Biphentin: The Newest ADD/ADHD Medication in Canada
ByDespite there being many medications available to treat Attention Deficit Hyperactivity Disorder (ADD or ADHD) in the US, there are relatively few medicines in Canada. We had one new medicine added to our arsenal in Canada around September 2006 – Biphentin. This article will summarize what role Biphentin can play in treating ADD/ADHD.
What is Biphentin?
Biphentin is a new formulation of methylphenidate. Methylphenidate is the same medication that is found in Ritalin. Methylphenidate has been around for over 50 years. Despite many concerns and warnings discussed in the media, it is a safe medicine, when taken as prescribed and monitored by a physician. It also can work very well. Approximately 70-80% of people with ADD/ADHD will have significant improvement when they take this medicine.
In Canada, methylphenidate also comes as: Ritalin, Ritalin SR, and Concerta.
In the US, methylphenidate also comes as: Ritalin, Ritalin LA, Concerta, Metadate CD, Focalin XR.
Biphentin is being marketed in Canada, and is made by Purdue Pharma. It is not being marketed in the US. I was told (in a personal communication – certainly not official!) that Biphentin may eventually be marketed in Europe, but likely not in the US. Why not the US? I was told that it is very competitive in the US to market another form of Methylphenidate.
What are the characteristics of Biphentin?
Biphentin is a long acting form of methylphenidate. It lasts 8-10 hours with once daily dosing.
Biphentin is a capsule – with little beads inside. This allows the medicine to be ‘sprinkled’ onto soft foods like: apple sauce, yogurt or ice cream. This can help with children who cannot swallow the pills. In Canada, this is the only medication option for methylphenidate that can be taken by children who cannot swallow pills. (As a side note, Adderall XR – which is an amphetamine, can also be opened and sprinkled.)
Biphentin comes in multiple strengths. This flexibility of dosing may make it easier for your doctor to find the right strength for you.
The strengths are: 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 50 mg, and 60 mg.
Who is Biphentin approved for?
Health Canada has approved Biphentin for the treatment of ADD/ADHD across the lifespan. Specifically, Biphentin is approved to treat ADD/ADHD in children, adolescents and adults.
What are the side effects of Biphentin?
Biphentin’s side effects are the same as the side effects of the other methylphenidate products. The common side effects include: decreased appetite, insomnia, worsening of tics, approx. 2% risk of slowing growth. There are rare concerns of agitation, mood symptoms, etc. [N.B. This post is for educational purposes only - speak to your Doctor about side effects in detail]
How much does Biphentin cost?
Biphentin will most likely be covered under private insurance plans through your work. If it isn’t, I am happy to report that in general, it is cheaper than the newer forms of ADD/ADHD medication. The price does depend on the strenght of the pill.
The cost of Biphentin for 30 days of treatment is estimated as follows:
- Biphentin 10 mg once daily for 30 days: $29.40
- Biphentin 15 mg once daily for 30 days: $38.40
- Biphentin 20 mg once daily for 30 days: $46.80
- Biphentin 30 mg once daily for 30 days: $60.90
- Biphentin 40 mg once daily for 30 days: $75.00
- Biphentin 50 mg once daily for 30 days: $89.10
- Biphentin 60 mg once daily for 30 days: $103.50
These prices are listed in Canadian dollars. These are estimates, and the prices may vary at your pharmacy.
As a brief comparison of cost – here are estimated costs of some of the other ADD/ADHD medications in Canada:
- Concerta 18 mg once daily for 30 days: $71.70
- Concerta 36 mg once daily for 30 days: $90.90
- Concerta 54 mg once daily for 30 days: $110.40
- Adderall XR 5 mg once daily for 30 days: $96.00
- Adderall XR 30 mg once daily for 30 days: $96.00
- Strattera 10 mg once daily for 30 days: $134.97
- Strattera 60 mg once daily for 30 days: $134.97
- Ritalin SR 20 mg once daily for 30 days: $25.20
- Ritalin 10 mg once daily for 30 days: $18.30
When can Biphentin be used?
Biphentin can be used to treat ADD/ADHD at any age – it is approved for the treatment of kids, teens and adults.
Biphentin can be used as a ‘first line’ treatment – i.e. the first medicine given for someone with ADD/ADHD.
