mikl_pls

Difference between Mydayis and Adderall XR?

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So there's a new ADHD stimulant medicine from Shire that's supposed to be coming out the third quarter of this year called Mydayis, or "mixed salts of a single-entity amphetamine product." When I looked up the "mixed salts of a single-entity amphetamine product," I got results for both Mydayis and generic Adderall XR.

So my question is, besides Mydayis acting up to 16 hours vs. Adderall XR acting up to 12 hours, does anyone know the difference between the two? They both have a 3:1 ratio of d:l-amphetamine. It comes in doses of 12.5 mg, 25 mg, 37.5 mg, and 50 mg. It's also only approved for patients 13 years and older (no approval for pediatric patients). The max dose for pediatrics (13-17 yo) is 25 mg and the max dose for adults is 50 mg.

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Mydayis uses time release beads in a capsule. There are 3 kinds of beads, immediate, and the other 2 beads are time release with differing release times. 

Basically this is like the dexedrine spansule.

 

Quote

MYDAYIS extended-release capsules contain mixed salts of a single-entity amphetamine, a CNS stimulant. MYDAYIS contains equal amounts (by weight) of four salts: dextroamphetamine sulfate and amphetamine sulfate, dextroamphetamine saccharate and amphetamine aspartate monohydrate. This results in a 3:1 mixture of dextro-to levo-amphetamine base equivalent. The 12.5 mg, 25 mg, 37.5 mg and 50 mg strength capsules are for oral administration. They contain three types of drug-releasing beads, an immediate release and two different types of delayed release (DR) beads. The first DR bead releases amphetamine at pH 5.5 and the other DR bead releases amphetamine at pH 7.0.

 pH is going to affect metabolism, a more basic environment slows it.  

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Aha! Thanks! Very interesting. I'm kind of interested in trying it, but the 16-hour duration of effect seems a little long. I usually get up at 9 AM, but for it to last until say 11 PM, I'd have to get up at 7 AM and take it right away. It appears to start working 2-4 hours post-dose, though.

I wasn't aware that was how Dexedrine Spansules worked, too. Thanks for that info!

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I  have yet to meet a time released amphetamine based product that lasts as long as advertised but I metabolize amphetamine quickly.

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Just now, notloki said:

I  have yet to meet a time released amphetamine based product that lasts as long as advertised but I metabolize amphetamine quickly.

Me neither, and I do too... My pdoc doesn't seem to get it when I tell her that 60 mg Adderall or 30 mg Dexedrine isn't enough for me. She did prescribe 90 mg Adderall XR one time but it was just once. I felt better than I ever remember that month, but I still felt like I needed a slightly higher dose. I think I would've been better off with Dexedrine, though; I prefer it over Adderall because I have less peripheral side effects from it.

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My doc's philosophy is "we can increase the dose until you go psychotic and then we will know how much is too much"  He has been very methodical about dose changes, they are always step wise. No big jumps.  

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2 hours ago, notloki said:

My doc's philosophy is "we can increase the dose until you go psychotic and then we will know how much is too much"  He has been very methodical about dose changes, they are always step wise. No big jumps.  

I wish my pdoc had that philosophy about dosing stimulants... lol.

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Posted (edited)

Mydayis is essentially Adderall XR with an extra delayed release action added onto it (XR has immediate and delayed releases, this has immediate, delayed, and even-more-delayed releases). It's almost exactly identical (practically and pharmacokinetically to taking 2/3rds the dose (of Mydayis) in Adderall XR, then 1/3rd the dose in Adderall IR 8 hours later. It should start working at the exact same time that an equivalent dose of XR would start working (so if let's say you normally take 25mg of XR and it starts working roughly at the 45 minute mark, 37.5mg of Mydayis would start working at roughly the 45 minute mark and would essentially just deliver equivalent effects for a longer period).

I mentioned that Contempla and Mydayis were recently approved when I last saw my pdoc and she said her and the psychiatrist that owns the practice are both in the Shire early prescribing program for Mydayis (or something similar) and were both quite excited about it. She even suggested trying it before I reminded her that the PPI I'm on would utterly ruin the release mechanism and cause some highly unpleasant side effects from dose-dumping so much amphetamine at once, which immediately killed that idea.

