Vyvanse vs Concerta — choosing the right ADHD medication for you

Managing attention-deficit/hyperactivity disorder (ADHD) comes with a lot of challenges when it comes to selecting the right medication, including ones like Vyvanse vs Concerta. 

Among the most commonly prescribed medications for ADHD are Concerta (methylphenidate ER) and Vyvanse (lisdexamfetamine). Both are stimulants the U.S. Food and Drug Administration (FDA) approved for ADHD treatment, but they don’t work the same and have different side effect profiles.

In this article, we explore Vyvanse and Concerta to help you understand their differences in their drug interactions, possible side effects, and associated costs — so you can make an informed choice with your provider.

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Vyvanse and Concerta overview

Concerta and Vyvanse are both Schedule II controlled substances, meaning they have a recognized medical use but also have a risk of misuse, abuse, and dependency. While both work to improve focus and reduce impulsivity in people with ADHD, they are different medications. The following table outlines their key differences.

**Costs are per drugs.com and reflect its discount at the time of publication. 

What is Concerta?

Concerta (methylphenidate ER) is a central nervous system (CNS) stimulant primarily prescribed for attention-deficit/hyperactivity disorder (ADHD). It works by affecting neurotransmitters in the brain that control hyperactivity, focus, and impulsivity to help to improve overall symptom management. 

As a Schedule II controlled substance, Concerta carries a potential for dependency when misused, so it’s important to use it under medical supervision.

Methylphenidate, Concerta’s active ingredient, is also found in other ADHD medications like Ritalin and Daytrana. What sets Concerta apart is its unique time-release delivery system, which ensures consistent symptom relief throughout the day.

Forms and dosages of Concerta

Concerta is formulated as an extended-release tablet once daily, offering up to 12 hours of symptom relief. 

Concerta is available in 18-, 27-, 36-, and 54-milligram strengths. It should be taken once daily in the morning to provide up to 12 hours of symptom relief. Tablets should be swallowed whole, not crushed or chewed, as this disrupts the time-release system.

Most adults start with 18 milligrams daily. Doses can be increased by 18 milligrams per week as needed up to a maximum dose of 70 milligrams a day.

Always follow your provider’s guidance and report any concerns for safe and effective treatment.

Concerta’s unique OROS delivery system

Concerta employs an Osmotic Controlled Release Oral Delivery System (OROS) to administer methylphenidate in a controlled, sustained manner. Once ingested, approximately 22% of the dose is released as the tablet’s outer layer dissolves. The remaining medication is housed within internal compartments that release the rest of the drug gradually throughout the day. 

This design ensures a steady release, minimizing peaks and troughs in medication levels, and provides up to 12 hours of symptom control. The OROS system’s consistent delivery is affected less by factors such as pH, food intake, and gastrointestinal motility, offering predictable pharmacokinetics. 

This distinguishes Concerta from immediate-release stimulants, which may require multiple doses a day and can lead to fluctuating drug levels.

Branded vs generic Concerta

While generic forms of methylphenidate ER are available, they may not fully replicate Concerta’s precise delivery mechanism.

It’s crucial to consult with your pharmacist or provider to confirm the details of your prescription. The FDA has downgraded the ratings of some generics in the past due to variability in efficacy, which highlights the importance of verifying the specific manufacturer and formulation of your medication.

If you have questions about the availability of generics or concerns about switching between brand-name and generic versions, consult with a licensed provider. Learn more about ADHD medications in the ADHD medication guide.

Conditions treated by Concerta

Concerta is FDA-approved to treat ADHD in children 6 years of age and older, adolescents, and adults up to the age of 65. Some providers prescribe it off-label (for a condition it’s not approved to treat) for narcolepsy. 

Cost of Concerta

Brand-name Concerta is costly. Drugs.com lists the following costs for it with the drugs.com discount applied.

• 100 18-milligram tablets: $1,367.73
• 100 27-milligram tablets:  $1,401.78
• 100 36-milligram tablets: $1,445.68
• 100 54-milligram tablets: $1,572.28

These prices are based on cash-paying customers and may vary depending on the pharmacy.

For generic methylphenidate extended-release, the cost is significantly lower. For example, a 

Prices can fluctuate based on location and insurance coverage. Consult with your pharmacist or insurance provider for the most accurate and up-to-date pricing information.

Concerta side effects

While Concerta is effective for managing ADHD, it causes side effects in some patients. Most people taking Concerta report few or mild side effects, but responses vary, and it’s important to be aware of possible reactions. 