Because Biphentin is a once a day treatment – the patient doesn’t have to worry about taking a pill in the middle of the day. This is particularly helpful for children who can take their pill in the morning, and then not have to go to the office at school to get their noon medicine. This makes it easier for a child at school.
If someone has been on a different form of methylphenidate and had problems, it may be reasonable to try Biphentin to see if this long acting formulation may work better.
If your child has trouble swallowing pills, but your doctor thinks that methylphenidate is the right choice of medication, then Biphentin is the best choice.
Can Biphentin Be Abused?
One of the concerns with any stimulant medicine is the risk that it may be abused. If someone takes too much of the medicine, and tries to take it as a drug – i.e. snort it – then it can produce a ‘high’.
I am happy to report, that similar to the other long acting preparations of stimulant medicines (like Concerta and Adderall XR), Biphentin is not abusable. That means that someone couldn’t use it to get a ‘high’.
It is important for you to also know that Biphentin is not addictive.
How does Biphentin compare to Ritalin, Ritalin SR and Concerta?
All of Biphentin, Ritalin, Ritalin SR and Concerta are the same medication – i.e. methylphenidate. The difference is the preparation and how it acts in the body.
Ritalin is a short acting medicine, and is required to be taken two or three times daily for symptom control. The advantage is that it is cheap. It doesn’t work as well as the long acting forms.
Ritalin SR is a long acting preparation of methylphenidate which has been around for a long time. It doesn’t work very well for many people. Sometimes it lasts 6 hours, but often it doesn’t work well at all. The advantage is that it’s cheap.
Concerta is an excellent preparation of methylphenidate. It is a once daily, long acting medicine. It works for up to 12 hours. It is well tolerated and has been a great medicine in the treatment of ADHD for the past 3 years or so in Canada, and longer in the US.
Biphentin is a once daily, long acting medicine. One major advantage over Concerta is that the capsule can be opened and sprinkled in apple sauce, yogurt or ice cream. This will help children with trouble swallowing. It is also approved for the treatment of adult ADHD, which Concerta is not yet (though I hear that this is coming shortly…).
One final difference between Biphentin and Concerta is that Biphentin releases approximately 40% of its medicine in the early part of the day, whereas Concerta only releases 22%. This may mean that Biphentin may work better for ADD/ADHD in the morning, whereas Concerta may last a little longer into the day.
The Bottom Line About Biphentin:
Treatment of ADD/ADHD requires many components – including psychotherapy, behavioral management, academic supports, and medication. This article has been focusing on medication for the purpose of describing a new treatment for ADHD in Canada. For more information on the other treatments of ADD/ADHD: 1) sign up for my ADD/ADHD newsletter at www.TheADHDDoctor.com, and 2) peruse this blog for more articles about ADD/ADHD.
Biphentin is a new great option for the treatment of ADD/ADHD in Canada. It has its unique features, as described above. It is welcomed, as in Canada, we have fewer medicines available than in the US. Biphentin may help in the treatment of your ADD/ADHD (or that of your loved one).
If you are considering the use of Biphentin, ask your doctor. You may want to print this article, and take a copy with you to your next doctor’s appointment.
my son is new to this biphentin and he just started it today the thing is how long does it take for the med to kick in. if any one knows please let me know thank you
Hello everyone. I am a 25 y/o male, 185lbs, 6’4″, diagnosed with depression (at age 15) and ADHD (today!). After today’s visit with the psychiatrist, I was prescribed Biphentin (10mg/day for one week, then 20mg/day). At first I was a bit hesitant to try anything from the Ritalin family, considering the general ugly stigma surrounding it. But logic must triumph in the end. Whether you’re a parent (deciding to give this medication to your child), or an adult who is taking the meds yourself, you must not let mass hysteria misinform your decision. The truth is, very few depression/ADHD medications on the market today have long-term study results (beyond say 75-100 years). Your doctor’s advice is only as good as the information science has uncovered over time. Some individuals have rather nasty reactions to medications, but that alone should not dissuade you from considering them as options. The choice you and your doctor have to make is whether or not the possible benefits of a drug outweigh the possible side effects. If your child has impaired daily functioning, then you must ask if a drug like Biphentin is suitable for their circumstance. If you just want your child to stop misbehaving, well, get over it. That’s what being a kid is all about.
