Stimulants by Duration

• Age: ≥ 6 y/o
• Onset: ~20-60 min
• Duration: 3-4 hours
• Considerations: Typically dosed multiple times per day. May be taken with or without food.
  • Liquid: Colorless, grape-flavored liquid; store at room temperature. 
  • Chewable: Grape-flavored chewable tablet.
• Initial Dose: 5 mg twice daily (before breakfast and lunch)
• Titration: 5-10 mg weekly
• Max Dose: 2mg/kg/day up to 60 mg/day
  

• Age: ≥ 6 y/o
• Onset: ~ 30 minutes
• Duration: 5-6 hours
• Considerations:  Give approximately 1/2 the methylphenidate dose. Administer orally twice daily, at least 4 hours apart, with or without food.
• Initial Dose:
  • New to methylphenidate: 2.5 mg twice daily
  • Currently taking methylphenidate: Start with half the current total daily dose of methylphenidate (up to 10 mg twice daily)
• Titration: Increase by 2.5-5 mg daily every 3 to 7 days
• Max Dose: 20 mg/day (10 mg twice daily)
  

• Age: ≥ 6 y/o
• Onset: ~ 20-60 min
• Duration: 3-4 hours
• Considerations: Abrupt onset and offset may increase the number and severity of side effects. Administer 30 to 45 minutes before meals.
• Initial Dose:
  • Pediatric (6+ y/o): 5 mg twice daily (before breakfast and lunch)
  • Adults: 10-15 mg twice or three times daily
• Titration: 5-10 mg weekly
• Max Dose: 60 mg/day
  

Adderall (amphetamine salt combo); tablets; Brand/Generic

• Age: ≥ 3 y/o
• Onset: 30-60 minutes
• Duration: 4-6 hours
• Considerations: May be taken with or without food. Administer first dose upon awakening and additional doses at intervals of 4-6 hours.
• Initial Dose:
  • 3-5 y/o: 2.5 mg daily
  • 6+ y/o: 5 mg 1-2 times daily
• Titration:
  • 3-5 y/o: 2.5 mg weekly
  • 6+ y/o: 5 mg weekly
• Max Dose:
  • ≤50 kg: 40 mg/day
  • >50 kg: 60 mg/day (Narcolepsy)
    

Evekeo (Amphetamine sulfate); tablet; Brand

• Age: ≥ 3 y/o
• Onset: ~ 30-60 minutes
• Duration: 4-6 hours
• Considerations: Take the first dose on awakening. Additional doses may be given at intervals of 4-6 hours. 
• Initial Dose:
  • 3-5 y/o: 2.5 mg daily
  • 6+ y/o: 5 mg once or twice daily
• Titration:
  • 3-5 y/o: 2.5 mg weekly
  • 6+ y/o: 5 mg weekly
• Max Dose: 40 mg/day

ProCentra (Dextroamphetamine sulfate); oral solution; Brand/Generic

• Age: ≥ 3 y/o
• Onset: ~ 30 min
• Duration: 4-6 hours
• Considerations: Bubblegum-flavored; may be taken with or without food. Shake bottle before administering. Store at room temperature.
• Initial Dose:
  • 3-5 y/o: 2.5 mg daily
  • 6+ y/o: 5 mg once or twice daily
• Titration:
  • 3-5 y/o: 2.5 mg weekly
  • 6+ y/o: 5 mg weekly
• Max Dose:
  • 3-5 y/o: 40 mg/day
  • 6+ y/o: 60 mg/day

Zenzedi (Dextroamphetamine sulfate); tablet; Brand only at the 2.5 mg and 7.5 mg doses / Generic

• Age: ≥ 3 y/o
• Onset: ~ 30-60 minutes
• Duration: 4-6 hours
• Considerations: Take the first dose on awakening. Additional doses may be given at intervals of 4-6 hours. Periodic drug holidays are recommended to assess the patient’s condition.
• Initial Dose:
  • 3-5 y/o: 2.5 mg daily
  • 6+ y/o: 5 mg once or twice daily
• Titration:
  • 3-5 y/o: 2.5 mg weekly
  • 6+ y/o: 5 mg weekly
• Max Dose:
  • 3-5 y/o: 20 mg/day
  • 6+ y/o:
    • ≤50 kg: 40 mg/day
    • >50 kg: 60 mg/day 

Aptensio XR (methylphenidate XR); capsule; Brand/Generic

• Age: ≥ 6 y/o
• Onset: ~ 60 min
• Duration: 8-12 hours
• Release Profile: 40% IR, 60% ER
• Considerations: Capsules may be swallowed whole or opened, and the entire contents can be sprinkled on applesauce.
• Initial Dose: 10 mg
• Titration: 10 mg weekly
• Max Dose: 60 mg/day

