dexmethylphenidate (Focalin, Focalin XR) (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

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.

Medically Reviewed by a Doctor on 7/24/2014


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