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, Daytrana, Methylin and others.
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 and Vyvanse – which are amphetamine medications, 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, 60 mg and 80 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 (i.e. 6 years old to 65 years old).
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 strength 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, and Concerta is as well.
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.
Sorry to bug you one last time but I would like to ask:
Can the “reaction” be from toxicity as opposed to an allergy?
If I would have taken a lower dose maybe I wouldn’t have had that reaction?
Doug, I don’t really know the answer to that – you’ll have to work on that with your doctor. Maybe an allergist could help to sort that out…
Hi Dr. Handelman, I’ve heard from a physician that Purdue is developing an advanced formulation of Biphentin. Do you know if this is true? Many thanks in advance, Andrew
Andrew – I can’t confirm that. If any news comes out, I’ll be sure to blog or post about it.
My son has been off Biphentin all summer, can I start again at his last dose strenght, or do I have to go up from 10mg capsules?
Cheryl – the answer to this is that it’s very individual – i.e. some people can start back right at the last dose, and some people need to start low and build again. Talk to your doctor.
Good day,
I have just been prescribed for the first time ever this medication for my son. My son was diagnosted with ADHD and starting friday september 23,2011 he will be starting this medication. I am a very worried mother and I am very concerned about any medication…
My son is 6 years old and the doctor prescribed me this medication 10mg a day. I need to be reasure that this is a good medication….
other note my son is in perfect health aside from his ADHD.
thank you
hi jocelyn, my son is 9 and was diagnosed at 6 with adhd and odd. we have run the gamit of so many meds and almost a yr ago he tried biphentin. we did 10, 20 now 30 and he is a completely different kid, he chooses the meds b/c he says he can focus and be calm. i am the type of worrisome mom too and i at time still worry for him. thats what makes us moms. i see your post was back in september but i hope you guys are doing ok now and he is well
I want to know if there is a Canadian equivalent to Focalin – it is the US drug that is the D isomer of methylphenidate. There is some indication that it works better on executive functioning and less on mood.
Helen – we do not have the isomer of methylphenidate (i.e. focalin) in Canada. And as far as I know, there aren’t plans to bring it here.
Dr. Handelman,
My daughter just turned 15 years old and weighs 146 pounds. She is Adhd – impulsive and is taking 30 mg of Biphentin in the morning. I am glad to hear that this medication is not addictive and can not be abused. Her focus and not being hyper has really improved, yet she doesn’t feel that it prevents her from being impulsive or having mood swings? When should this drug leave her system? When should she be able to sleep? Am I noticing agitation, aggression and mood swings because she is coming down off this drug? She has anxiety as well and worries about most everything, sometimes to the point of crying uncontrollably. She doesn’t eat during the day and although she consumes more around 5pm., what can I give her nutritious when she takes her pill, but that won’t lessen the effects of the medication throughout the day? What dosage should she be taking each day? Maybe I should try Concerta and if so, how much? Maybe a non-stimulant like Stratterra would work better, if so how much? Your knowledge would be very helpful. Thank you.
Janice – I would love to help, though it seems that you are asking many questions that are important to address with the treating doctor. Sorry, but I cannot do a consultation over my blog.
Dr. Handelman,
I always consult with her doctor, yet your opinion would be helpful too. In reading many of the comments on your blog, I too am wondering if my daughter’s dosage of 30 mg daily should be increased, as she is 145 lbs? Her doctor increased her dosage to 40 mg daily, yet according to dosage given by weight that she should be taking
70 mg = 1.06 up to 80 mg = 1.2 . After trying a higher dosage for 4 days and if anxiety and even tears are still displayed on this 4th day, is it likely that her dosage would be too high or is this just not the medication for her? Thank you.
Dr. Handleman, I am an adult with adhd and also taking 300 mg wellbutrin. Is it okay to take these together? I am having a very difficult time sleeping. I am supposed to increase 10mg of biphentin to 20mg. I am concerned I will get no sleep if I do this. What do you think?
I cannot take Dexidrene anymore because I have an issue with hypertrophic cardiomyopathy and am taking meds for it. Are there any ADHD meds that I could discuss with my doctor?
Thank you
Linda – look into clonidine, and most importantly Intuniv. It isn’t in Canada yet, but it’s in the USA. Also, maybe Wellbutrin, if the doctor will allow it.
Can too high of a dose of biphentin make symptoms reapear?
My sons dose was just increase by 5mg and he is very fidgity, started making noises and says he is bored. Could it be caused by the increase or could it just be that he is bored?
Carey- it could be the dose increase… Check with your doctor.
My daughter’s dosage has been increased from 30mg up to 40mg and she weighs 140 pounds, should she be taking this much more of the Biphentin?
I was curious on how i can get this Med….In canada…? My daughter is in a study right now… Which is working great… It is not FDA approved where we are from….
Philly – if you are in Canada, you can get it by just getting your doctor to write a prescription. If you are in the US (sorry your comment isn’t clear to me), then Metadate CD is the closest.
We are in Ohio… I guess my main concern was would i be able to bring the medication back across to Ohio… ? Her doctors are willing to write the script… Not sure where to get started … I am working on getting my passport to travel to Canada to get the medication she needs if indeed i can come back across the border with seeing it is a class 2…
Philly,
There are a couple of issues:
1) Will a prescription from an Ohio based doctor be accepted in Ontario (or another Canadian province)? Possibly no – especially if it is for a stimulant. This relates to medical licensing – i.e. if the doctor writing the prescription is not licensed in the province – then the pharmacist would likely not take the Rx. I’d suggest you go online – and find a couple of pharmacies in the city you would go to, and ask the pharmacist if they would take your doctor’s Rx for Biphentin. If you can’t find one, you may need to see a Canadian doctor to write an Rx for you.
2) Bringing the medicine over the border: I don’t think this is an issue (of course, I am not a border/customs/immigration specialist – please do your own research). My opinion is based on the fact that people cross the border every day – with controlled medicines in their pill bottles – like stimulants, as well as pain medicines, etc. If the pills are in the pharmacy bottle, with the label on it – it’s my understanding that the border officials don’t take issue with it. If you have random pills around, and no clear prescription documentation, then get ready for a bigtime search!
I hope those comments help.
My son (18 years old) has been taking biphentin for 4 years at 120mg in the morning ( he metabolizes it fast). We have been paying 250 a month and i know he wont be able to afford this on his own, so we would like to change to concerta since this is now covered by indian affairs in canada. But they only cover concerta for ages 6-18. Do you have any idea if concerta only works on that age or if concerta is an easy change over from biphentin?
Jeanie – both Biphentin and Concerta are officially indicated for Adult ADHD (i.e. over 18 years old). I don’t know the rules of the Indian Affairs medication plan, but maybe they can cover a medication by application if the doctor feels your son needs it.
When it comes to Concerta, to get an equivalent dose to Biphentin 120 mg, you’ll need a high dose of Concerta. See my post on concerta dosing: http://www.addadhdblog.com/concerta-getting-the-right-dose/
To let you know how to convert Biphentin to its methylphenidate component – multiply the dose by 40% (because it’s 40% immediate release). I hope that helps!
I am an adult with ADD and have tried different meds over the past 30 plus years. I am currently trying Biphentin 40 mg and my doctor and I both feel I should increase my dose. I am reluctant because of the insomnia. I like how the medication helps – but am fustrated at the inability to sleep and the feeling like I will have to take more medications to combat this side effect. would it be better to go back (way back) to ritalin?
thanks – sleepless in Hamilton, ON