47% 25.9 Concerta Methylphenidate hydrochloride 36 86.47% 31.1 Amphetamine Adzenys XR-ODT Amphetamine — — 18.8 Evekeo Amphetamine sulfate 20 73.40% 14.7 Adderall XR Total mixed amphetamine salts 30 — 18.8 Amphetamine sulfate 7.5 73.40% 5.51 Amphetamine aspartate monohydrate 7.5 47.22% 3.54 Dextroamphetamine sulfate 7.5 73.40% 5.51 Dextroamphetamine saccharate 7.5 56.26% 4.22 a Divide molecular weight of the active moiety by that of the salt. A.C.C. has received research support from, consulted with, acted as invited speaker for, and/or served on advisory boards for Alcobra Pharma, Alkili, Arbor Pharmaceuticals, Forest Research Institute, Ironshore Pharmaceuticals, KemPharm, Inc., Lilly USA, Lundbeck, Neos Therapeutics, Neurovance, NextWave Pharmaceuticals, NLS Pharma Group, Noven Pharmaceuticals, Otsuka Pharmaceutical, Pfizer, Purdue Pharma, Rhodes Pharmaceuticals, Shire Pharmaceuticals, Sunovion Pharmaceuticals, Supernus Pharmaceuticals, Theravance Biopharma, and Tris Pharma.