On 7/31/2017 at 0:30 PM, notloki said:

My doc's philosophy is "we can increase the dose until you go psychotic and then we will know how much is too much"  He has been very methodical about dose changes, they are always step wise. No big jumps.  

That's absolutely hilarious!

Edited by JustNuts

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6 hours ago, JustNuts said:

Mydayis is essentially Adderall XR with an extra delayed release action added onto it (XR has immediate and delayed releases, this has immediate, delayed, and even-more-delayed releases). It's almost exactly identical (practically and pharmacokinetically to taking 2/3rds the dose (of Mydayis) in Adderall XR, then 1/3rd the dose in Adderall IR 8 hours later. It should start working at the exact same time that an equivalent dose of XR would start working (so if let's say you normally take 25mg of XR and it starts working roughly at the 45 minute mark, 37.5mg of Mydayis would start working at roughly the 45 minute mark and would essentially just deliver equivalent effects for a longer period).

I mentioned that Contempla and Mydayis were recently approved when I last saw my pdoc and she said her and the psychiatrist that owns the practice are both in the Shire early prescribing program for Mydayis (or something similar) and were both quite excited about it. She even suggested trying it before I reminded her that the PPI I'm on would utterly ruin the release mechanism and cause some highly unpleasant side effects from dose-dumping so much amphetamine at once, which immediately killed that idea.

1

I gotcha. Sounds neat, but at the same time, I wonder if it's worth trying and how different the effects are from Adderall XR.

By PPI do you mean proton-pump inhibitor? If so, I take esomeprazole... would that ruin the extended release mechanism?

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13 hours ago, mikl_pls said:

I gotcha. Sounds neat, but at the same time, I wonder if it's worth trying and how different the effects are from Adderall XR.

By PPI do you mean proton-pump inhibitor? If so, I take esomeprazole... would that ruin the extended release mechanism?

You can get the same effects from XR and an IR booster. Mydayis is just a single-pill version of that with no chance of forgetting to take the IR booster at the right time.

Yes, proton pump inhibitor is what I meant by "PPI". Esomeprazole is a PPI and if taking it chronically yes it will definitely screw with the extended release mechanism because chronic PPI use significantly raises gastric pH, which screws up basically all pH-based forms of extended-release/delayed-release/time-release/slow-release/sustained-release/etc mechanisms. However, exactly how much it screws with the extended release mechanism is variable. For Adderall XR, the primary measured change in the only trial done that directly assessed the impact of a course of PPIs is a decrease in the median Tmax from 5 hours to 2.75 hours [total amphetamine], 4 hours to 2.8 hours [d-amp only], and 5 hours to 2.75 hours [l-amp only] (as well as some other significant stuff - the most significant probably being the rather considerable pharmacokinetic variability in subjects taking XR+PPI - see the full text of https://www.ncbi.nlm.nih.gov/pubmed/19820270 for all of the details).

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1 hour ago, JustNuts said:

You can get the same effects from XR and an IR booster. Mydayis is just a single-pill version of that with no chance of forgetting to take the IR booster at the right time.

Yes, proton pump inhibitor is what I meant by "PPI". Esomeprazole is a PPI and if taking it chronically yes it will definitely screw with the extended release mechanism because chronic PPI use significantly raises gastric pH, which screws up basically all pH-based forms of extended-release/delayed-release/time-release/slow-release/sustained-release/etc mechanisms. However, exactly how much it screws with the extended release mechanism is variable. For Adderall XR, the primary measured change in the only trial done that directly assessed the impact of a course of PPIs is a decrease in the median Tmax from 5 hours to 2.75 hours [total amphetamine], 4 hours to 2.8 hours [d-amp only], and 5 hours to 2.75 hours [l-amp only] (as well as some other significant stuff - the most significant probably being the rather considerable pharmacokinetic variability in subjects taking XR+PPI - see the full text of https://www.ncbi.nlm.nih.gov/pubmed/19820270 for all of the details).

Extraordinarily informative! Thank you very much for the link and the time you put into your response! I suppose I should probably only take esomeprazole as needed (for a few weeks at a time or something) for my GERD and stop it when my sx's are under control. (My GERD doesn't improve with diet changes.)

