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Medication Table: ADHD Medications

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Sommaire : This medication table is for informational purposes only and is not a replacement for clinical judgment and consulting a drug reference (such as PDR or Lexi-Comp).
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ADHD Medications

Stimulants

Medication

Duration of Action 

Forms

Dose (Start, Initial Target, Max)

Long-acting



Dextroamphetamine class 
  • Adderall XR (amphetamine mixed salt)
12-hr Capsule 5,10,15,20,25,30 mg
Capsules can be opened and granules can be sprinkled on apple sauce, pudding, yoghurt, etc.
Child: Start 5-10 mg q AM, increase by 5 mg weekly, max 30 mg qAM

Adolescents/Adult: Start 5-10 mg q AM, increase by 5 mg weekly, max 50 mg qAM

  • Dexedrine spansule
6-8 hr Capsule 10,15 mg
Spansule can be opened up and sprinkled on apple sauce, etc. 
Child: Start 10 mg q AM, increase by 2.5-5 mg weekly, max 20-30 mg qAM

Adult: Max 50 mg daily

  • Vyvanse (lisdexamfetamine dimesylate)

13-14 hr Capsule 10,20,30,40, 50,60,70 mg
Capsule content can be dissolved in liquid, such as water, orange juice and yoghurt.
Child: Start 20 mg qAM, titrate up 10 mg weekly, max 60 mg qAM

Adolescent: Start 30 mg qAM, titrate 10 mg weekly, max 70 mg qAM

Adult: Start 30 mg daily, increase by 10 mg weekly, max 70 mg q AM

Methylphenidate class 
  • Methylphenidate OROS (Concerta)
12-hr

Extended release tablet 18,27,36,54 mg
Cannot be crushed or opened (thus cannot be compounded.)

Child: Start 18 mg q AM, increase by 9-18 mg weekly, max 72 mg daily (or 1 mg/kg/day)

Adolescent/ Adult: Start 36 mg q AM, increase by 9-18 mg weekly, max 90 mg qAM

  • Methylphenidate (Biphentin)
10-12 hr

Capsule 10,15,20,30,40,50,60,80 mg
Can be cracked open and beads sprinkled on apple sauce, pudding, yoghurt, ice cream, etc. 

Child: Start 10 mg qAM, titrate up by 5-10 mg weekly, max 60 mg qAM

Adolescent: Start 20 mg qAM, titrate up by 5-10 mg weekly, max 80 mg qAM

  • Methylphenidate CR (Foquest) 
13-16 hr Capsule 25,35,45,55,70,85,100 mg
Cannot be crushed or opened (thus cannot be compounded.)
Child/adolescent: Start 25 mg daily; titrate up by 10-15 mg weekly; max 70 mg daily
Adults: Max 100 mg daily

Short-acting



Dexedrine

(dextro-amphetamine sulphate)


4-6 hr 

Tablet 5mg
Can be crushed.

Can be compounded into 5 mg/mL suspension; lasts 14 days in fridge.

Child/youth: Start 2.5 - 5mg bid, increase 2.5-5 mg weekly, max 20-30 mg qAM

Adult: Max 50 mg daily

Methylphenidate (Ritalin)

3-4 hr 

Tablet 5,10,20 mg

Can be crushed.

Can be compounded into 1 mg/mL suspension; lasts 14 days in fridge.

Child: Start 2.5 mg bid-tid, increase 5 mg weekly, max 60 mg qAM

Adult: Start 2.5 mg bid-qid; increase by 5 mg weekly; max 100 mg daily

Stopping Stimulant Medications

  • Stimulant medications can usually be stopped suddenly without needing to taper down.

Non-Stimulants

Medication

Forms

Dose (Start, Initial Target, Max)

Alpha adrenergic



  • Clonidine (Catapres)
Tab: 0.025, 0.1, 0.2 mg
Can be crushed, dissolved in liquid.

Child: Start 0.1 mg bedtime; increase in 0.1 mg/day increments every 7 days until therapeutic response; may give twice daily; max 0.4 mg/day in 2 divided doses.
Adolescent/adults: Start 0.1 mg morn + 0.1 mg bedtime; target dosage 0.2-0.6 mg daily in divided doses

  • Clonidine ER (extended-release) (Kapvay) 
    NOT AVAILABLE IN CANADA
XR formulation: 0.1, 0.2 mgChild / adolescent: Start 0.1 mg bedtime, increase stepwise until desired response. Next steps: 0.1 mg morn + 0.1 mg bedtime; 0.1 mg morn + 0.2 mg bedtime; then 0.2 mg morn + 0.2 mg bedtime. 
  • Guanfacine XR (Intuniv)

Tab XR: 1, 2, 3, 4 mg

Do not open or crush - this would render it immediate release.

As monotherapy

Child (aged 6-12): Start 1 mg at bedtime, up to 4 mg qhs or divided doses

Adolescent (aged 13-17): Start 1 mg at bedtime, up to 7 mg qhs or divided doses

As adjunctive therapy

Child/Adolescent: 4 mg max

Others



  • Atomoxetine (Strattera)

Cap 10, 18, 25, 40, 60, 80,100 mg

Needs to be swallowed whole (i.e. cannot crush) to reduce GI side effects.

Can be compounded to liquid 6 mg/mL.

Child: Start 0.5 mg/kg/day, titrate up to 0.8 mg/kg/day initial therapeutic target; max 1.2 mg/kg/day

Adolescent: Start 0.5 mg/kg/day; titrate up to 60 mg/day then 80 mg/day

Max dose lesser of 1.4 mg/kg/day or 100 mg daily

Adult: Start 40 mg daily x 1-2 weeks; then titrate up to 60-80 mg q AM

Max lesser of 1.4 mg/kg/day or 100 mg

  • Bupropion SR (Wellbutrin SR)

Tab: 100, 150 mg 

Do not cut, crush (or chew).

Child: Unknown

Adol/adult: Start 100 mg, initial target 150 mg daily; max 400 mg daily

  • Bupropion XL (Wellbutrin XL)

Tab: 150, 300 mg 

Do not cut, crush (or chew).

Child: Unknown

Adol/adult: Start 150 mg, initial target 300 mg; max 450 mg

Stopping Non-Stimulants

  • Alpha adrenergics such as clonidine or guanfacine should be stopped gradually over 2-4 weeks, in order to avoid any rebound hypertension.
  • Atomoxetine, bupropion are long acting and have antidepressant effects, and should also be tapered gradually and then stopped over 4-weeks. 

References

Medication monographs; CADDRA Guidelines; Lexi-Comp. 

    Affichée le : Oct 20, 2020
    Date de la dernière modification : Dec 12, 2023

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