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Dexmethylphenidate Dosage

Applies to the following strength(s): 2.5 mg ; 5 mg ; 10 mg ; 20 mg ; 30 mg ; 40 mg ; 15 mg ; 25 mg ; 35 mg

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Attention Deficit Disorder

PATIENTS NEW TO METHYLPHENIDATE:
Immediate Release:
-Initial dose: 2.5 mg orally twice a day, at least 4 hours apart
-Maintenance dose: Dose may be adjusted in increments of 2.5 to 5 mg at weekly intervals.
-Maximum dose: 10 mg orally twice a day (20 mg/day)

Extended Release:
-Initial dose: 10 mg orally once a day in the morning
-Maintenance dose: Dose may be adjusted in increments of 10 mg at weekly intervals.
-Maximum dose: 40 mg orally once a day in the morning

PATIENTS CURRENTLY USING METHYLPHENIDATE:
Immediate Release:
-Initial dose: Half the total daily dose of racemic methylphenidate orally twice a day
-Maximum dose: 10 mg orally twice a day (20 mg/day)

Extended Release:
-Initial dose: Half the total daily dose of racemic methylphenidate orally once a day in the morning
-Maximum dose: 40 mg orally once a day in the morning

PATIENTS SWITCHING FROM IMMEDIATE RELEASE TO EXTENDED RELEASE:
-Continue same daily dosage orally once a day in the morning.

Comments:
-Dosage should be individualized according to the needs and responses of the patient.
-This drug should be used as part of a comprehensive treatment program that may include other measures (psychological, educational, social) such as counseling or other therapies.

Use: ADHD

Usual Pediatric Dose for Attention Deficit Disorder

PATIENTS NEW TO METHYLPHENIDATE (Age 6 years or older):
Immediate Release:
-Initial dose: 2.5 mg orally twice a day, at least 4 hours apart
-Maintenance dose: Dose may be adjusted in increments of 2.5 to 5 mg at weekly intervals.
-Maximum dose: 10 mg orally twice a day (20 mg/day)

Extended Release:
-Initial dose: 5 mg orally once a day in the morning
-Maintenance dose: Dose may be adjusted in increments of 5 mg at weekly intervals.
-Maximum dose: 30 mg orally once a day in the morning

PATIENTS CURRENTLY USING METHYLPHENIDATE (Age 6 years or older):
Immediate Release:
-Initial dose: Half the total daily dose of racemic methylphenidate orally twice a day
-Maximum dose: 10 mg orally twice a day (20 mg/day)

Extended Release:
-Initial dose: Half the total daily dose of racemic methylphenidate orally once a day in the morning
-Maximum dose: 30 mg orally once a day in the morning

PATIENTS SWITCHING FROM IMMEDIATE RELEASE TO EXTENDED RELEASE (Age 6 years or older):
-Continue same daily dosage orally once a day in the morning.

Comments:
-Dosage should be individualized according to the needs and responses of the patient.
-This drug should be used as part of a comprehensive treatment program that may include other measures (psychological, educational, social) such as counseling or other therapies.

Use: ADHD

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

-Paradoxical Aggravation of Symptoms or Other Adverse Events Occur: Reduce dosage or discontinue drug if necessary.

-Improvement Not Observed After Appropriate Dosage Adjustment Over 1-Month Period: Discontinue treatment.

Precautions

US BOXED WARNING:
Drug Dependence: This drug should be given cautiously to patients with a history of drug dependence or alcoholism. Chronic abusive use can lead to marked tolerance and psychological dependence, with varying degrees of abnormal behavior such as frank psychotic episodes. Careful supervision is required during drug withdrawal since severe depression may occur; withdrawal may unmask symptoms of the underlying disorder that may require follow-up.

Safety and efficacy have not been established in patients younger than 6 years.

Consult WARNINGS section for additional precautions.

US Controlled Substance: Schedule II

Dialysis

Data not available

Other Comments

Administration advice:
-Take this drug with or without food.
-This drug may be swallowed whole, or capsule contents can be sprinkled on a spoonful of applesauce.
-The drug and applesauce mixture should be consumed in its entirety immediately and not stored for future use.
-Do not crush, chew, or divide drug capsules.

General:
-The extended release capsules use a bi-modal release where half the dose is provided in immediate release beads and half the dose is in delayed release beads. A single, once-daily dose of an extended release capsule provides the same amount of active ingredient as two immediate release tablets given 4 hours apart.
-There is no evidence to indicate how long an ADHD patient should be treated with this drug. However, pharmacological treatment of ADHD may be needed for extended periods.
-The long-term usefulness of this drug should be re-evaluated periodically with patients undergoing periods without medication to assess patient functioning without pharmacotherapy. Improvement may be sustained when the drug is either temporarily or permanently discontinued.
-Stimulants are not intended for use in patients who exhibit symptoms secondary to environmental factors and/or other primary psychiatric disorders, including psychosis. Appropriate educational placement and psychosocial intervention are often helpful.
-In overdosage cases, control agitation and seizures if present and protect the airway before evacuating gastric contents. Measures to detoxify the gut include gastric lavage, activated charcoal, or a cathartic. Efficacy of peritoneal dialysis for overdosage has not been established.

Monitoring:
-Cardiovascular: Blood pressure, heart rate, digital changes/ulceration; electrocardiogram and echocardiogram if cardiac disease detected.
-Hematologic: Periodic CBC, differential, and platelet counts during prolonged therapy.
-Other: Regular height and weight checks for patients under 18 years.
-Psychiatric: Depression/bipolar disorder, aggression and hostility, new psychotic or manic symptoms

Patient advice:
-This drug has the potential to be abused and can lead to dependence. Let your doctor know if you or your child have ever abused (or have a family history of drug abuse) or been dependent on alcohol, prescription medicine, or street drugs.
-From time to time, your doctor may stop treatment to evaluate your ADHD symptoms.
-Children should have their height and weight checked regularly while taking this drug.

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