*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Concerta and Vyvanse are stimulants that are sometimes prescribed for treating patients with attention deficit hyperactive disorder (ADHD) ages 6 and older.1 Differences include that Concerta has a less expensive, generic form and may act more quickly.2 Vyvanse has a chewable form, lasts longer, is less likely to be abused, and has fewer side effects.3 In addition, they have different side effects and drug interactions.
If you’re considering Concerta or Vyvanse, or want to discuss your current prescription with a provider, you will be limited in your options. Klarity and Circle Medical are two online psychiatry platforms that can and will prescribe stimulant medications, which are controlled substances. These platforms can connect you with a provider quickly and offer assessments and prescription consultation.
Boxed Warning: Methylphenidate (Concerta) – Risk of medication misuse or abuse
Methylphenidate, the active ingredient in Concerta, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Concerta has a risk of misuse (abuse) which can lead to dependence on the medication.
Concerta is a controlled substance, which means that it’s more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
Boxed Warning: Lisdexamfetamine dimesylate (Vyvanse) – Risk of medication misuse or abuse
Lisdexamfetamine dimesylate, the active ingredient in Vyvanse, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Lisdexamfetamine dimesylate has a risk of misuse (abuse) which can lead to dependence on the medication.
Vyvanse is a controlled substance, which means that it’s more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
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Key Differences Between Concerta & Vyvanse
Concerta and Vyvanse are both stimulant medications for ADHD but they are not interchangeable. They have different uses, doses, and forms. Also, they each have unique side effects and warnings. Concerta and Vyvanse take different amounts of time to begin working, last different lengths of time, and have different potentials for abuse.
The key differences between Concerta and Vyvanse are:
Conditions Treated
Concerta and Vyvanse are both Food and Drug Administration (FDA)-approved for the treatment of ADHD.2, 3 Vyvanse is also approved for moderate-to-severe binge eating disorder. A drug that is FDA-approved means it has been proven in randomized controlled clinical trials to be safe and effective for a certain use. Concerta and Vyvanse also differ in off-label uses. Off-label means a drug has not been approved by the FDA for a certain use, but a physician may choose to use the medication based on their professional judgment.
Concerta and Vyvanse each have unique off-label uses. Concerta has experimental uses that have been studied as potential treatments for the symptoms of diminished motivation in Alzheimer’s disease,4 fatigue in patients with cancer,5 and depression in older adults.6 and it has been studied as a potential treatment for impaired cognitive performance or memory in early dementia. 7 Vyvanse has been studied for use as a treatment for depression, though the authors indicate it requires more study.8 Studies have also examined Vyvanse as a potential treatment for erectile dysfunction,8 and excessive daytime sleepiness.9
Standard Dosages & Forms
Concerta comes in 8 mg, 27 mg, 36 mg, and 54 mg tablets taken in the morning.2 It is an extended-release medication, meaning the Concerta dose is slowly absorbed throughout the day. The extended-release formulation allows the medication to only be taken once a day.
Vyvanse comes in 20 mg, 30 mg, 40 mg, 50 mg, 60, and 70 mg as tablets, chewable tablets, or capsules that can be opened and mixed with yogurt, water, or orange juice.3 Vyvanse is also taken once daily in the morning. It is an immediate-release tablet, meaning the entire Vyvanse dose is absorbed at once.
Side Effects
Side effects that are unique to Concerta include thirst, excessive sweating, dry eye, blurry vision, glaucoma, vertigo, muscle tightness, tingling or prickling sensations, and fatigue.2 Psychiatric side effects include psychiatric events, hallucinations, confusion, hypervigilance, and panic attacks. Also, upper respiratory tract issues, serious cardiovascular events, heart murmur, intestinal obstruction, and prolonged or painful erection may occur. Additional side effects include elevated white blood cell count, decreased leukocytes, and hot flashes.
