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

Most common
Insomnia (≥5%)
Decreased appetite (≥5%)
Headache (≥5%)
Dry mouth (≥5%)

Adderall XR

Most common
Anorexia (up to 22%)
Insomnia (up to 17%)
Abdominal pain (up to 11%)
Emotional lability (up to 7%)

Concerta vs. Adderall XR Dosage

Concerta

Dosage
Dosage Table
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

Dosage
Dosage Table
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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