dexmethylphenidate (Focalin, Focalin XR)

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GENERIC NAME: dexmethylphenidate hydrochloride

BRAND NAME: Focalin, Focalin XR

DRUG CLASS AND MECHANISM: Dexmethylphenidate is a medication used for treating attention deficit hyperactivity disorder (ADHD). It is chemically similar to methylphenidate (Ritalin, Concerta). It stimulates the central nervous system (CNS or brain) in a manner that is similar to amphetamines; however, its actions are milder than amphetamines. It stimulates the brain by increasing the level of neurotransmitters, dopamine and norepinephrine, in the brain neurotransmitters are chemicals produced by nerves that are released and attach to other nearby nerves as a means of communication among nerves). The exact mechanism of action of the drug in people with ADHD is unknown. FDA approved dexmethylphenidate extended-release capsules in May 2005.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablet: 2.5, 5, 10 mg. Capsules (extended-release) dexmethylphenidate: 5, 10, 15, 20, 25, 30, 35, and 40 mg

STORAGE: Store dexmethylphenidate between temperatures of 15 C to 30 C (59 F to 86 F).

PRESCRIBED FOR: Dexmethylphenidate is used for the treatment of attention deficit hyperactivity disorder (ADHD) in patients 6 years and older.

DOSING:

Adults:

  • The dose of immediate release tablets is 2.5 mg twice daily and increase by 2.5 or 5 mg weekly if needed. The maximum dose is 20 mg daily.
  • Methylphenidate-naive patients: Start with 10 mg extended release capsules by mouth once daily in the morning and adjust the dose weekly in 10 mg increments. The maximum dose is 40 mg daily.
  • Patients currently using methylphenidate: The starting dose of extended release capsules is one-half the total daily dose of methylphenidate. Patients currently taking immediate-release dexmethylphenidate tablets may be switched to same daily dose of extended-release capsules.

Children (ages 6 years and older):

  • The dose of immediate release tablets is 2.5 mg twice daily and increase by 2.5 or 5 mg weekly if needed. The maximum dose is 20 mg daily.
  • Methylphenidate-naive patients: The initial dose of extended release capsules is 5 mg by mouth once daily in the morning. The dose may be adjusted weekly in 5 mg increments if needed. The maximum dose is 30 mg daily.
  • Patients currently using methylphenidate: Initiate with one-half the total daily dose of methylphenidate. Patients currently taking immediate-release dexmethylphenidate tablets may be switched to same daily dose of extended-release capsules.

Safe and effective use of dexmethylphenidate is not established for children under 6 years of age.

DRUG INTERACTIONS: Dexmethylphenidate should not be combined with monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil), selegiline (Zelapar, Emsam, and Eldepryl), tranylcypromine (Parnate), procarbazine (Matulane), rasagiline (Azilect), and isocarboxazid (Marplan) because of risks of hypertensive crisis. Dexmethylphenidate and MAO inhibitors should be separated by at least 14 days.

Dexmethylphenidate should be used with caution with blood pressure medications or individuals with high blood pressure because it can increase blood pressure and decrease effectiveness of blood pressure medications.

PREGNANCY: There are no adequate studies done on dexmethylphenidate to determine safe and effective use in pregnant women.

NURSING MOTHERS: It is not known whether dexmethylphenidate enters breast milk; therefore, it is best to be cautious before using it in nursing mothers.

SIDE EFFECTS: Side effects of dexmethylphenidate are increased blood pressure, indigestion, loss of appetite, dry mouth, headache, sleeplessness and anxiety.

Dexmethylphenidate may be abused and it is a Schedule II controlled medication. Long term abuse can cause tolerance, psychological dependence, abnormal behavior, and psychosis. Use cautiously in people with a history of drug or alcohol abuse.

REFERENCE: FDA Prescribing Information.


Medically Reviewed by a Doctor on 7/24/2014



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