Drug companies often abuse their power and influence over the public. They exploit vulnerable groups of people by ensuring the most necessary drugs are the most expensive. Doctors have, on occasion, been known to prescribe or promote certain medications in return for perks from the drug’s maker. This does not mean you should distrust the medical community entirely. Remember, the majority of doctors out there hold true to their Hippocratic Oath. And the science behind each drug is usually a labor of love–it’s the financial game of Twister afterward that causes distrust.
Just be wary of who is prescribing what to you or your child. If you don’t like one answer, go out and find another. We are fortunate enough to live in a world where we can thoroughly research our intentions and come up with a multi-faceted, well informed decision.
On that note, it’s time to take my first pill! I shall update soon.
Update:
Day one on Biphentin yields no noticeable results. As with most medications, it takes a bit of time to adjust.
I’m updating again to respond to an earlier comment that suggested ADHD is somehow an inherent human trait.
Wow.
I’m always amazed at how cavalier people can be toward medicine. We have created drugs that cure deadly diseases, have nearly perfected pain relief and palliative care, made incredible strides in medical technologies–allowing us to perform surgeries and operations for life-threatening illnesses. We depend on the medical field daily for ourselves and our families. Without these advancements, many of us would be lucky to live into our 40′s.
And yet, armed with anecdotal evidence, these champions of herbalism try to peddle their snake oil, believing they the answers to all of life’s questions reside in some Chinese vitamin.
Stop spitting in the face of medicine and try to have at least an OUNCE of faith in the profession that works tirelessly to enhance your quality and quantity of life.
One more peep about homeopathy (the most laughable hoax of the modern world), and you should be forced to relinquish your right to use antibiotics.
Don’t bite the hand that feeds you!
My son is 5 years old and has been diagnosed with ADHD/Autism. He is currently taking 10mg of Biphetin and its working really well. His appetite hasn’t changed much but he is having a lot of difficulty settling at bedtime. I’m wondering if Melatonin is a safe and positive solution to help him get to; and stay asleep?
generally melatonin is a safe option. check with your doctor for any concerns.
Dr. Kenny
Jake- While I agree with most of what you are saying, there is some truth to herbals. They don’t all work for everyone but if they do why not try a none chemical route? I’m a registered nurse who works cancer/palliative and believe me I totally advise use of drugs when necessary. For some, it’s as simple as that certain element missing from their diet like those who see results with the use of Omega’s.
Well we’ve decided to switch to Adderall XR. First dose today. We took my son of all meds during the march break and he finally gained a couple lbs. (Almost 8yrs old and finally at 49lbs) The teachers said he had a very good day at school today and was finally staying in class (used to run out all the time and not participate) for all his classes and focused very well. I hope this will work for as long as he needs it.
We’ve also tried melatonin for 2 yrs now and we noticed that it wasn’t working lately. Our pedi mentioned that some kids need to be “primed” As in taking it a couple of hours before bed. Finally it is working again. He mentioned that he might need a second dose before bed but so far it’s been working with just one dose. Hope that helps for some.
Dr Kenny- Do you have information regarding ADHD/autism together? Has Aspergers always gone hand in hand with ADHD? Is this a new trend that we are seeing or something that has been under-diagnosed?
I am a 44 year old man who was recently diagnosed with ADHD. I am on Concerta, which seems to be working. I live in Simcoe county and was wondering if anybody knows of a good local doctor or a source of education that can fill in some gaps of knowledge for me, or maybe help in guiding me in learning how to deal with this condition. I look forward to any suggestions.
Afternoon all,
Just to start things off, my son who is now 9 has ADHD – Combined. He was diagnosed when he was 5 by our family GP. He was started on Ritalin then changed to Concerta, for which he has been on for the past few years. Our new GP, has recommended that he come off the Concerta and start on Strattera. We just stopped his Concerta on Monday while he has gradually been on the Strattera to where he is now taking 25mg/day. Since he has stopped his Concerta, his problems at school have started up again (i.e. interrupting the class and teacher, not raising his hand, answering out of turn and very hyperactive at school and even worse at home at night). The problem we are facing is that he has reached the maximum dose of Concerta for his age/weight of 54mg/day.
