Adderall Xr Vs. Ozempic®: Drug Comparison

Adderall XR^® (amphetamine/dextroamphetamine extended-release) contains amphetamine, a Schedule II controlled substance. It is a stimulant medication used primarily to treat attention-deficit hyperactivity disorder (ADHD) by increasing levels of dopamine and norepinephrine in the brain, which helps improve focus, attention, and impulse control. Its FDA-approved indications include ADHD in both children and adults, and it may also be used to treat narcolepsy, though this is more common with immediate-release formulations. Adderall XR comes in capsule form and is designed for once-daily dosing. Common side effects include insomnia, decreased appetite, and increased heart rate, while serious warnings include a boxed warning for potential abuse, dependence, and cardiovascular risks, especially in individuals with underlying heart conditions or a history of substance abuse. It also interacts with certain other medications.

Ozempic^® (semaglutide) is an injectable medication used to improve blood sugar control in adults with type 2 diabetes, to reduce the risk of major cardiovascular events in individuals with established heart disease, and to reduce the risk of kdiney problems in certain populations. It works by mimicking the hormone glucagon-like peptide-1 (GLP-1), which increases insulin secretion, decreases glucagon release, and slows gastric emptying. Administered once weekly, Ozempic is often part of a comprehensive treatment plan that includes diet and exercise. Common side effects include nausea, vomiting, diarrhea, and abdominal pain, and it should be used with caution in patients with a history of pancreatitis​.

Central nervous system (CNS) stimulant

Glucagon-like peptide-1 (GLP-1) receptor agonist

Adderall XR (mixed salts of a single-entity amphetamine product) is indicated:

• For the treatment of attention deficit hyperactivity disorder (ADHD) in adults and pediatric patients 6 years and older.

Ozempic (semaglutide) is indicated:

• As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus

• To reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes mellitus and established cardiovascular disease

• To reduce the risk of sustained eGFR decline, end-stage kidney disease and cardiovascular death in adults with type 2 diabetes mellitus and chronic kidney disease

• Typically taken orally once daily

• Comes in 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, and 30 mg extended-release capsules

• Typically taken as an injection once weekly

• Comes in single-patient-use pens that deliver 0.25 mg, 0.5 mg, 1 mg, or 2 mg per injection

Pediatric patients ages 6 to 12: Most common adverse reactions (≥5% and with a higher incidence than on placebo) were:

• Loss of appetite

• Insomnia

• Abdominal pain

• Emotional lability

• Vomiting

• Nervousness

• Nausea

• Fever

Pediatric patients ages 13 to 17: Most common adverse reactions (≥5% and with a higher incidence than on placebo) were:

• Loss of appetite

• Insomnia

• Abdominal pain

• Weight loss

• Nervousness

Adults: Most common adverse reactions ≥5% and with a higher incidence than on placebo were:

• Dry mouth

• Loss of appetite

• Insomnia

• Headache

• Weight loss

• Nausea

• Anxiety

• Agitation

• Dizziness

• Fast heart beat

• Diarrhea

• Weakness

• Urinary tract infections

The most common adverse reactions, reported in ≥5% of patients are:

• Nausea

• Vomiting

• Diarrhea

• Abdominal pain

• Constipation

• Known hypersensitivity or idiosyncrasy to amphetamine

• During or within 14 days following the administration of monoamine oxidase inhibitors (MAOI)

• Drug interactions: alkalinizing agents (GI antacids and urinary), acidifying agents (GI and urinary)

• Personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome type 2

• Serious hypersensitivity reaction to semaglutide or any of the excipients in Ozempic

• Drug interactions: Ozempic delays gastric emptying and may impact the absorption of concomitantly administered oral medications

• Risks to patients with serious cardiac disease

• Increased blood pressure and heart rate

• Psychiatric adverse reactions

• Long-term suppression of growth in pediatric patients

• Seizures

• Peripheral vasculopathy, including Raynaud’s phenomenon

• Serotonin syndrome: Increased risk when coadministered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations

• Motor and verbal tics, and worsening of Tourette’s syndrome

• Pregnancy: May cause fetal harm

• Lactation: Breastfeeding not recommended

• Pancreatitis

• Diabetic retinopathy complications

• Never share an Ozempic pen between patients, even if the needle is changed

• Low blood sugar: Concomitant use with an insulin secretagogue or insulin may increase the risk of low blood sugar, including severe low blood sugar

• Acute kidney injury

• Hypersensitivity reactions

• Acute gallbladder disease

• Females and males of reproductive potential: Discontinue Ozempic in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide

WARNING: ABUSE, MISUSE, AND ADDICTION

Adderall XR has a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CNS stimulants, including Adderall XR, can result in overdose and death:

• Before prescribing Adderall XR, assess each patient’s risk for abuse, misuse, and addiction.

• Educate patients and their families about these risks, proper storage of the drug, and proper disposal of any unused drug.

• Throughout treatment, reassess each patient’s risk and frequently monitor for signs and symptoms of abuse, misuse, and addiction.

WARNING: RISK OF THYROID C-CELL TUMORS

In rodents, semaglutide causes thyroid C-cell tumors. It is unknown whether Ozempic causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined.

Ozempic is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC and symptoms of thyroid tumors.

*This information is from the label for brand name Adderall XR^®. See the Full Prescribing Information for more complete information. Dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate, and amphetamine aspartate, the active ingredients in Adderall XR, may also be the active ingredients in other medications, and this information may not be accurate for all medications that include the active ingredients dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate, and amphetamine aspartate.

*This information is from the label for brand name Ozempic^®. See the Full Prescribing Information for more complete information. Semaglutide, the active ingredient in Ozempic, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient semaglutide.