View Full Version : XR vs IR, and a few questions about the meds


Vim717
12-28-13, 12:26 PM
I'm new to the forums, sorry if I'm just making another thread of the same topic but I can't exactly figure website search tools out.
So, I'm on both 10mg Adderall XR and 10mg IR. I have a good amount of questions and I'm off my medicine for the holidays, so bear with me. I'll ask the sciency ones first.

-Why does XR use amphetamine salts rather than Dextro/levo-amphetamine as IR does? (besides the cost issue. do amphetamine salts last longer in your system?)
-When I take IR, I feel a lot more motivated to do things. I've read this is because of the Levo-amphetamine but is it just because I'm taking amphetamines rather than mixed salts (which I can assume, are mixed with others things that might lessen the effect of the medicine)

then, I have a few more just about being off them:
-When I don't take my medicine for even a day or two, I feel terrible during those days. I have general lethargy and aggression towards others. Is this normal? I would assume it's not withdrawal because I've only taken it for 6 months (and had weekend med breaks).
-When I'm off my medicine and past the above issues, I often find myself doing ridiculously stupid things. Such as hiding our INTJ biology teachers projector remote onto the back of his skeleton and not telling him for half an hour, or hitting on my friends who have partners. I'd like to know if it's just me, or if anyone else gets the stupids when they're off their medicine for less than a week.

Sorry to have spammed you all with this wall of miswritten questions, but I am curious about all of this. :D

dvdnvwls
12-28-13, 02:24 PM
Adderall is the same drug, regardless of the wording. It is not dextro/levo-amphetamine in one and amphetamine salts in the other, it is both in both. "Mixed salts" refers to the chemical form that the amphetamine itself is in, not to any fillers. Adderall contains "amphetamine salt" in the same way that potato chips contain "sodium salt".

The difference between XR and IR is simple: 10 mg IR gives you 10 mg of Adderall right now; 10 mg XR gives you 5 now and 5 later, by making half of the pill harder to dissolve. Those two pills are the exact same drug in the exact same amount, just with different coatings on the XR.

Lethargic feelings on the first few days after stopping medication makes perfect sense. You will need lots of extra sleep. Make sure you're getting a good sleep all the time - Adderall works poorly without proper sleep.

We have ADHD - when un-medicated, we can do stupid things. No kidding. :) But it can also come from being over-tired, as described above. And amphetamine of any kind is a stimulant. When you take away a stimulant, you are not as stimulated as you were before. Feeling "down" and tired for a while after stopping medication is to be expected. That tiredness will soon fade.

purpleToes
12-28-13, 03:21 PM
To add to what Dvdnvwls said, which is all correct, you could be seeing different names for the same substance if your IR is from a different manufacturer from your XR.

If you search the forum, you'll find many members discussing the variability of the quality of generic "adderall" XR based on manufacturer; however the most likely reason you experience a stronger effect from 10mg IR than 10mg XR is that you're getting 10mg all at once versus 5mg now/5mg later as Dvdnwvls explained.

Your pharmacist (not the pharmacy techs) can be a great resource for many technical questions about your medications. In the U.S., pharmacists must have a doctorate degree in pharmacy (Pharm D.) and that's a lot more than just ordering stock and filling bottles. I have learned so many interesting and helpful things about various medicines from my pharmacist(s), like the real reason I'm supposed to throw out the remainder of a $100 vial of medicine if opened longer than 30 days (will it kill me? Will it just not not work as well?); and whether I ruined a medicine that was supposed to stay refrigerated by accidentally leaving it in a hot car for several hours. Another time he was able to give me an idea how many of his patients who took Vyvanse needed more than 60mg (very few) and how many needed twice a day dosing (only one) which helped me to decide whether I wanted to ask my psychiatrist to let me try it. If you catch them when they aren't too busy, or if you ask the to call you back, the good ones are often happy to talk with you about detailed, "sciency" questions.

NCpharmadude
12-29-13, 04:37 AM
To add to what Dvdnvwls said, which is all correct, you could be seeing different names for the same substance if your IR is from a different manufacturer from your XR.

If you search the forum, you'll find many members discussing the variability of the quality of generic "adderall" XR based on manufacturer; however the most likely reason you experience a stronger effect from 10mg IR than 10mg XR is that you're getting 10mg all at once versus 5mg now/5mg later as Dvdnwvls explained.

Your pharmacist (not the pharmacy techs) can be a great resource for many technical questions about your medications. In the U.S., pharmacists must have a doctorate degree in pharmacy (Pharm D.) and that's a lot more than just ordering stock and filling bottles. I have learned so many interesting and helpful things about various medicines from my pharmacist(s), like the real reason I'm supposed to throw out the remainder of a $100 vial of medicine if opened longer than 30 days (will it kill me? Will it just not not work as well?); and whether I ruined a medicine that was supposed to stay refrigerated by accidentally leaving it in a hot car for several hours. Another time he was able to give me an idea how many of his patients who took Vyvanse needed more than 60mg (very few) and how many needed twice a day dosing (only one) which helped me to decide whether I wanted to ask my psychiatrist to let me try it. If you catch them when they aren't too busy, or if you ask the to call you back, the good ones are often happy to talk with you about detailed, "sciency" questions.