Side effects that are unique to Vyvanse include muscle pain or weakness and involuntary muscle control.3 Psychiatric side effects include paranoia, compulsive picking at the skin, talkativeness, and anger. Other side effects that may occur include heart enlargement, intestinal death, Steven Johnson syndrome, swelling, hair loss, nose bleeds, and change in taste perception.
Strength
Potency is the strength of a medication. The larger the dose, the more potent a drug is. The starting dose of Concerta is 18 mg, while adults may also start with 36 mg.2 Children may be prescribed 18-54 mg, while adolescents and adults may be prescribed 18-72 mg per day. Adolescents should not be prescribed more than 2 mg/kg/day. Also, Concerta can be taken with or without food.
The starting dose for Vyvanse is 30 mg and your doctor may increase your dose weekly in increments of 10 mg or 20 mg.3 The maximum dose of Vyvanse prescribed is 70 mg. Vyvanse can also be taken with or without food.
How Long It Takes to Work
Concerta begins working about 1 hour after taking it and continues to reach its full effect for the next 5-9 hours.2 Vyvanse will start to take effect 30 minutes to an hour after taking it.3 You will notice an effect about 1-3.5 hours after taking it and the effects will last for about 14 hours.3, 10
Addiction Potential
The addiction potential of a drug depends on the amount of time it stays in your body and the time a drug stays in the body depends on its half-life. Half-life is the amount of time it takes for half of the drug’s concentration to be reduced. Concerta’s half-life is 3.6 hours and Vyvanse’s is less than an hour in children and adults.2, 3
The table below summarizes the key differences between Concerta versus Vyvanse:2, 3, 10
Key Components | Concerta | Vyvanse |
What is the generic name? | Methylphenidate | Lisdexamfetamine |
What forms does it come in? | Tablets | Capsules, tablets, and chewable tablets |
What are the typical dosages? | 18 mg, 27 mg, 36 mg, and 54 mg | 20 mg, 30 mg, 40 mg, 50 mg, 60, and 70 mg |
Who is approved to take it? | Children and adolescents 6-17 years old and adults | Children and adolescents 6-17 years old and adults |
How long will they last? | About 6-10 hours | About 14 hours |
Potential for Abuse | Higher | Lower |
What Is Concerta?
Concerta is FDA-approved to treat ADHD in children 6-12 years, adolescents 12-17 years old, and adults up to 65 years old.2 It acts by blocking dopamine and norepinephrine transporters in nerve endings to increase dopamine and norepinephrine. These act as a stimulant and produce feelings of pleasure, motivation, and reward. The result is improved attention span and decreased distractibility.
What Is Vyvanse?
Vyvanse is also FDA-approved to treat ADHD in children 6-12 years, adolescents 12-17 years old, and adults up to 65 years old.3 It also acts by increasing dopamine and norepinephrine as a stimulant. The result is improved attention span and feelings of pleasure and reward. The generic (lisdexamfetamine) is not currently available.
Get Personalized, Affordable ADHD Treatment
The providers on Klarity offer comprehensive, personalized ADHD treatment. From diagnosis to therapy to medication management, a Klarity provider will be there for you. And, if needed, they’re able to prescribe controlled substances, like Adderall and Concerta.
How Are Concerta & Vyvanse Similar?
Concerta and Vyvanse are both stimulants.2, 3 They are both intended for ADHD in children, adolescents, and adults. They come as oral drugs and have similar side effects, warnings and precautions, and drug interactions. Concerta and Vyvanse can both be prescribed by primary care doctors, psychiatrists, and nurse practitioners.
Both drugs are intended for patients ages 6-65 years old.2, 3 Stimulants act by increasing dopamine and norepinephrine to stimulate the reward system for increased attention span and interest in tasks like studying. Concerta and Vyvanse can cause abuse, misuse, addiction, dependence, dizziness, dry mouth, nausea, decreased weight, and upper abdominal pain. They both have warnings for psychiatric conditions and long-term growth suppression. Also, they interact with drugs that increase serotonin.
