dexmethylphenidate

Generic Name: dexmethylphenidate (dex METH il FEN i date)

Brand Names: Focalin, Focalin XR

What is dexmethylphenidate?

Dexmethylphenidate is a mild stimulant to the central nervous system (brain and nerves).

Dexmethylphenidate is used to treat attention deficit hyperactivity disorder (ADHD).

Dexmethylphenidate may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about dexmethylphenidate?

Do not use dexmethylphenidate if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take dexmethylphenidate before the MAO inhibitor has cleared from your body.

Before using this medication, tell your doctor if you are allergic to any drugs, or if you have severe depression or a history of mental illness, seizures or epilepsy, high blood pressure, a history of drug or alcohol addiction, congestive heart failure, or if you have recently had a heart attack.

Some stimulants have caused sudden death in children and adolescents with serious heart problems or congenital heart defects. Before taking dexmethylphenidate, tell your doctor if you have any type of heart problems.

Long-term use of dexmethylphenidate can slow a child's growth. Tell your doctor if the child using this medication is not growing or gaining weight properly.

Dexmethylphenidate may be habit-forming and should be used only by the person it was prescribed for. Dexmethylphenidate should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Keep track of how many pills have been used from each new bottle of this medicine. Dexmethylphenidate is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What should I discuss with my healthcare provider before taking dexmethylphenidate?

Do not use dexmethylphenidate if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take dexmethylphenidate before the MAO inhibitor has cleared from your body. You should not take dexmethylphenidate if you are allergic to dexmethylphenidate or methylphenidate (Ritalin, Concerta), or if you have:

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  glaucoma;

  
  


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  motor tics (twitches);

  
  


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  a personal or family history of Tourette's syndrome; or

  
  


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  if you have significant tension, agitation, or anxiety.

  
  

Some stimulants have caused sudden death in children and adolescents with serious heart problems or congenital heart defects. Before taking dexmethylphenidate, tell your doctor if you have any type of heart problems.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use dexmethylphenidate:

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  severe depression or a history of mental illness;

  
  


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  a history of drug or alcohol addiction;

  
  


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  seizures or epilepsy;

  
  


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  high blood pressure;

  
  


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  heart disease, heart rhythm problems, or congestive heart failure; or

  
  


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  if you have recently had a heart attack.

  
  

FDA pregnancy category C. It is not known whether dexmethylphenidate is harmful to an unborn baby. Before using this medication, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether dexmethylphenidate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Long-term use of dexmethylphenidate can slow a child's growth. Tell your doctor if the child using this medication is not growing or gaining weight properly.

Do not give this medication to a child younger than 6 years old. Dexmethylphenidate may be habit-forming and should be used only by the person it was prescribed for. Dexmethylphenidate should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Keep track of how many pills have been used from each new bottle of this medicine. Dexmethylphenidate is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

How should I take dexmethylphenidate?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Take this medicine with a full glass of water.

This medication is usually taken in the morning before breakfast. You may take it with or without food.

You may open the dexmethylphenidate capsule and sprinkle the medicine into a spoonful of applesauce to make swallowing easier. Swallow this mixture right away without chewing. Do not save the mixture for later use. Discard the empty capsule.

To be sure this medication is helping your condition, your doctor will need to check your progress on a regular basis. Do not miss any scheduled visits to your doctor.

Store dexmethylphenidate at room temperature away from moisture and heat.

See also: Dexmethylphenidate dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, or if it is already evening, skip the missed dose and take the medicine the next morning. Taking this medicine late in the day can cause sleep problems. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include dry mouth, sweating, headache, warmth or tingly feeling, vomiting, agitation, tremors, muscle twitches, confusion, hallucinations, fast or pounding heartbeats, large pupils, and seizure (convulsions).

What should I avoid while taking dexmethylphenidate?

Avoid taking dexmethylphenidate in the evening because it may cause sleep problems (insomnia).

Dexmethylphenidate can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Dexmethylphenidate side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using dexmethylphenidate and call your doctor at once if you have any of these serious side effects:

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  dangerously high blood pressure (severe headache, blurred vision, ringing in your ears, chest pain, numbness, seizure);

  
  


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  fast or uneven heart rate;

  
  


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  blurred vision or other visual changes;

  
  


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  unusual behavior, confusion; or

  
  


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  twitching or tics.

