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dexmethylphenidate

Pronunciation

Generic Name: dexmethylphenidate (dex METH il FEN i date)
Brand Name: Focalin, Focalin XR

What is dexmethylphenidate?

Dexmethylphenidate is a mild stimulant to the central nervous system. It affects chemicals in the brain that contribute to hyperactivity and impulse control.

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

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

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

You should not use dexmethylphenidate if you have glaucoma, tics or Tourette's syndrome, or severe anxiety, tension, or agitation.

Do not use dexmethylphenidate if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

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Dexmethylphenidate may be habit forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

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

Do not use dexmethylphenidate if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

You should not take this medication if you are allergic to dexmethylphenidate or methylphenidate (Ritalin, Concerta), or if you have:

  • glaucoma;

  • a personal or family history of tics (muscle twitches) or Tourette's syndrome; or

  • if you have significant tension, agitation, or anxiety.

Some stimulants have caused sudden death in people with serious heart problems or congenital heart defects. Tell your doctor if you have:

  • heart disease, heart rhythm disorder;

  • coronary artery disease (hardened arteries); or

  • history of heart attack.

To make sure this medicine is safe for you, tell your doctor if you have:

  • high blood pressure;

  • a personal or family history of mental illness, psychotic disorder, bipolar illness, depression, or suicide attempt;

  • peripheral vascular disease such as Raynaud's syndrome;

  • epilepsy or other seizure disorder;

  • tics (muscle twitches) or Tourette's syndrome; or

  • a history of drug or alcohol addiction.

Dexmethylphenidate may be habit forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction.

FDA pregnancy category C. It is not known whether dexmethylphenidate will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether dexmethylphenidate passes into breast milk or if it could harm a nursing baby. Tell 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 medicine to a child younger than 6 years old without medical advice.

How should I take dexmethylphenidate?

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

You may take dexmethylphenidate with or without food.

To make swallowing easier, you may open the dexmethylphenidate capsule and sprinkle the medicine into a spoonful of applesauce. Swallow right away without chewing. Do not save the mixture for later use.

Your doctor will need to check your progress while you are using dexmethylphenidate.

Store at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Dexmethylphenidate is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking dexmethylphenidate?

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

This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Dexmethylphenidate side effects

Get emergency medical help if you have any of these signs of an allergic reaction: fever; hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking dexmethylphenidate and call your doctor at once if you have:

  • mood swings, aggression, hostility, confusion, hallucinations, unusual thoughts or behavior, muscle twitches;

  • numbness, pain, cold feeling, unexplained wounds, or skin color changes (pale, red, or blue appearance) in your fingers or toes;

  • chest pain, pounding heartbeats or fluttering in your chest, feeling like you might pass out;

  • sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance;

  • blurred vision or other visual changes;

  • seizure (convulsions);

  • penis erection that is painful or lasts 4 hours or longer (rare); or

  • dangerously high blood pressure (severe headache, buzzing in your ears, uneven heartbeats).

Common side effects may include:

  • loss of appetite, weight loss;

  • mild fever; or

  • nausea, stomach pain.

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.

See also: Side effects (in more detail)

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?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with dexmethylphenidate, especially:

  • an antacid;

  • an antidepressant;

  • blood pressure medication;

  • a blood thinner (warfarin, Coumadin);

  • cold or allergy medicine that contains a decongestant; or

  • seizure medication.

This list is not complete. Other drugs may interact with dexmethylphenidate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about dexmethylphenidate.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 8.02. Revision Date: 2014-03-24, 8:25:21 AM.

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