Similarities between Concerta & Vyvanse include that they are both:
- Are both stimulant medications
- Have multiple uses as FDA-approved and off-label treatments
- Have similar dosage forms
- Have similar side effects
- Have similar warnings and precautions
- Have similar drug interactions
What Are Concerta & Vyvanse Used to Treat?
Concerta and Vyvanse are FDA-approved to treat ADHD.1 Vyvanse is also approved to treat binge-eating disorder.5 A drug that is FDA-approved means it has been proven in randomized controlled clinical trials to be safe and effective for a certain use. Concerta and Vyvanse also have off-label uses. Off-label means a drug has not been approved by the FDA for a certain use, but a physician may choose to use the medication based on their professional judgment.
Side Effects of Concerta & Vyvanse
Common side effects of Concerta include upper abdominal pain, decreased appetite, decreased weight, headache, dry mouth, nausea, insomnia, anxiety, dizziness, irritability, and hyperhidrosis.2 Side effects that are common for Vyvanse include insomnia, anxiety, irritability, dizziness, dry mouth, heart enlargement, and psychomotor hyperactivity.3
Commonly experienced side effects are often mild, though some may require medical attention. This is not a comprehensive list of possible mild or serious side effects. You should talk with your prescriber and pharmacist about any potential side effects from either medication.
The table below compares the possible side effects of Concerta and Vyvanse:*2, 3
Side Effects | Concerta | Vyvanse |
Drug dependence | Yes | Yes |
Drug tolerance | Yes | Yes |
Vertigo | Yes | No |
Headache | Yes | Yes |
Fatigue | Yes | No |
Irritability | Yes | Yes |
Vomiting | Yes | Yes |
Decreased appetite | Yes | Yes |
Libido changes | Yes | Yes |
Erectile dysfunction | Yes | Yes |
*All medications, including stimulants, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.
Warnings & Precautions for Concerta & Vyvanse
Concerta and Vyvanse have many precautions that should be considered before use. Warnings include avoiding use with alcohol, use while pregnant or breastfeeding, and allergic reactions.2, 3 Other warnings include drug abuse, dependence, or overdose, serious heart conditions, poor blood circulation, and impaired growth in children.
Risks to consider when taking Concerta and Vyvanse include:2, 3
- Interactions with alcohol: Alcohol should not be consumed with ADHD medications. They can raise the risk of alcohol poisoning and seizures.
- Use while pregnant or breastfeeding: Concerta has been known to cause birth defects and Vyvanse can cause complications for infants. Tell your doctor if you are pregnant or thinking about becoming pregnant while you are taking either of these medications.
- Allergic reactions: Like other drugs, you can have a severe allergic reaction to Concerta or Vyvanse. The risk is rare, but if you do have one, you should seek immediate medical care.
- Drug abuse, dependence, or overdose: Though rare when used correctly, Concerta and Vyvanse have a risk of abuse. If you overdose, seek immediate medical attention.
- Glaucoma: Concerta can increase pressure in the eyes similar to glaucoma.
- Tics: Concerta can make tics worse.
- Serious heart conditions: People with serious heart events, high blood pressure, or elevated heart rate should not take Concerta or Vyvanse. They can speed up heart activity.
- Psychiatric conditions: People with psychotic disorder, Bipolar disorder, aggression issues, anxiety, and suicidal ideation or behaviors should not take ADHD medications. They can make these conditions worse.
- Seizures: Concerta can lower the threshold needed to have a seizure, making seizures more likely to occur.
- Priapism: Concerta can cause prolonged and painful erections when used long-term.
- Peripheral vasculopathy, including Raynaud’s phenomenon: Both Concerta and Vyvanse should not be used in patients with poor blood circulation.
- Long-term suppression of growth: When taken long-term, Concerta and Vyvanse can slow growth without growth rebound after discontinuation.
- Visual disturbances: Concerta can cause blurry vision.
