Attention deficit hyperactivity disorder.
Swallow whole with liquids. Take once daily in the AM. <6yrs: not established. Methylphenidate-naive: 6–12yrs: initially 18mg once daily, max 54mg/day; 13–17yrs: initially 18mg once daily, max 72mg daily or 2mg/kg/day (whichever is less). 18–65yrs: initially 18mg or 36mg/day; max 72mg/day. Switching from methylphenidate 5mg 2 or 3 times daily: initially Concerta 18mg once daily. Switching from methylphenidate 10mg 2 or 3 times daily: initially Concerta 36mg once daily. Switching from methylphenidate 15mg 2 or 3 times daily: initially Concerta 54mg once daily. Switching from methylphenidate 20mg 2 or 3 times daily: initially Concerta 72mg once daily. For all: may adjust in 18mg/day increments at 1-week intervals; max 54mg/day for children; max 72mg/day for adolescents and adults.
Marked anxiety, tension, agitation. Glaucoma. Motor tics. Tourette's syndrome in patient or family. During or within 14 days of MAOIs.
History of drug dependence or alcoholism; monitor for abnormal behavior. Structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease: not recommended. Hypertension. Heart failure. Recent MI. Arrhythmia. Reduce dose or discontinue if paradoxical worsening of symptoms occurs. Reevaluate periodically. Preexisting GI narrowing. Psychosis. Bipolar disorder. May exacerbate behavior disturbances, thought disorders; monitor for worsening aggressive behavior or hostility. Seizure disorders; discontinue if occur. Peripheral vasculopathy, including Raynaud's Phenomenon; monitor for digital changes. Monitor growth, blood pressure, CBC, differential, platelet counts, vision. Pregnancy (Cat.C). Nursing mothers.
See Contraindications. Hypertensive crisis with MAOIs. Caution with pressor agents. May potentiate coumarin anticoagulants, anticonvulsants (eg, phenobarbital, phenytoin, primidone), tricyclics, SSRIs.
Decreased appetite, headache, dry mouth, nausea, insomnia, anxiety, dizziness, weight loss, irritability, hyperhidrosis; hypertension, visual disturbances, tics, possible GI obstruction; children and adolescents: upper abdominal pain.