Table 1

Some medications used to manage ADHD13

Drug	Brand(s)	Excipient	Comments	Composition	Duration	Start dose	Licensed max dose	BNF* max daily dose	Licensed for adults
Methylphenidate prolonged release tablets	Affenid XL Atenza XL Concerta XL Kixel XL Xenidate XL		Affenid cheapest Concerta most expensive	22%–25% IR + 75%–78% MR Available as 18 mg, 27 mg, 36 mg, 54 mg	12 hours	18 mg	72 mg	108 mg (Concerta XL)	Yes
	Delmosart Xaggitin XL	S S				18 mg	72 mg		Yes
	Matoride XL		Not available as 27 mg			18 mg	54 mg		Cont†
Methylphenidate modified release (capsules containing beads can be opened)	Addepta XL	S	Addepta yet to launch	30% IR+70% MR Available as 10 mg, 20 mg, 30 mg	8 hours	5 mg	60 mg	100 mg	No
	Equasym XL	G, S				5 mg
	Exattent XL	G, S	Also 40 mg, 50 mg, 60 mg			5 mg
	Focusim XL	G, S	Not available as 60 mg	50% IR+50% MR Available as 10 mg, 20 mg, 30 mg, 40 mg, 60 mg	8 hours	20 mg	80 mg	100 mg	Yes
	Medikinet XL	G	Also 50 mg. Take with food			10 mg
	Meflynate XL Metyrol XL Ritalin XL	G, S G, S G, S, W				20 mg
Methylphenidate immediate release	Medikinet or generic		Useful for flexible dosing	Uncoated tablet	4 hours	5 mg bd	60 mg (child)	100 mg	No
Lisdexamfetamine	Elvanse Adult, Elvanse	G, S	Approximately 30% lisdexamfetamine is dexamfetamine	Capsule containing powder (can be opened)	>12 hours	30 mg	70 mg (50 mg in CKD4)		Yes
Dexamfetamine	Amfexa or generic		Greatest abuse potential; licensed for narcolepsy	Uncoated tablet	4–6 hours	5 mg bd	n/a	60 mg	No
Atomoxetine	Atomaid or generic	G, S, W	Capsule contents may be irritant	Hard capsule	24 hours	40 mg	100 mg	120 mg	Yes
Guanfacine	Intuniv		Do not stop abruptly Adults on tertiary specialist advice	Prolonged-release tablet	>24 hours	1 mg	7 mg	7 mg	Cont†
Clonidine‡	Generic		Slow-release tablets licensed in USA for children but not in UK	Uncoated tablet	5–24 hours	25 μg	400 μg	n/a	No

*Typical maximum dose listed in BNF.13
†‘Cont’=may be continued in those benefitting from the drug when started prior to age 18 years.
‡Clonidine doses refer to product licensed in the USA for managing ADHD in children.
bd, two times per day; BNF, British National Formulary; CKD, chronic kidney disease; G, gelatin; IR, immediate release; MR, modified release; N, no; n/a, not available; S, shellac; W, wheat starch or starch from unknown source; Y, yes.