Common side effects associated with Concerta include:

• Decreased appetite
• Headache
• Dry mouth
• Nausea
• Trouble sleeping
• Anxiety
• Dizziness
• Weight loss
• Irritability
• Increased sweating

Serious side effects, though less common, may occur:

• Increased blood pressure and heart rate
• Mental (psychiatric) problems
• Seizures
• Painful and prolonged erections (priapism)
• Circulation problems in fingers and toes (peripheral vasculopathy, including Raynaud’s phenomenon)
• Slowing of growth (height and weight) in children
• Eye problems (increased pressure in the eye and glaucoma)
• New or worsening tics or worsening Tourette’s syndrome
• Eyesight changes or blurred vision
• Possible blockage of the intestine

If you take Concerta, promptly report any severe or concerning symptoms to your healthcare provider and the FDA by visiting MedWatch or calling 1-800-FDA-1088. 

Warnings and drug interactions

Before starting Concerta, discuss your complete medical history with your healthcare provider, especially if you have or have had:

• Cardiovascular conditions (for example, heart disease, hypertension)
• History of substance abuse disorder (SUD)
• Mental health disorders (for example, anxiety, bipolar disorder)
• Circulatory problems

Concerta may interact with some medications, including:

• Monoamine oxidase inhibitors (MAOIs)
• Coumarin anticoagulants
• Antidepressants and selective serotonin reuptake inhibitors (SSRIs)
• Halogenated anesthetics during surgery
• Risperidone

Concomitant use of these medications can increase the risk of adverse effects or reduce therapeutic efficacy. Tell your healthcare provider about all medications and supplements you’re taking. 

Dependency and abuse potential

As a Schedule II controlled substance, Concerta has an FDA boxed warning for the potential for abuse, misuse, and addiction. Misuse can lead to substance use disorder, misuse, abuse, overdose, or death. 

To mitigate these risks, follow your healthcare professional’s dosage schedule and avoid sharing your medication with others. Regular consultations with your healthcare provider are important to monitor the medication’s effectiveness and any potential side effects. 

What is Vyvanse?

Vyvanse (lisdexamfetamine) is a once-daily, time-released stimulant medication primarily used to treat ADHD in adults and pediatric patients 6 and older.

Vyvanse was FDA-approved in 2007. It’s a Schedule II controlled substance, which means it has a medical purpose but potential for abuse, misuse, and addiction. Vyvanse is classified as a CNS stimulant and is known for its unique delayed activation process.

Vyvanse targets neurotransmitters in the brain associated with behavior regulation, including impulsivity, focus, and hyperactivity. This makes it effective in reducing common ADHD symptoms.

Forms and dosages of Vyvanse

Vyvanse is considered a prodrug, which means it is inactive until metabolized by the body. When ingested, the body gradually converts Vyvanse into its active form, dextroamphetamine, making it effective over an extended period of time. This process also reduces the potential for abuse compared to other stimulant medications.

Vyvanse is available in both capsule and chewable tablet forms with the following dosage strengths: 5, 10, 20, 30, 40, 50, 60, and 70 milligrams.

Starting dose: For adults treating ADHD, the recommended starting dose is 30 milligrams once daily in the morning.

Titration schedule: The dosage may be adjusted in increments of 10 or 20 milligrams at weekly intervals. Adjustments are based on individual efficacy and tolerability.

Maximum dose: The maximum recommended dose for adults is 70 milligrams a day.

Tapering off: When discontinuing Vyvanse, it’s important to consult a healthcare provider. While Vyvanse doesn’t typically require a tapering schedule due to its pharmacological profile, sudden cessation after prolonged use may lead to withdrawal symptoms in some individuals. A healthcare professional can provide guidance on safely discontinuing the medication.

Note: Dosage should always be personalized and determined by a healthcare provider based on individual needs and response to treatment.

It’s recommended to take Vyvanse in the morning, with or without food. To maintain the extended-release effect, capsules should be swallowed whole without crushing or chewing.

Conditions treated by Vyvanse

Vyvanse is FDA-approved to treat ADHD in people 6 and older and moderate to severe binge eating disorder (BED) in adults. Some providers may also prescribe Vyvanse off-label for narcolepsy. Consult your healthcare provider to determine if Vyvanse is a suitable option for managing your condition.

