besa Health Help Center

🚨 Core Requirement

Monthly In-Person Apps & PDMP Verification

✏️ Processes

1. Mandatory In-Person Clinical Protocol

Physical Encounter: All ADHD medication management requires a face-to-face, in-office encounter every 30 days. No telehealth is authorized at this time.
Documentation: Every visit must include recorded vitals (Heart Rate/Blood Pressure), a PDMP (Prescription Drug Monitoring Program) check, and a clinical assessment.
Refill Logistics: Prescriptions are strictly for a 30-day supply.

2. Medication Prescriptions and Maximum Dosage

The following guidelines are for medication selection and safety limits. Prescribing XR (Extended Release) and IR (Immediate Release) formulations together is acceptable, provided the instructions clearly indicate the time of dosing.

TO. Amphetamine Class

Medication	Duration	Starting Dose	Max Dose /Notes
Adderall IR	4–6 hrs	5–10 mg QD/BID	60 mg/day
Adderall XR	8–10 hrs	10–20 mg QAM	60 mg/day (Can be BID if needed)
Mydayis	16hrs	12.5 mg QAM	50 mg/day
Adzenys XR-ODT	8–10 hrs	6.3–12.5 mg QAM	37.6 mg/day (Rec. adult doses 12.5 mg)
Dexedrine/Zenzedi	3–5 hrs	5–10 mg QD/BID	60 mg/day
Dexedrine ER	6–8 hrs	10–20 mg QAM	60 mg/day
Vyvanse	9–14 hrs	20–30 mg QAM	70 mg/day (See IR combo rules below*)
Xelstrym	9 hrs	9 mg Patch	18 mg/day (Apply 2 hrs prior)
Evekeo IR	3–5 hrs	5 mg QD/BID	60 mg/day

*Vyvanse Combo Rule: If Vyvanse dose is less than 60 mg, Adderall IR or Dexedrine IR PRN is permitted. Combined Lisdexamfetamine + IR total must not exceed 60 mg/day.

B. Methylphenidate Class

Medication	Duration	Starting Dose	Max Dose /Notes
Methylphenidate IR	3–5 hrs	5–10 mg QD/IDB	60 mg/day
Concert	10–12 hrs	18–27 mg QAM	72 mg/day
Aptensio XR	8–12 hrs	10–20 mg QAM	60 mg/day
Metadata CD	8–12 hrs	20 mg QAM	60 mg/day
Focalin (IR)	3–4 hrs	2.5–5 mg BID	40 mg/day
Focalin XR	8–12 hrs	10 mg QAM	40 mg/day
Azstarys	8–13+ hrs	39.2/7.8 mg QAM	52.3/10.4 mg (Titrate after 1 week if indicated)

3. Out-of-Guideline Regimens

For new patients stable on regimes exceeding these guidelines:

Patients must be referred to external Psychiatry.
Any exceptions require clearance from Dr. Yang

4. Attendance & Security

In-Person Requirement: No "bridge" prescriptions for missed visits. Patients must be seen in person to receive a 30-day supply.
PDMP: Mandatory check at every visit.
Pharmacy Availability: Patients must confirm stock availability prior to their monthly appointment. If a medication is out of stock, pharmacy changes may be conducted after appointment (Patient should wait a week for pharmacy re-stock if possible first before re-route)

If you have any questions or would like more information, please reach out to the Delegating Physician.

ADHD Medication Management Policy