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3yr
Prodrug technology use in ADHD

Prodrugs are used to boost drug permeation; they work by boosting lipophilicity or water solubility. Adequate prodrugs demonstrate sufficient lipophilicity, sufficient solubility/stability in water, and conversion to the parent drug in the body, as well as being safe.

Prodrugs can improve the delivery of an active drug or decrease toxicity. They are inactive compounds that need in vivo conversion to release therapeutically active medications. Prodrugs can concentrate in cells and act specifically.

How familiar are you with prodrugs in the treatment of ADHD? What do you see as the potential benefits or challenges with prodrugs?

  • 3yr
    Possibility of less abuse than as compared to regular drug and with the added capabilities should benefit from the get to.
  • 3yr
    prodrugs can be helped offering more predictability with half life and tolerance along with reducing abuse potential. currently there are limited options for prodrugs, primarily vyvanse and mydayis main options
  • 3yr
    I am familiar with Vyvanse and the use of a prodrug to help with more reliable onset and duration of peak action
  • 3yr
    I prefer prodrugs due to decreased risk of abuse. But it is hard to get the insurance company to cover the cost of the med. I haven't been able to use azstarzys due to poor insurance coverage so far.
  • 3yr
    Insurance coverage is not adequate. The marketers say that the advise potential is less
  • 3yr
    Insurance coverage is not adequate. The marketers say that the advise potential is less
  • 3yr
    Prodrugs seem to have a longer half life, so the number of pills dispensed is less and there is a smoother PK/PD profile. They are also less likely to be abused
  • 3yr
    Azstarys and Vyvanse are 2 that use a pro drug tech helping the med last longer and decreasing abuse potential. It's nice to have.
  • 3yr
    Most familiar with Vyvanse in this category. Often pro-drugs are harder to get covered by insurance. Have heard of the Azstarys but have not had it covered as yet. Prodrugs can have longer duration and usually have smoother uptake and less side effects
  • 3yr
    Familiar ie Vyvanse snd work well for many of my patients. Can have an abrupt cut off effect.
  • 3yr
    I have used prodrugs in my ADHD patients—they have a longer duration of action, smoother blood levels which can be helpful to some patients. However, the mechanism of action is not particularly different than the original compound so efficacy is not dramatically better. Even with prodrugs, at least for adhd treatment, one still often needs to add an additional short acting compound to help with evening symptoms to help with evening functioning.
  • 3yr
    Not very familiar with prodrugs as not on our open have used them occasionally and it has worked well.Cost needs to come down.
  • 3yr
    Azstarys is a prodrug for dexmethylphenidate. Vyvanse is a prodrug for D-amphetamine. They seem to be safer and equally as effective as the long acting versions, with less potential for abuse. However, both are expensive, so cost and insurance coverage are likely to be issues.
  • 3yr
    Helps provide longer duration of action and reduce potential for abuse. Seen in medication like Vyvanse and Azstarys. Also provides smoother drug release over time
  • 3yr
    Vyvanse is a prodrug of d-amphetamine. Provides longer and smoother duration of action and limits abuse potential
  • 3yr
    I think use of prodrug, like Vyvanse, should help adherence since it has a nice adherence, since it's long acting, avoiding having to re-dose in the afternoon/after school time for children.
  • 3yr
    Prodrugs can have a longer duration of action and have smoother uptake and fewer side effects. I tend to prefer prodrugs, especially for stimulants, since they are less abuseable.
  • 3yr
    somwhat familiar, it would be an easier sale for treatment naive patients
    newer drug usually requires PA which is a hassle
  • 3yr
    A prodrug has less abuse potential than a regular drug. So I always prefer prescribing a prodrug.
  • 3yr
    Now a methylphenidate product with better time release and limited abuse potential, Astarzys
  • 3yr
    Prodrugs can often increase the lipophilìcity or water permeability. They also tend to have less potential for abuse or toxicity. Also, they have longer duration of action. The biggest challenge with them is insurance coverage and cost.
  • 3yr
    Philip Creps fromMindful Health Sollutions:, Mission Viejo, CA 92691: prodrug provides a longer period of active coverage for ADHD during the day.
  • 3yr
    I have used prodrug formulations for ADHD in my practice for years. I think they are of great benefit for slow timely release of medic for smooth transition, longer duration and lower side effect profile
  • 3yr
    Prodrugs offer another armamentarium in treatment of ADHD.
    Useful for parents and individuals that have difficulty with remembering afternoon doses and have issues with compliance.
    Prodrugs offer more precise onset and length of action with lower abuse potential.
    Another technological advancement in drug delivery system.
  • 3yr
    My patients have benefited from prodrug Vyvanse and now Azstarys. Both are the closest I have seen in achieving the advertised length of action when compared to others. When tolerated, they appear to be a smoother option for symptom control. I tend to use them in middle schoolers and upwards. Glad to have the technology as an option.
  • 3yr
    An example of prodrug for d-amphetamine is Vyvanse, with duration of action up to 14 hours. An ex. of prodrug for methylphenidate by Kem Pharm are KP415 & KP484, with duration of action up to 16 hours. Prodrugs improve onset of action, duration of action, consistency of delivery & abuse potential.
  • 3yr
    Specifically, Vyvanse comes to mind. Reportedly peak action is more reliable than Adderall XR, i.e. a narrower time to peak across all users and for the individual user. Risk of diversion is less since the undigested product is inactive.

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