Concerta vs. Adderall XR
See how Concerta and Adderall XR compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Both Concerta and Adderall XR are Schedule II stimulants with boxed warnings for abuse, misuse, and dependence.
Concerta uses an osmotic tablet for a steady 12-hour release, while Adderall XR releases in two pulses through beads inside the capsule.
Concerta is approved for ages 6 to 65, while Adderall XR's labeling covers age 6 and up with no stated upper limit.
Concerta vs. Adderall XR Drug Summary
Concerta
Concerta is a CNS stimulant in the piperidine class, FDA-approved to treat ADHD in patients ages 6 to 65. It's an extended-release tablet taken once each morning, using an osmotic delivery system (OROS) that releases methylphenidate steadily over about 12 hours.
Adderall XR
Adderall XR is a CNS stimulant combining four amphetamine salts, FDA-approved to treat ADHD in children, adolescents, and adults starting at age 6. It's an extended-release capsule taken once daily in the morning, delivering medication in two separate pulses.
Concerta vs. Adderall XR Side Effects
Concerta
Adderall XR
Concerta vs. Adderall XR Dosage
Concerta
Adderall XR
| STAGE | DOSE | WHEN |
| Starting dose | 18 mg once daily | At the start |
| Maximum dose | 72 mg once daily | If needed |
| Dose changes | 4 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 30 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Concerta
| STAGE | DOSE | WHEN |
| Starting dose | 18 mg once daily | At the start |
| Maximum dose | 72 mg once daily | If needed |
| Dose changes | 4 increases | As tolerated |
Adderall XR
| STAGE | DOSE | WHEN |
| Starting dose | 10 mg once daily | At the start |
| Maximum dose | 30 mg once daily | If needed |
| Dose changes | 2 increases | As tolerated |
Concerta vs. Adderall XR Indications
Concerta
Concerta is FDA-approved to treat ADHD in patients between the ages of 6 and 65. It is not approved for adults over 65 or children under 6. Off-label, some clinicians prescribe it for narcolepsy.
ADHD in children ages 6 to 12
ADHD in adolescents ages 13 to 17
ADHD in adults ages 18 to 65
Off-label: narcolepsy (not FDA-approved)
Adderall XR
Adderall XR is FDA-approved to treat ADHD in children, adolescents, and adults starting at age 6. Its labeling has no upper age cutoff, unlike Concerta's 65-year limit. It is not approved for children under 6 or patients with end-stage renal disease.
ADHD in children ages 6 to 12
ADHD in adolescents ages 13 to 17
ADHD in adults 18 and older
Not approved for children under 6
Concerta vs. Adderall XR Pros and Cons
Concerta
Concerta's osmotic tablet delivers methylphenidate steadily over about 12 hours, which many patients experience as smoother symptom control than pulsed formulations. Coverage varies by plan, and it's typically the pricier of the two options without insurance.
Pros
Smooth, steady 12-hour release with less peak-and-crash effect
Rigid tablet shell makes crushing or snorting harder
Approved up to age 65, covering older adults with ADHD
Cons
Must be swallowed whole; can't be opened or sprinkled on food
Five dosage strengths can mean more titration visits
Typically pricier without insurance, roughly $380 to $650 a month, versus $200 to $350 for Adderall XR
Adderall XR
Adderall XR delivers amphetamine salts in two pulses, giving a second peak later in the day that some patients find effective and others feel as a mid-afternoon dip. It's generally the less expensive option without insurance, though coverage still varies by plan.
Pros
Capsule can be opened and sprinkled on soft food
Fewer dosage strengths can simplify finding the right dose
Typically cheaper without insurance, roughly $200 to $350 a month, versus $380 to $650 for Concerta
Cons
Two-phase release can cause a mid-day dip as the first dose fades
Higher reported rates of appetite loss and insomnia in trials
Less long-term safety data in patients over 65
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