Alternative Formulary Recommendations

This guide serves as a resource to aid in decision-making for stimulant dose conversions. This guide should not be considered a substitute for clinical judgement, and all patients should be monitored closely for clinical and adverse effects, especially when starting a new medication.

The table below is not an exhaustive list of all available options, but contains the options most similar to Adderall XR® as a dosage form. The Partners For Kids ADHD prescribing resource includes a larger table with more options and can be found here.

General Recommendations:

• Utilize this guide by comparing current dosages of amphetamine mixed salts to the equivalent methylphenidate dose.
• No specific guidance is available in literature for switching from amphetamine mixed salts to methylphenidate at direct doses. Consider switching at half of the methylphenidate dose shown, particularly if adverse events are a concern. Dosage increases can occur every 7 days if the new medication is well tolerated and increase is needed to improve symptom control.
• When switching to a new medication, regular follow up is recommended to ensure there are no significant adverse effects.
• Patient response to different stimulant classes can vary. Be prepared to increase or decrease a dose based upon efficacy and safety in each patient who required a switch.
• The Partners For Kids prescribing resource linked above provides guidance on dosage adjustments.

All listed options are covered on Ohio Department of Medicaid’s Unified Preferred Drug List.