Despite 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.