Methylphenidate Hydrochloride(meth ill fen’ i date)
Apo-Methylphenidate (CAN), Apo-Methylphenidate SR (CAN), Biphentin (CAN), ConcertaDNC, Daytrana, Metadate CDDNC, Metadate ERDNC, Methylin, Methylin ERDNC, PMS-Methylphenidate (CAN), Quillivant-XR, Ritalin, Ritalin LADNC, Ritalin-SRDNC, Sandoz-Methylphenidate (CAN), Teva-Methylphenidate ER-C (CAN)
PREGNANCY CATEGORY C
CONTROLLED SUBSTANCE C-II
Drug class
CNS stimulant
Therapeutic Actions
Mild cortical stimulant with CNS actions similar to those of the amphetamines; efficacy in hyperkinetic syndrome, attention-deficit disorders in children appear paradoxic and are not understood.
Indications
Narcolepsy (Ritalin, Ritalin SR, Metadate ER, Methylin)
Attention-deficit disorders, hyperkinetic syndrome, minimal brain dysfunction in children or adults with a behavioral syndrome characterized by the following symptoms: Moderate to severe distractibility, short attention span, hyperactivity, emotional lability, and impulsivity, not secondary to environmental factors or psychiatric disorders
Unlabeled uses: Treatment of depression in the elderly, cancer and stroke patients; alleviation of neurobehavioral symptoms after traumatic brain injury; improvement in pain control and sedation in patients receiving opiates
Contraindications and Cautions
Contraindicated with hypersensitivity to methylphenidate; marked anxiety, tension, and agitation; glaucoma; motor tics, family history or diagnosis of Tourette syndrome; severe depression of endogenous or exogenous origin; normal fatigue states; concurrent use or use within 2 wk of MAOI.
Use cautiously with seizure disorders; hypertension; drug dependence, alcoholism; emotional instability, psychosis; seizures; lactation, pregnancy; short gut syndrome, peritonitis, esophageal motility disorders (Concerta).
Available Forms
Tablets—5, 10, 20 mg; chewable tablets—2.5, 5, 10 mg; SR tabletsDNC—20 mg; ER tabletsDNC—10, 18, 20, 27, 36, 54 mg; ER capsulesDNC—20, 30 mg (Metadate CDDNC); and 10, 40, 50, 60 mg (Ritalin LADNC); transdermal patch—10, 15, 20, 30 mg/9 hr; solution—5 mg/5 mL, 25 mg/mL; ER suspension—5 mg/mL (Quillivant-XR)
Dosages
Adults
Individualize dosage. Give orally in divided doses bid or tid, preferably 30–45 min before meals; dosage ranges from 10–60 mg/day PO. If insomnia is a problem, drug should be taken before 6 PM. Timed-release tablets have a duration of 8 hr and may be used when timing and dosage are adjusted to the 8-hr daily regimen. ER forms: 18 mg PO daily in the morning; may be increased by 18 mg/day at 1-wk intervals to a maximum of 54 mg/day (Concerta); 10- to 20-mg/day increments to a maximum 60 mg/day (Metadate CD, Ritalin LA).
Pediatric patients 13–17 yr
Initially, 18 mg/day PO taken in the morning without regard to food; titrate to a maximum 72 mg/day PO. Do not exceed 2 mg/kg/day. Tablets must be swallowed whole and should not be cut, crushed, or chewed (Concerta, Daytrana). Or, 10–30 mg/day by transdermal patch; apply patch 2 hr before effect needed and remove after 9 hr.
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