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Unless you need more than 8 hours of sleep each night then I'd recommend Mydayis, if it really works as it claims- and some of that will depend on the individual. If you do need more than 8 hours sleep each night then I'd go with Vyvanse if your looking for a long acting ADHD med, I've used Vyvanse for a while and it works well, takes about 1 1/2 hours to fully kick in and lasts around 8 hours for me but advertises at up to 12 hours. I currently take Adderall IR for mornings then Vyvanse in the afternoons (I work a lot of hours, from around 7 am until 11:30 pm, 5 consecutive days a week). Vyvanse is a lot more mellow than Adderall IR or XL, at least for me. No jittery feelings for me, no heightened anxiety on Vyvanse like I get with Adderall. Although if I eat 45 minutes before taking Adderall IR the anxiety is much lower- it is difficult to eat 45 minutes after taking Adderall IR as it, for me, is an appetite suppressant. Hopefully Mydayis will be mellow like the Vyvanse while lasting longer. The reason I'm switching to Mydayis is to avoid taking 2 pills, Adderall IR and later in the day Vyvanse, and more importantly to avoid the anxiety of the IR. Hopefully Mydayis really will work longer than Vyvanse. I've  noticed that I have to subtract a bit of time from the manufacturers claims on most ADHD medications.

Also, if you're experiencing major depression when your ADHD medication wears off, which is often part of the crash, then it MAY (NOT IS, but MAY) be because the dosage is too high. The higher the high, the harder the crash. I speak from personal experience. As my dosage was lowered a bit my depression upon coming down from the med was much, much lower. Don't have the high energy level as I did with the higher dosage but don't have the 2 hours of major depression after the med wears off either. And with the high energy level I found I hardly got anything done anyway. Just bounced from one project to another without completing anything.

Remember that ADHD meds are not meant to make us feel like Superman/Supergirl. We should feel "normal", not like we have boundless energy and can take on the world. If a person is taking a stimulant to "move mountains" then that person is, or is in severe danger of becoming, an addict & should be seeking treatment rather than a new stimulant medication. And I know what I'm talking about. As a registered nurse I see it often.

One suggestion: Wake up a couple hours before you need to, take the Mydayis, go back to sleep (if you're the type of person that can do that) & by the time you need to get up 2 hours later the Mydayis will have kicked in. That's what I used to do with Vyvanse, and it worked well for me until the Vyvanse wore off 8 hours later, until my medical provider prescribed an Adderall IR supplement to go with Vyvanse. Man, I really hope Mydayis lives up to its claims. 16 hours (well, probably more like 10 to 14 hours for me) of an effective ADHD medication  with a mellow and gradual onset without the anxiety associated with IR's rapid onset would be a dream come true. I don't want a high, I don't want to move mountains, I just want to function at a "normal" level for most of my day. And it's not just the long work hours for me. I've struggled with ADHD long before I started working a bazillion hours a week.

And a lot of medical providers are scared to dose outside the norms. Even the liberal ones are afraid of having to explain themselves and risk losing their prescription privileges or getting them suspended and having that on their records. And many of them assume most patients complaining about dosing are addicts anyway. That's not true, from what I've seen, but some are and ruin it for the rest of us.

Good luck to you.

Edited by DividedSage
To correct a spelling error.

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Also, I strongly prefer an experienced NP (Nurse Practicer) to an MD, DO or PA. NP's, in general, just seem to have a better bedside manner. Probably because all NP's, before becoming medical providers, must spend a certain number of years practicing as a medical care giver. With thousands of hours spent with patients, and a nurse spends more time with patients than any other medical personnel, except possibly a CNA, nurses tend to be more personal with and more trusting of their patients than medical providers, until given a legitimate reason not to be.

Edited by DividedSage
Spelling again, darn autocorrect.

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Hey

 

I just filled my mydayis 37.5. I usually take 25xradderal and then when needed (usually 2 times a day, 20mg quick adderal) My two concerns are waking up to take it so I can get going (it takes about 30 min for a quick release and about an hour for xr for me to feel it ) Also, has any body had trouble eating on it? I've tried eveeko on my less busy days and I could eat on that. With adderal I usually have to set reminders to eat because I'll forget and I try to do as much solid food as possible but I also blend up fruits and veggies as well. 

 

Thanks in advance 

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