Brand Name: Adhansia XR or Aptensio XR
Generic Name: Methylphenidate AdhansiaXR: 20% IR, 80% ER or Methylphenidate AdhansiaXR: 20% IR, 80% ER
Advantages: These two medications use the same technology as Ritalin LA and Metadate CD (but with different ratios of Immediate Release to Extended Release). These two medications are almost identical to Ritalin LA or Metadate CD, but with Aptensio XR lasting 8 – 9 hour and Adhansia XE lasting 14-16 hours.
Disadvantages: The high cost (without insurance) is not justified by the subtle differences.
Summary: Adhansia XR and Aptensio XR are two newer extended-release methylphenidate medications, very similar to Ritalin LA and Metadate CD, although they last a little longer.
All four medications have methylphenidate as the active ingre- dient. All four medications use the same technology as these medi- cations, a combination of uncoated beads of medication (releases immediately over one-half hour) and coated beads (released over about 8–10 hours).
More Details: If all four of these medications use the same technology (coated beads) and all four medications have methylphenidate as their main ingredient, then what makes them unique? And why does the FDA not consider them to be generics of Ritalin LA? The only substantial difference in these four medica- tions is that they are produced with a different ratio of immediate release-beads to extended-release beads. Adhansia XR lasts longer than the other three medications because it contains 80 percent extended release versus 70 percent for Metadate CD, 60 percent for Aptensio XR, and 50 percent for Ritalin LA. On the other hand, the higher the percentage of extended release means a lower percentage of immediate release, which can cause Adhansia XR to take longer to take effect in the morning. Adhansia XR would be expected to last the longest because it has 80 percent extended-release beads.
It is great to have options that can be tailored to each child, but are the extra few hours gained from Adhansia XR worth the very significant increase in cost? Without insurance, you would pay $254 a month more for Adhansia XR than Metadate CD, or more than $3,000 per year. If insurance covers Adhansia XR, it would be a good option for your older child, who goes to sleep later, but if Adhansia XR is not covered by your insurance, you should question the benefits of Adhansia XR. Finally, you should consider that Concerta contains the same active ingredient (methylphenidate) and lasts nearly as long as Adhansia XR.
Remember what was said earlier about evergreening? Evergreening is the practice of making subtle changes to the active-ingredient mol- ecule or in the delivery system in order to get FDA approval as a brand name, rather than a generic. Why? Because they can charge more. Adhansia XR and Aptensio XR are unique medications with some minor advantages, but overall, this is a perfect example of evergreening. On the other hand, this is one case where the attempt by the phar- maceutical companies to make more money gives you and your physician more options for treating your child’s ADHD.
One small advantage of Metadate CD, Adhansia XR, and Aptensio XR is that unlike Concerta, these capsules can be opened and sprinkled on a spoonful of applesauce or pudding or ice cream. However, the small beads must be swallowed without chewing (if they are chewed, all of the medication will be released too early and would cause the child to get more medication than intended).
The bottom line is that Adhansia XR lasts a little longer than other bead-delivery forms of methylphenidate, and Aptensio XR takes effect a little quicker in the morning. But they are both expensive, not usually covered by insurance, and probably not worth the significant increase in cost. In most cases, Concerta would usually be a better choice.
Note: Aptensio XR has been available in Canada as Biphentin since 2006. Same medication, different name.
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