We have seen a psychologist for him,which did not help at all. He is now scheduled to see some ADHD experts in May through a program in Quebec called “Le Copin”, which are pediatricians that deal with ADHD. We are seeing our GP on Monday and I plan on asking her to put him back on the Concerta in the meantime, as his issues at school cannot continue.
My question is, since he is at the maximum of Concerta, will increasing his Strattera help or should we try something else all together (either change Concerta or Strattera or both).
We need something that will control his ADHD all day to allow him to focus his attention, control his hyperactivity and respond to what we ask him to do and to follow the rules at school and at home.
Evenings for us are usually terrible, as his Concerta usually starts to wear off around 4 – 6pm, then he is most times uncontrollable and defiant. Trying to get him to come in from outside is almost impossible and bedtime, boy let’s not get me started. I usually liken him to the Energizer bunny, he just keeps going and going….
Any thoughts?
Rob W: here are a few points to consider when talking to your doctor.
If you look at the CADDRA guidelines (i.e. Canadian ADHD experts guidelines for treatment) http://www.caddra.ca/cms4/pdfs/caddraGuidelinesChapter01.pdf – see page 13 – the recommendation is that concerta can go up to 72 mg.
If the end of the day is a problem, you can ask your doctor for a short acting methylphenidate at 5 or 10 mg to be taken at 4 pm to balance things out.
If you want to try strattera – don’t stop the concerta until at least 4 weeks of strattera is taken. That will give the strattera time to ‘kick in’.
Also, some doctors will use a combination of strattera and concerta if needed.
There are a few things to consider…
Best of luck.
Dr. Kenny
John,
Dr. Bilkey is in Barrie: http://www.bilkeyadhdclinic.com. He may be a help to you!
Best,
Dr. Kenny
my son is five and was recently diagnosed with adhd. we decided that we would probably try biphentin just prior to grade one. My son asked us why we were going to wait. We knew thn that it was even bothering him – the inability to control his impulsivness. He’s very smart with alot of potential IF he can only focus. Without the teachers knowledge we decided to start right away. I could not believe that the very first day (starting at 10mg, and weighing 66lbs) the teacher approached my to ask if we had started it early. She said it was the first time in 3 months that my son sat the table in a group and completed a task without being seperated. we are now at 15mg and there have been no negative side effects at all. only that he has more control over himself. he’s the same outgoing boy that we love.
Hi
My son is turning seven in a few months. We have struggled with his hyper nature since he was two years old. He struggles in school as far as keeping his hands to himself and not distracting the other kids. His kindergarten teacher last year struggled with him but handled him well. We’ve been called to the school for appointments with the teacher this year and the school aid as well. They’ve considered that he had ADD and we’ve already been thinking it for quite some time now. A psycologist came to the school to sit in the classroom and observe him and she filled out a sheet for the doctor about his behavior. My husband and I filled ou the same sheet as well as the teacher and we came to very different results. He’s very emotional and he can’t seem to control himself in any environment. He has an appointment with the pediatrician on wednesday but I’m afraid that I am going to be told to put him on Ritalin like the doc said the first time i went with our concerns. Is Biphentin a good choice for our son? Thank you Carrie
Hi
My daughter is an adopted child and lost her adoptive mother 2 years ago to illness. At that time , I had her checked and she was diagnosed with ADHD. Her natural brother has the same diagnosis. she has all the symptoms but somehow I cannot rule our other “loss” causes. Is there a chance their could be psychiatric treatments to deal with the grieving as well?
Also , she is on 40 Mg of Biphentin and has night fears , occasional hyperventilating when active , and is now developing a blinking and lower jaw twitch(combined) when she is quiet. Could this be an absence seizure symptom?
The meds help but are not to a level where schooling is a huge challenge.
Hi Dr. Kenny,
I have a 7 year old son who has been on 30mg of Biphentin for 12 weeks now. He is 43lbs(lost 3lbs since starting Biphentin)and is doing great during the school hours. His teachers are amazed at the difference in him socially and in the classroom. He is still very touchy and in your face with others but as long as he has some type of control he is keeping his aggression in check. The only problem right now is that he has suddenly developed some pretty serious phobia’s. When we were walking home from school yesterday he saw a bee and was so scared that he got a pain in his chest. I had to carry him all the way home and once we were home he was fine until it was dark outside and he became afraid of monsters. My son has never been afraid of anything and now even loud noises bother him. He has also chewed on his nails and skin around his nails to the point of drawing blood. His pedi said that there is no other choice of medication for him because he can’t swallow pills.