I promise I'm not trying to be nitpicky or a Know-It-All here, I just have to make one slight correction since I work at a pharmacy and am studying to be a Pharmacist. Using the example given above, a single 10 mg IR (immediate release) tablet will produce a concentration vs time profile (essentially a graph of the concentration of drug in your blood over time) that resembles a Bell curve. It will climb as it is being absorbed, reach a peak, and then begin to decline as the drug is metabolized/removed from the body. As the drug is metabolized/removed from the body, the effects will begin to wear off and another dosage would be needed, hence why sometimes you see the IR tablets written so that they are to be taken 2-3 times daily. What the extended release dosage forms are designed to do is to release enough drug to produce a similar concentration peak as the immediate release tablets, and continue to release more over time to replace the amount lost to metabolism/excretion (this is often achieved by making some portion of the dosage form dissolve immediately and the rest take some time to dissolve). What this does, is it extends the therapeutic effect of the drug by maintaining the desired concentration for longer (6, 8, maybe even 12 hours but usually not that long) so that multiple doses would not be needed, ideally. Therefore, a 10 mg XR should produce the same effect as the 10 mg IR tablet, and keep it going for longer. So, for instance, a single 10 mg XR medication may replace your twice daily dosage of the 10 mg IR tablet, you will not be receiving less drug and should not require a dose adjustment. The extended release forms are more for convenience depending on your lifestyle. My apologies for the essay!

Yes, Pharmacists are excellent resources and are typically more than willing to help you with any questions you may have regarding your medications. If you find that certain medications are not working for you, they may be able to help you find an alternative that may be more helpful. People tend to respond differently to the individual medications within the general class of drug, so sometimes there is a bit of experimentation or trial and error that may have to occur before finding the one that is most useful for you. Many states require the Pharmacist/Pharmacy technicians to at least offer counseling by the pharmacist when you are picking up your medications. Most people decline, but I do believe it is helpful for people to receive it when it is a medication that they are not familiar with and do not take frequently, such as antibiotics or pain medications for accidents.

sarahsweets
12-29-13, 05:39 AM
dose for dose xr and ir are the same its just that xr releases half right away and the other half later. All of the xr is made by SHIRE (the company that makes the brand) EXCEPT ACTAVIS which is a new version of xr that IMO sucks.

purpleToes
12-29-13, 07:07 AM
I promise I'm not trying to be nitpicky or a Know-It-All here, I just have to make one slight correction since I work at a pharmacy and am studying to be a Pharmacist. Using the example given above, a single 10 mg IR (immediate release) tablet will produce a concentration vs time profile (essentially a graph of the concentration of drug in your blood over time) that resembles a Bell curve. It will climb as it is being absorbed, reach a peak, and then begin to decline as the drug is metabolized/removed from the body. As the drug is metabolized/removed from the body, the effects will begin to wear off and another dosage would be needed, hence why sometimes you see the IR tablets written so that they are to be taken 2-3 times daily. What the extended release dosage forms are designed to do is to release enough drug to produce a similar concentration peak as the immediate release tablets, and continue to release more over time to replace the amount lost to metabolism/excretion (this is often achieved by making some portion of the dosage form dissolve immediately and the rest take some time to dissolve). What this does, is it extends the therapeutic effect of the drug by maintaining the desired concentration for longer (6, 8, maybe even 12 hours but usually not that long) so that multiple doses would not be needed, ideally. Therefore, a 10 mg XR should produce the same effect as the 10 mg IR tablet, and keep it going for longer. So, for instance, a single 10 mg XR medication may replace your twice daily dosage of the 10 mg IR tablet, you will not be receiving less drug and should not require a dose adjustment. The extended release forms are more for convenience depending on your lifestyle. My apologies for the essay!


Welcome to the forums, NCpharmadude!
You're saying 10mg XR should have the same effect initially as 10mg IR, but magically sustain it for twice as long? Sorry, work in a pharmacy or not, that's completely wrong, and not even possible. I hope you're not telling patients that because it will really screw with them. You can't get the same initial concentration peak as 10mg by releasing less than 10mg. 10mg XR doesn't release the entire 10mg all at once or there'd be nothing left to release later. It releases half (5mg) immediately, and the remainder later. Therefore the peak concentration from the first portion can only be comparable to 5mg IR, not 10mg IR.

purpleToes
12-29-13, 07:47 AM
I'm new to the forums, sorry if I'm just making another thread of the same topic but I can't exactly figure website search tools out.
So, I'm on both 10mg Adderall XR and 10mg IR. I have a good amount of questions and I'm off my medicine for the holidays, so bear with me. I'll ask the sciency ones first.

-Why does XR use amphetamine salts rather than Dextro/levo-amphetamine as IR does? (besides the cost issue. do amphetamine salts last longer in your system?)
-When I take IR, I feel a lot more motivated to do things. I've read this is because of the Levo-amphetamine but is it just because I'm taking amphetamines rather than mixed salts (which I can assume, are mixed with others things that might lessen the effect of the medicine)

then, I have a few more just about being off them:
-When I don't take my medicine for even a day or two, I feel terrible during those days. I have general lethargy and aggression towards others. Is this normal? I would assume it's not withdrawal because I've only taken it for 6 months (and had weekend med breaks).
-When I'm off my medicine and past the above issues, I often find myself doing ridiculously stupid things. Such as hiding our INTJ biology teachers projector remote onto the back of his skeleton and not telling him for half an hour, or hitting on my friends who have partners. I'd like to know if it's just me, or if anyone else gets the stupids when they're off their medicine for less than a week.

Sorry to have spammed you all with this wall of miswritten questions, but I am curious about all of this. :D

Why are you going off your medicine?
Yes you will surely have a return of symptoms, possibly even some rebound, if you skip a dose, let alone several doses. Adderall is a short-acting medicine. You can't stop it and expect to "coast" for a while like with antidepressants.

Skipping weekends seems okay for some people, but most find they need medication 7 days a week because symptoms interfere with functioning, including social functioning, in all settings, not only school and work.

sarahsweets
12-29-13, 08:05 AM
good point purple, why go off your meds?