  
  

Less serious side effects may include:

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  sleep problems (insomnia);

  
  


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  loss of appetite;

  
  


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  upset stomach;

  
  


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  feeling restless, anxious, or jittery;

  
  


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  dry mouth, sore throat; or

  
  


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  headache.

  
  

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Dexmethylphenidate Dosing Information

Usual Adult Dose for Attention Deficit Disorder:

Extended-release:

Patients currently not involved in treatment with dexmethylphenidate, racemic methylphenidate, or other stimulants:
Initial: 10 mg once a day (in the morning)
Maintenance: Dosage may be adjusted in 10 mg increments at approximately weekly intervals.
Maximum dose: 40 mg/day

Patients currently involved in treatment with methylphenidate:
Initial: one-half the total daily dose of racemic methylphenidate
Maximum dose: 40 mg/day

Patients currently taking dexmethylphenidate immediate-release:
Initial dose: dose equal to the daily dose of immediate-release administered once a day (in the morning).
Maximum dose: 40 mg/day

Usual Pediatric Dose for Attention Deficit Disorder:

Immediate-release:
6 to 18 years:
Patients not currently taking racemic methylphenidate or other stimulants:
Initial: 2.5 mg twice a day, with an interval of at least 4 hours between doses.
Maintenance: Dosage may be adjusted in 2.5 to 5 mg increments at approximately weekly intervals.
Maximum dose: 10 mg twice a day

Patients currently taking methylphenidate:
Initial: one-half the dose of racemic methylphenidate.
Maximum dose: 10 mg twice a day.

Extended-release:
6 to 18 years:
Patients not currently taking dexmethylphenidate, racemic methylphenidate, or other stimulants:
Initial: 5 mg once a day (in the morning)
Maintenance: Dosage may be adjusted in 5 mg increments at approximately weekly intervals.
Maximum dose: 30 mg per day

Patients currently taking methylphenidate:
Initial: one-half the dose of racemic methylphenidate.
Maximum dose: 30 mg per day

Patients currently taking dexmethylphenidate immediate-release:
Initial dose: dose equal to the daily dose of immediate-release administered once a day (in the morning).
Maximum dose: 30 mg per day

What other drugs will affect dexmethylphenidate?

Before taking dexmethylphenidate, tell your doctor if you are using any of the following medicines:

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  antacids;

  
  


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  blood pressure medications;

  
  


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  a blood thinner such as warfarin (Coumadin);

  
  


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  clonidine (Catapres);

  
  


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  seizure medications such as phenytoin (Dilantin), phenobarbital (Luminal, Solfoton), primidone (Mysoline); or

  
  


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  antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), or trimipramine (Surmontil).

  
  

This list is not complete and there may be other drugs that can interact with dexmethylphenidate. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

More dexmethylphenidate resources

• Dexmethylphenidate Side Effects (in more detail)
• Dexmethylphenidate Dosage
• Dexmethylphenidate Use in Pregnancy & Breastfeeding
• Drug Images
• Dexmethylphenidate Drug Interactions
• Dexmethylphenidate Support Group
• 46 Reviews for Dexmethylphenidate - Add your own review/rating

• dexmethylphenidate Advanced Consumer (Micromedex) - Includes Dosage Information


• Dexmethylphenidate Prescribing Information (FDA)


• Dexmethylphenidate MedFacts Consumer Leaflet (Wolters Kluwer)


• Dexmethylphenidate Hydrochloride Monograph (AHFS DI)


• Focalin Prescribing Information (FDA)


• Focalin Consumer Overview


• Focalin XR Prescribing Information (FDA)


• Focalin XR Extended-Release Capsules MedFacts Consumer Leaflet (Wolters Kluwer)

Compare dexmethylphenidate with other medications

• ADHD
• Auditory Processing Disorder

Where can I get more information?

• Your pharmacist can provide more information about dexmethylphenidate.

See also: dexmethylphenidate side effects (in more detail)