Azstarys (Serdexmethylphenidate and dexmethylphenidate);capsule; Brand

• Age: ≥ 6 y/o
• Onset: ~ 30 min
• Duration: 12-14 hours
• Release Profile: 30% IR, 70% ER
• Considerations: Administer once daily in the morning, with or without food; capsules can be taken whole or opened and sprinkled onto applesauce or mixed with water.
• Initial Dose: 39.2/7.8 mg
• Titration: Increase to 52.3/10.4 mg or decrease to 26.1/5.2 mg after one week
• Max Dose: 52.3/10.4 mg daily

Concerta (methylphenidate ER (OROS)); OSM tablets; Brand/Generic

• Age: ≥ 6 y/o
• Onset: ~ 30-60 min
• Duration: Up to 12 hours
• Release Profile: 22% IR, 78% CR via osmotic delivery
• Considerations: Must be swallowed whole; the non-absorbable shell may pass in stool. Administer once daily in the morning, with or without food. Do not chew or crush the tablet.
• Initial Dose:
  • 6-12 y/o: 18 mg daily
  • 13+ y/o: 18 mg - 36 mg daily
• Titration: 18 mg/day at weekly intervals
• Max Dose:
  • 6-12 y/o: 54 mg/day
  • 13+ y/o: 72 mg/day

Cotempla XR-ODT (Methylphenidate XR-ODT); ODT; Brand

• Age: 6-17 y/o
• Onset: ~ 30-60 min
• Duration: ~ 8 hours
• Release Profile: 25% IR, 75% ER
• Considerations: Grape-flavored, allow to dissolve in saliva. Advise to take consistently either with food or without food.
• Initial Dose: 17.3 mg
• Titration: 8.6 mg - 17.3 mg weekly
• Max Dose: 51.8 mg

• Age: ≥ 6 y/o
• Onset: Approximately 2 hours after application
• Duration: 9-hour wear time; continuous release for 9-12 hours
• Considerations: Apply the patch to the hip area (alternating sites) 2 hours before the effect is needed. The patch may be removed earlier if shorter duration is desired or if late-day side effects occur. Monitor for skin rash or sensitivity. Discard patches appropriately.
• Initial Dose: 10 mg patch applied daily
• Titration: 5 mg every 3 - 7 days
• Max Dose: 30 mg/day

• Age: ≥ 6 y/o
• Onset: ~ 30 min
• Duration: 8-12 hours
• Release Profile: 50% IR, 50% ER
• Considerations: Capsules may be swallowed whole or opened, and the entire contents can be sprinkled on applesauce.
• Initial Dose:
  • New to methylphenidate:
    • 6-17 y/o: 5 mg
    • Adults: 10 mg
  • Currently on methylphenidate: Focalin XR dosage is half (1/2) the current total daily dosage of methylphenidate
  • Currently on Focalin IR: Give the same daily dose of Focalin XR
• Titration:
  • 6-17 y/o: 5 mg weekly
  • Adults: 10 mg weekly
• Max Dose:
  • 6-17 y/o: 30 mg/day
  • Adults: 40 mg/day

• Age: ≥ 6 y/o
• Onset: delayed until early morning (~10-12 hours after evening dose)
• Duration: 12-14 hours
• Considerations: Take in the evening between 6:30-9:30 pm. Capsules can be opened and sprinkled on applesauce.
• Initial Dose: 20 mg once daily in the evening
• Titration: 20 mg weekly
• Max Dose: 60 mg/day

• Age: ≥ 6 y/o
• Onset: ~ 45 min
• Duration: up to 8 hours
• Release Profile: 30% IR, 70% ER
• Considerations: Cherry-flavored; may be taken with or without food. Long-acting chewable tablet. The 20 mg and 30 mg tablets may be split in half.
  
• Initial Dose: 20 mg
  
• Titration: 10-20 mg weekly
  
• Max Dose: 60 mg/day

• Age: ≥ 6 y/o
• Onset: ~ 45 min
• Duration: ~ 12 hours
• Release Profile: 20% IR, 80% ER
• Considerations: Fruit-flavored; Shake bottle vigorously for at least 10 seconds before administering. May be taken with or without food. Store at room temperature. Suspension expires four months after reconstitution.
• Initial Dose: 20 mg
  
• Titration: 10-20 mg weekly
  
• Max Dose: 60 mg/day

Relexxii (Methylphenidate ER (OROS) Tablets); Brand

• Age: ≥ 6 y/o
• Onset: ~60 min
• Duration: 8-12 hours
• Release Profile: 20% IR, 80% CR via osmotic delivery
• Considerations: Must be swallowed whole; the non-absorbable shell may pass in stool. Administer once daily in the morning, with or without food. Do not chew or crush the tablet.
• Initial Dose:
  • 6-12 y/o: 18 mg once daily in the morning
  • 13+ y/o: 18 mg once daily in the morning
• Titration: Increase by 18 mg/day at weekly intervals
• Max Dose:
  • 6-12 y/o: 54 mg/day
  • 13+ y/o: 72 mg/day
  • Adults: 72 mg/day

