Generic Name and Formulations:
Dexmethylphenidate HCl (single-isomer methylphenidate) 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg; ext-rel caps (contains immediate-release + e-c del-rel beads).
Novartis Pharmaceuticals Corp
Attention deficit hyperactivity disorder.
Take once daily in the AM. Swallow whole or sprinkle contents onto applesauce (swallow immediately); do not crush, chew or divide beads. Initially 10mg/day; may increase by 10mg weekly. Usual dose: 20–40mg/day. Doses >40mg/day: not recommended. Switching from racemic methylphenidate: give ½ of total daily racemic methylphenidate dose. Switching from immediate-release dexmethylphenidate: give same total daily dose.
Take once daily in the AM. Swallow whole or sprinkle contents onto applesauce (swallow immediately); do not crush, chew or divide beads. <6yrs: not established. Individualize. ≥6yrs: initially 5mg/day; may increase by 5mg weekly. Usual dose: 10–30mg/day. Doses >30mg/day: not recommended. Switching from racemic methylphenidate: give ½ of total daily racemic methylphenidate dose. Switching from immediate-release dexmethylphenidate: give same total daily dose.
Marked anxiety, tension, agitation. Glaucoma. History of tics or 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. Ventricular arrhythmia. Assess cardiovascular status prior to treatment. Psychotic disorders. Bipolar disorder. Depression. Seizure disorders; discontinue if occur. Peripheral vasculopathy, including Raynaud's Phenomenon; monitor for digital changes. Reduce dose or discontinue if paradoxical aggravation of symptoms occur. Reevaluate periodically. Monitor for worsening aggressive behavior or hostility. Monitor growth, BP, HR, 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 (eg, imipramine, clomipramine, desipramine), SSRIs; adjust doses. May decrease effectiveness of antihypertensive agents. Caps: may be affected by drugs that affect pH (eg, antacids, acid suppressants).
Dyspepsia, dry mouth, decreased appetite, headache, anxiety, anorexia, insomnia, nausea, abdominal pain, weight loss; hypertension, tachycardia, visual disturbances, tics, priapism.
XR (NO); tabs (YES)
XR caps, tabs—100