Brand Name: Amphetamine Transdermal System
Generic Name: Dextro-amphetamine 0% IR, 100% ER 100% dex, 0% levo
Advantages: A skin patch for stimulant medication has 4 advantages:
- Flexible Duration Patch can be removed at different times depending on daily demands.
- Flexible fine-tuned dosage, by cutting patch
- Crash-resistant Because it wears off gradually. The irritability that can occur when a stimulant wears off at the end of the day is greatly reduced.
- Compliance (parent knows that a child had the patch on all day, because if removed, it cannot be reapplied.)
Disadvantages: Skin irritation
Summary: Noven Pharmaceuticals is currently developing a skin patch for the delivery of dextro-amphetamine for children with ADHD. Clinical tri- als are ongoing, and early results are very promising. Once these clinical trials are complete, Noven will apply to the FDA for final approval. No brand name has yet been announced.
Noven is the same company that produces Daytrana, the only other skin patch for a stimulant medication approved by the FDA, which has been used for approximately the past fifteen years. Daytrana uses meth- ylphenidate, but the new patch will use dextro-amphetamine. Another skin patch is also available for clonidine (Catapres TTS), which is a non- stimulant also used for the treatment of ADHD. Catapres TTS is not as effective as the stimulant medications.
More Details: A skin patch has two significant advantages: First, it is the only delivery system for an ADHD medication that gives the physician and patient complete flexibility in how long a medication lasts. Current trials indicate that the amphetamine skin patch takes about two hours to take effect and lasts at least nine hours (which is how long the patch was worn in these trials). However, the patch can be removed earlier or later than that time, allowing for a flexible duration of effectiveness determined by how long the patch remains in contact with the skin.
Second, the dosage can be fine-tuned by cutting the patch. (See the section on Daytrana for a detailed explanation of the advantages of cutting the patch to fine-tune the dose and of removing the patch at dif- ferent times to customize the effect of medication throughout the day.) Because of the flexibility, Daytrana is an excellent medication for treating ADHD. However, significant skin irritation is an added side effect. Unfortunately, not much more information will be available about this new medication until it is approved by the FDA and physi- cians start using it. A decision about brand name has not yet been made.
Just a note about all amphetamine medications: Taking any amphetamine medication with fatty foods delays the time that it takes to reach the peak concentration in the blood by 1–2 hours. That doesn’t mean that your child cannot take it with food, but understand that it might delay the onset and peak times. Further, acidifying agents/foods may lower absorption of amphetamine (requiring a slightly higher dose), while alkalinizing agents/foods may increase absorption (requiring a slightly lower dose). This effect is not seen with methylphenidate medi- cations. However, in practice, the effect of food intake does not usually alter the effectiveness by any significant degree.
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