- Potential for gastrointestinal obstruction: Concerta tablets are not broken down and therefore should not be given to patients with gastrointestinal narrowing.
- Blood cell count monitoring: Blood levels should be monitored periodically with the long-term use of Concerta.
- Serotonin Syndrome: Though usually only likely to occur when combined with other medications, Vyvanse can cause serotonin syndrome.
Potential Drug Interactions With Concerta & Vyvanse
Concerta & Vyvanse can interact with various substances, acting in similar ways or enhanced by other drugs.2, 3 They can interact with drugs that increase serotonin and risk serotonin syndrome. Concerta can interact with some seizure and anti-blood clotting medications, while Vyvanse can interact with some blood pressure medications.
Disclaimer: Taking certain medications, herbs, or supplements alongside Concerta and Vyvanse can change how these medications work in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrists, and pharmacists know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Medications and substances that have harmful interactions with Concerta and Vyvanse include:2, 3
Complicating Interactions | Concerta | Vyvanse |
Tricyclic antidepressants | X | X |
MAOIs | X | X |
SSRIs | X | X |
SNRIs | X | |
Other serotonin drugs, e.g., triptans, fentanyl, lithium, tramadol, tryptophan, Buspirone, St. John’s Wort | X | |
Anticonvulsants, e.g., phenobarbital, phenytoin, and primidone | X | |
Anti-blood clotting drugs | X | |
Vasopressors | X | |
Risperidone | X | |
Quinidine, ritonavir | X | |
Hydrochlorothiazide, furosemide, and acetazolamide | X | |
Ammonium chloride, sodium acid phosphate, and methenamine salts | X |
Which Is Right for You: Concerta or Vyvanse?
Depending on the dosage form you need, the side effects you want to avoid, and your medical history, your doctor may favor one drug over the other. The medication best for your needs can depend on many factors, so you may need to consider online psychiatry services if seeing a doctor in person isn’t feasible. They can help you consider the benefits and risks of each medication.
How to Get a Prescription for Concerta & Vyvanse
Like other ADHD medications, Concerta and Vyvanse are only available by prescription. You can get them from your doctor, nurse practitioner, or psychiatrist. They can help you consider ADHD medications as a treatment by educating you on who the medications are for, what their side effects are, and how they are intended to be used.
Get Personalized, Affordable ADHD Treatment
The providers on Klarity offer comprehensive, personalized ADHD treatment. From diagnosis to therapy to medication management, a Klarity provider will be there for you. And, if needed, they’re able to prescribe controlled substances, like Adderall and Concerta.
Questions to Ask Your Health Team About Concerta & Vyvanse
It is important to have open communication with your doctor so can accurately decide which medication is best for you. Also, you should go to your appointment prepared with any questions or concerns you have. It is also important to be open about your habits because these medications can be very dangerous.
Questions to ask your prescriber about Concerta and Vyvanse include:
- Is it safe to take Concerta or Vyvanse with my other medications?
- Will Concerta or Vyvanse be covered by my insurance?
- Which one has the best results as a treatment for ADHD?
- Does my medical history increase my risk of side effects for either?
- How long can I expect side effects to last?
- How often should I see you for checkups while taking Concerta or Vyvanse?
- What should I do if I am unsure whether ADHD medications are right for me?
- When should I expect to start feeling better?
- What should I do if I experience side effects?
- Which side effects are severe?
- What options are there besides stimulant medications for ADHD?
In My Experience
In my experience, patients have success and few side effects with both drugs. Side effects tend to be mild and some can go away over time. If you want to get prescribed ADHD medication, your doctor will want to know what symptoms you are having and then decide with you if a stimulant is best.
Additional Resources
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Online psychiatry, sometimes called telepsychiatry, platforms offer medication management by phone, video, or secure messaging for a variety of mental health conditions. In some cases, online psychiatry may be more affordable than seeing an in-person provider. Mental health treatment has expanded to include many online psychiatry and therapy services. With so many choices, it can feel overwhelming to find the one that is right for you.