My question is – Is this phobia a stage that will eventually run it’s course or do we need to try to force him to swallow a different medication?
Also, do you have any recommendations for the finger biting issue – it is definately anxiety related.
Carolyn F: There are several other medicines that can be opened. Adderall XR is a capsule that can be sprinkled, and Vyvanse is a capsule that can be opened and poured into water.
Ask your doctor if you can try these…
Hello Dr. Kenny,
My husband was diagnosed with ADD at the age of 7. At that point he was prescribed Ritalin which did nothing. Then they tried a minimal dose of Dexedrine and the miracles of an attention span came to life! At an early age, we knew our daughter might have the same… now she is 6 and the children psychologist agrees that she might indeed have the same as her dade with a bit of hyperactivity (problems focussing, constant repeating, cannot finish a project, etc.).
It’s been two weeks today that she has been on 15mg of biphentin (weighs 52 lbs). We wanted to start her off slowly. The first 3 days were a blessing. We were so happy. She was focussing and no more repeating! Day 4, 5, 6… were not that great. She became highly sensitive, emotional and the sadness in her eyes is unbearable. Today, we have decided to take her off until we hear back from her doctor. Does this mean that it’s the wrong medication? I would appreciate your input
Can any of the meds used to treat ADHD cause anxiety issues? My son seems to be developping fears daily. Used to love balloons and now has a full blown panic attack if he sees one because it might “pop”. Same with fireworks and now bees and flies and heck anything lately! I have tons of pictures of him holding caterpillars last year and now he’s terrified.
My 6 year old son is now on a dose of 30mg, and it seems to be working well. I have not noticed any negative side effects. He sleeps the same and is still a very active, social and fun kid. He eats less at lunch but makes up for it later in the day. He keeps saying he doesn’t understand why he’s taking it because he doesn’t think it’s doing anything. However the teacher and the whole family notice his ability to maintain his focus and impulses better than without the biphentin. I can finally go to the grocery store without feeling bad because I had to rewind him 20 + times to try and control himself in public. Now he does the typical rolling of the eyes and says he’s bored.
I was so scared to try any medication on my son, but when the dr. told me that if it was a true diagnosis he wouldn’t feel anything but normal and that I’d know right away if the medication was right for him, I felt I owed it to him to try. I am glad I did.
correction: I had to remind him. LOL
My 3 year old daughter has not yet been diagnosed with ADHD, but has Tuberous Sclerousis Complex. It has caused delayed development. She has very little speach, and has extreme hyperactivity. No concentration on anything!!! She recently saw a phyciatrist who prescribed her 5mg of Biphentin daily to try to neutrilize whatever may be going on. Do you think this may be a good idea to try her with these meds even if she does not have ADD/ADHD? Will it have any lasting effects on her? I’m a little leary about giving it to her! What do you think?
Sometimes these medicines help in other conditions as well. I think it’s important that you go back to the prescribing doctor and ask the questions you need to to reassure yourself.
Christina, Yes – anxiety can be a side effect. Talk to your doctor about this…
Hello Dr. Kenny,
I have an 8 year old son who is autistic, has with many autistic kids ADHD is also in the mix.
Over 3 years we have tried multiple medications. Ritalin caused him to become very agressive. We then tried dexedrine and he became HYPER hyperactive. We were giving him Strattera for the last 18 months but when we uped the dose (to reflect is growth) he became very, very irritable and had mood swings.
So what’s left for us? The doctor is considering an anti-depressent. I must also add that he takes risperidone to help with is control issues (1,25mg daily).
Hi Dr. H,
My son ( now 13yrs) has been diagnosed with ADHD and ODD since he was in kindergarten. We have tried a variety of medications over the years, and now currently on Concerta and Risperidal.
