Description
Brand Name
Dexedrine tab
Dextrostat tab
Zenzedi
Advantages
Dextro-amphetamine is an Immediate Release (IR) medication, short-acting medication. There were three different brand names of dextro-amphetamine, but Dexedrine and Dextrostat brand names are no longer available. The IR form can be used with an Extended-Release form in the morning, before the ER has kicked in or at the end of the day to extend the effect after the ER has worn off.
Disadvantages
Because dextro-amphetamine is a short-acting medication (3.5-4 hr.) it should not be used as the primary
medication to treat ADHD, but instead can be used to supplement an IR form. There is no advantage to the brand name Zenzedi, except that it comes in multiple dosages not available in the generic. The generic is substantially cheaper and equally effective.
Excerpt from the book: ADHD Medications: Does It Work and Is It Save? Available on Amazon
In 1937, the same year that Bradley conducted his experiments, the pharmaceutical company Smith, Kline & French took Benzedrine (which was the combination of dextro-amphetamine and levo-amphet- amine). It then removed the inactive levo-amphetamine, leaving only dextro-amphetamine, and called it Dexedrine. It was approved by the FDA in 1940 as a treatment for obesity and nasal congestion. Later, in the 1970s, after physicians took note of Bradley’s work, Dexedrine was approved for the treatment of ADHD.
Shortly after this, Shire Pharmaceuticals (which eventually would develop Adderall in the 1990s) signed on with its own ver- sion of dextro-amphetamine, which it called Dextrostat. Dexedrine and Dextrostat were identical forms of dextro-amphetamine. More recently, Zenzedi was introduced, and it also is identical to Dexedrine and Dextrostat.
For twenty years, Dexedrine and Ritalin ruled the market for ADHD medication treatments. But the problem with Dexedrine, Dextrostat, and Zenzedi is that they are all short-acting, immediate- release medications, lasting only about 3½–4 hours, requiring multiple doses per day. This would produce the same roller-coaster effect as described with Ritalin in Chapter 8 on side effects. Therefore, the use of only immediate-release amphetamine in multiple doses throughout the day is not recommended.
Two scenarios would justify using these short-acting immediate- release amphetamines. First, some long-acting extended-release amphet- amines (Vyvanse) can take up to an hour to take effect in the morning. While you are waiting for the medication to begin to take effect, you are scrambling to get ready to leave for school, and distractibility and impul- sivity will not help. In this case, an immediate-release amphetamine that takes effect in a half hour can be given as soon as your child gets out of bed, and the extended-release amphetamine can be given as you are leaving the house in the morning.
The second scenario occurs when an extended-release amphet- amine is given in the morning but wears off in the late afternoon. A dose of the immediate-release medications could then be given as your child sits down for dinner, which will take effect a half hour later, allowing your child to eat with a good appetite and the medication to then take effect as homework is started after dinner.
Zenzedi has one small advantage over Dexedrine, Dextrostat, and the other short-acting generics. Zenzedi comes in multiple dosage options (2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg and 30 mg), which should make it easier to fine-tune the dosage.
Dexedrine also comes in a liquid, which is easier for some children to swallow and even easier to fine-tune the dose. However, Dexedrine Liquid is available only as short-acting liquid, while two other liquid preparations of amphetamine (Dynavel XR Liquid and Adzenys ER) are available in an extended-release form lasting 8–10 hours.
Dextro-amphetamine did come in a liquid, as Immediate Release Dexedrine Liquid, but is no longer available. However, Zenzedi is virtu- ally identical to the original Dexedrine Liquid.
Currently, the only short-acting, immediate-release dextro- amphetamine available as a brand name is Zenzedi; the immediate- release brand-name versions of Dexedrine and DextroStat are no longer available. However, more than twenty different pharmaceutical com- panies have produced inexpensive generics of the immediate-release dextro-amphetamine.
It is not clear why anyone would prescribe such an expensive brand-name medication when much cheaper generics are available that are just as effective as the brand name. If your insurance covers Zenzedi or if the GoodRx app is used, the cost is almost the same for the brand name as for the generic ($26 vs. $23); in that case, prescribing the brand name would be appropriate.
Zenzedi does offer a copay savings card, which ensures that you pay no more than $75 per prescription (Zenzedi.com).
