dexmethylphenidate (Focalin, Focalin XR)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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.

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