He has a very fast metabolism and uses up the medication quite quickly. Regular Ritalin was wearing off after 1-2 hours, and gave him some side effects. Though Concerta is adequatley controlling his ADHD, and with minimal side effects, I am concerned about the doasge he is on, and the cost. I heard Biphentin is a similiar medication but costs less. Would it be off any benefit to him? he is on Concerta 72 mg at 0800h, and 54mg at 1300h. Risperidal .25mg 0800h and .5mg at bedtime. I spend over $1000.00 on thes meds every 3 months.
Laurie – This is a high dose of concerta. Watch out for the generic – (if you are in Canada) because it is cheaper, but it won’t last as long.
You may want to ask about vyvanse – it often lasts longer for people.
Also – if you are in Ontario – look for the trillium drug plan: http://www.drhandelman.com/ontario-government-drug-plan/
If you are in a different place – see if there is a government assistance program for families who need help with medications.
Michelle, there are 3 main groups of medicines to try with Autism. They are: The adhd medicines, risperidone, and the antidepressants. Another additional medicine which can be used is: clonidine, or Intuniv in the US.Talk to your doctor about the options.
Hi Dr. Kenny
My daughter who has multiply diagnoses ( ADHD, cerebral palsy, learning disabilities, non verbral disability, Epilipsy, anxiety disorder and just diagnosed with PDD NOS ) was diagnosed with ADHD when she was 7 and she started taking Ritalin SR at the age of 8. We found it helped at first but as she got older it never worked as good , so they put her on concerta. That seemed to be alright until she started to grow and the doctor didn’t want her to do big jumps of doses, so he put her on the biphentin when she was in grade 8 and I’m so glad he did because now she just graduated grade 12. Without these medications I believe my daughter would have not made it through school and now she is getting ready for Adult life and will still be on the Biphentin 50 mg for days she needs to focus.
How can I tell if my son is on too high of a dosage? He goes very quiet after taking it, and doesnt seem to be himself…
Michelle – that is a symptom that it is worth talking to your doctor about.
Hi Dr. Kenny,
I’m 36 and I have been diagnosed with ADD. My doctor initially prescribed 10mg Biphentin which worked wonders for my ADD, however, I had to stop due to side effects (My doctor said I was allergic, however, my symptoms were listed as possible rare side effects on the drug fact sheet). I am now on Strattera, however, I am going to try something new as I do not like how drowsy and depressed I am on it.
I liked the results of bifentin other than the side effects/allergy. Do you think I may have the same reaction to the other methylphendiate medications? or would you recommend I something like dexedrine or adderall?
Thank you.
Greg – if it was an allergy, it was likely to a component in the pill – i.e. an excipient. But it could be the actual medicine. If you move over to the amphetamine category (i.e. adderall or vyvanse) then this won’t be an issue. It’s really a judgment call as to what you do next.
Hello dr
I suffer from depression and my current antidepessent, cipralex, causes extreme fatigue and lathargy. My psychiatrist just prescribed biphentin to counteract the fatigue. I am weary to take the medicAtion as it seems to be a primary ADHD drug. I suppose I am worrying aboutthe stigma attached to the medication, but would like your input on using the drug for non-ADHD purposes. My physician said that it would increase my awaeness and wake me up. How does it work one way for ADHD sufferers in that is subdues hem and it is supposed to stimulate me? I find that confusing. Any information about using the drug as a non- ADHD regiment would be appreciated. Thank you!
My son ADD started biphenton 10mg and the frst 4 days were great his abilty to control impulses were great! Behavoir much better,, now the 6th day his old habits are returning… is this common.. were the first few days all in our head..anyone else experience this? He starts 15mg on Friday
Beware the bearers of medication and there promises of good health and well being. I am 33 years old and have been kicked around by many a doctor with statements of your add/adhd Depressed and otherwise. I have been prescribed many different medications, ritilin, citalipram, prosac, rispidal, contentra, lorazipan, and many more these medications where prescribed by my family doctor with little to no follow up. If I complained about reactions sleeplessness or emotional numbness the family doctor just switched me to a new medication. I repeat no follow up no counselling no psychiatric care, or anything. Now under my own self guidance I found a competent psychiatrist that I have been seeing at first four times a month and am happy to report that I am 100% medication free and living much better then I have in five years. Please if your having trouble with symptoms like these ask to see a psychiatrist they are far more competent in the matters of the mind then many family doctors.