Ritalin LA (methylphenidate LA); capsule; Brand/Generic

• Age: ≥ 6 y/o
• Onset: ~ 20-60 min
• Duration: 8-12 hours
• Release Profile: 50% IR, 50% ER
• Considerations: Capsules may be swallowed whole or opened, and the entire contents can be sprinkled on applesauce. Should not be crushed, chewed, or divided.
• Initial Dose: 10-20 mg
  • Patients currently using Ritalin: dosage is equivalent to Ritalin dose
• Titration: 10 mg weekly
• Max Dose: 60 mg/day
  

Adderall XR (amphetamine salt combo ER); capsule; Brand/Generic

• Age: Pediatric patients ≥6 years and adults
• Onset: Approximately 30–60 minutes
• Duration: 10–12 hours
• Release Profile: Biphasic – an immediate-release portion followed by a delayed-release phase via beaded capsule technology
• Considerations: May be taken with or without food; avoid concomitant use with acidifying agents which may affect absorption
• Initial Dose (Pediatric):
  • Typically 10 mg once daily in the morning
• Titration (Pediatric):
  • Increase by 5–10 mg increments at weekly intervals based on clinical response and tolerability
• Max Dose (Pediatric):
  • Generally should not exceed 30 mg per day

Adzenys XR-ODT (Amphetamine ER); ODT; Brand

• Age: ≥ 6 y/o
• Onset: ~ 30 min
• Duration: ~12 hours
• Release Profile: 50% IR, 50% ER
• Considerations: Orange-flavored. May be taken with or without food. Allow tablet to disintegrate in saliva before swallowing.
  • Adderall XR Equivalent Doses
• Initial Dose:
  • 6-17 y/o: 6.3 mg
    
  • 18+ y/o: 12.5 mg
• Titration: 3.1 mg - 6.3 mg weekly
• Max Dose:
  • 6-12 y/o: 18.8 mg/day
  • 13+ y/o: 12.5 mg/day

• Age: ≥ 6 y/o
• Onset: ~60 min
• Duration: up to 13 hours
• Considerations: May be taken with or without food. Liquid and tablet formulations are interchangeable.
  • Tablet: The 5mg dose is scored to allow for accurate dosing down to 2.5mg.
  • Liquid: Bubblegum flavor
• Initial Dose:
  • 6-12 y/o: 2.5-5 mg
  • 13+ y/o: 5-10 mg
• Titration:
  • 6-12 y/o: 2.5 mg every 4-7 days
  • 13+ y/o: 5 mg every 4-7 days
• Max Dose: 20 mg

Mydayis (Dextroamphetamine-Amphetamine ER Capsules); Brand/Generic

• Age: ≥ 13 y/o
• Onset: Approximately 1-2 hours
• Duration: Up to 16 hours
• Considerations: Capsules may be swallowed whole or sprinkled on cold applesauce and consumed immediately without chewing. Administer once daily upon awakening to avoid insomnia. Consistency with or without food is recommended. Do not substitute for other amphetamine products on a milligram-per-milligram basis.
• Initial Dose: 12.5 mg once daily in the morning
• Titration: 12.5 mg weekly
• Max Dose:
  • 13-17 y/o: 25 mg/day
  • Adults: 50 mg/day

Vyvanse (Lisdexamfetamine dimesylate); chewable tablet / capsule; Brand/Generic

• Age: ≥ 6 y/o
• Onset: ~60 min
• Duration: 8-12 hours

• Considerations: Can be taken with or without food. It is a pro-drug that is metabolized into 100% dextroamphetamine, with a reduced risk of abuse. The chewable tablet and capsule are interchangeable on a mg-to-mg basis. 

  • Chewable tablet: Strawberry-flavored and can be taken with or without food. 

  • Capsule: The capsule can be opened and its contents dissolved in liquid, such as water, yogurt, or orange juice. Use immediately after dissolving.

• Initial Dose: 20-30 mg
  
• Titration: 10-20 mg every 3-7 days
• Max Dose: 70 mg
  

Xelstrym (Dextroamphetamine patch); Brand

• Age: ≥ 6 y/o
• Onset: Approximately 2 hours after application
• Duration: 9-hour wear time; continuous release for 9-12 hours
• Considerations: Apply the patch to the hip, upper arm, chest, upper back, or flank area 2 hours before the effect is needed. Rotate application sites with each new patch. Do not use more than one patch in a 24-hour period. Do not substitute for other amphetamine products on a milligram-per-milligram basis.
• Initial Dose:
  • Pediatric (6-17 y/o): 4.5 mg/9 hours daily
  • Adults: 9 mg/9 hours daily
• Titration: 4.5 mg/9 hours weekly
• Max Dose: 18 mg/9 hours
  • Severe Renal Impairment: 13.5 mg/9 hours
  • End-Stage Renal Disease (ESRD): 9 mg/9 hours