Cost of Vyvanse

Vyvanse is available exclusively in brand-name form and doesn’t have a generic equivalent, which contributes to it having a higher cost than many other ADHD medications. Drugs.com lists a cost of $1,370.62 for 100 capsules or chewable tablets of Vyvanse regardless of strength. That cost includes the drugs.com discount.

Contact your insurance provider or pharmacist for accurate pricing under your health insurance.

Side effects of Vyvanse

While Vyvanse is effective for many people, it can cause side effects. Most side effects are mild and manageable, but monitoring your response to the medication is important.

Common side effects of Vyvanse include:

• Dry mouth
• Decreased appetite
• Constipation
• Anxiety
• Trouble sleeping
• Increased heart rate
• Feeling jittery

Serious but rare side effects when taking Vyhanse can include:

• Abuse, misuse, and addiction: Vyvanse has a high potential for abuse and dependence. Take it only as prescribed, and inform your healthcare provider if you have a history of substance abuse.
• Mental health (psychiatric) problems: Some individuals may experience new or worsening psychiatric symptoms like aggression, depression, or psychosis. Contact your healthcare provider immediately if you notice significant mood or behavior changes.
• Slowing of growth in children: Vyvanse may slow down growth in height and weight in children and adolescents. Regular growth monitoring is important, and treatment may be adjusted if necessary.
• Circulation problems in fingers and toes (peripheral vasculopathy, including Raynaud’s Phenomenon): Symptoms include numbness, pain, or color changes in fingers or toes. Report these signs to your healthcare provider promptly.
• New or worsening tics or Tourette Syndrome: Inform your doctor if you or your child develop new or existing tics that worsen during treatment.
• Serotonin Syndrome: A potentially life-threatening condition that can occur when Vyvanse is taken with certain other medications. Symptoms include agitation, hallucinations, rapid heartbeat, dizziness, and gastrointestinal issues. Seek immediate medical attention if these occur.

Warnings and drug interactions for Vyvanse

Vyvanse has an FDA boxed warning regarding the potential for abuse and dependence. It’s a Schedule II controlled substance and should be used cautiously, especially in individuals with a history of substance abuse.

Vyvanse can also cause sudden death and serious cardiovascular adverse events in people with pre-existing structural cardiac abnormalities or other serious heart problems. Inform your healthcare provider if you have a history of heart disease, structural cardiac abnormalities, cardiomyopathy, serious heart arrhythmia, or coronary artery disease before starting Vyvanse.

Vyvanse can also interact with certain drugs, including monoamine oxidase inhibitors (MAOIs), serotonergic drugs, CYP2D6 inhibitors, alkalinizing agents, acidifying agents, and tricyclic antidepressants (TCAs). It’s important to share a full list of medications and supplements with your provider to avoid any potential adverse interactions.

Vyvanse vs Concerta: how to choose

Talking to a doctor, understanding how each medication works, and considering your needs are important when choosing Vyvanse or Concerta for ADHD. The stimulants in both medications treat ADHD symptoms like inattention, hyperactivity, and impulsivity. They boost brain neurotransmitters like dopamine and norepinephrine, improving focus, attention, and self-control. Absorption, release mechanisms, and formulation vary among 12-hour medications.

Key differences between Concerta and Vyvanse

Vyvanse is a prodrug, meaning it remains inactive until the body metabolizes it in the digestive system, usually taking about 1 to 2 hours to reach full effect. This delayed activation helps the medication work effectively. It also remains effective for 10 to 14 hours. 

Concerta, on the other hand, uses the OROS so it begins working shortly after ingestion and releases a steady amount of the active ingredient, methylphenidate, throughout the day. This immediate start may benefit those who need prompt symptom relief. Its effects last for 12 hours.

Formulation and administration

• Concerta is available only as extended-release tablets and shouldn’t be split or crushed due to its specialized OROS delivery.
• Vyvanse offers more flexibility with capsules and chewable tablets, making it a suitable option for those who have difficulty swallowing pills.

Medical considerations

• Both Concerta and Vyvanse are stimulants and may not be suitable for individuals with a history of substance abuse disorder, heart conditions, or cardiovascular issues, as they can lead to abuse, misuse, and addiction as well as increased heart rate and blood pressure.

Find the right ADHD treatment plan for you

Find a provider on Klarity Health today to begin your journey toward effective ADHD management and symptom relief. Your provider will assess your symptoms and determine which medication, if any, is a medically necessary part of your treatment plan.