Dexmethylphenidate

Dexmethylphenidate is a prescription medication used to treat attention deficit and hyperactivity disorder (ADHD). Dexmethylphenidate belongs to a group of drugs called stimulants. It is believed to work by balancing certain chemicals in the brain.

This medication comes in oral (by mouth) tablet form and is typically taken 2 times a day, with or without food. It is also available in an extended-release (long-acting) capsule that is usually taken once a day, with or without food. Do not chew or crush the extended-release capsules. Swallow the capsules whole.

Common side effects include headache, upset stomach, and trouble sleeping.

Ddexmethylphenidateexmethylphenidate is a prescription medication used to treat attention deficit hyperactivity disorder (ADHD).

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. 

Take dexmethylphenidate exactly as prescribed by your doctor. Follow the directions on your prescription label carefully. Your doctor will determine the best dose for you.

Capsules:

• For patients new to methylphenidate: Begin treatment with dexmethylphenidate at 5 mg/day for children and 10 mg/day for adults, increasing the dose weekly in 5 mg increments for children and in 10 mg increments for adults. Doses above 30 mg/day in children and 40 mg/day in adults have not been studied. 
• For patients already using methylphenidate: Start dexmethylphenidate therapy with half (1/2) the current total daily dose of methylphenidate.
• Patients already using dexmethylphenidate immediate-release tablets: Switch to the same daily dose of dexmethylphenidate extended-release capsules.

Tablets:

• Patients new to methylphenidate: The recommended starting dose of dexmethylphenidate for patients who are not currently taking racemic methylphenidate, or for patients who are on stimulants other than methylphenidate, is 5 mg/day (2.5 mg twice daily). Dosage may be adjusted in 2.5 to 5 mg increments to a maximum of 20 mg/day (10 mg twice daily). In general, dosage adjustments may proceed at approximately weekly intervals.

• For patients currently using methylphenidate: The recommended starting dose of dexmethylphenidate is half the dose of racemic methylphenidate. The maximum recommended dose is 20 mg/day (10 mg twice daily).

Dexmethylphenidate is a federally controlled substance (CII) because it can be abused or lead to dependence. Keep dexmethylphenidate in a safe place to prevent misuse and abuse. Selling or giving away dexmethylphenidate may harm others, and is against the law. Tell your doctor if you or your child have (or have a family history of) ever abused or been dependent on alcohol, prescription medicines or street drugs.

WARNING: DRUG DEPENDENCE

Dexmethylphenidate 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. Frank psychotic episodes can occur, especially with parenteral abuse. Careful supervision is required during withdrawal from abusive use, since severe depression may occur. Withdrawal following chronic therapeutic use may unmask symptoms of the underlying disorder that may require follow-up.

The following have been reported with use of dexmethylphenidate and other stimulant medicines.
1. Heart-related problems:

• sudden death in patients who have heart problems or heart defects
• stroke and heart attack in adults
• increased blood pressure and heart rate

Tell your doctor if you have any heart problems, heart defects, high blood pressure, or a family history of these problems.
Your doctor should check you carefully for heart problems before starting dexmethylphenidate.
Your doctor should check your blood pressure and heart rate regularly during treatment with dexmethylphenidate.
Call your doctor right away if you have any signs of heart problems such as chest pain, shortness of breath, or fainting while taking dexmethylphenidate.

2. Mental (psychiatric) problems:

All Patients

• new or worse behavior and thought problems 
• new or worse bipolar illness 
• new or worse aggressive behavior or hostility

Children and Teenagers

• new psychotic symptoms (such as hearing voices, believing things that are not true, are suspicious) or new manic symptoms

Tell your doctor about any mental problems you have, or about a family history of suicide, bipolar illness, or depression. 
Call your doctor right away if you have any new or worsening mental symptoms or problems while taking dexmethylphenidate, especially seeing or hearing things that are not real, believing things that are not real, or are suspicious.

Dexmethylphenidate should not be taken if you:

• are very anxious, tense, or agitated
• have an eye problem called glaucoma
• have tics or Tourette’s syndrome, or a family history of Tourette’s syndrome. Tics are hard to control repeated movements or sounds.
• are taking or have taken within the past 14 days an anti-depression medicine called a monoamine oxidase inhibitor or MAOI
• are allergic to anything in dexmethylphenidate
• are a child less than 6 years old because it has not been studied in this age group

See "Drug Precautions" for serious side effects.

Other serious side effects of dexmethylphenidate include:

• serious allergic reactions
• slowing of growth (height and weight) in children
• seizures, mainly in patients with a history of seizures
• eyesight changes or blurred vision

Common side effects of dexmethylphenidate include:

• headache
• upset stomach
• trouble sleeping
• anxiety
• decreased appetite
• dry mouth
• dizziness
• nervousness

 Talk to your doctor if you or your child has side effects that are bothersome or do not go away.

Tell your doctor about all of the medicines that you take including prescription and nonprescription medicines, vitamins, and herbal supplements. Dexmethylphenidate and some medicines may interact with each other and cause serious side effects. Sometimes the doses of other medicines will need to be adjusted while taking dexmethylphenidate.

Your doctor will decide whether dexmethylphenidate can be taken with other medicines.

Especially tell your doctor if you take:

• anti-depression medicines including MAOIs
• seizure medicines
• blood thinner medicines
• blood pressure medicines
• antacids
• cold or allergy medicines that contain decongestants

Know the medicines that you take. Keep a list of your medicines with you to show your doctor and pharmacist.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

This medication falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding. It is not known if dexmethylphenidate is excreted in human breast milk or if it will harm your nursing baby.

Swallow capsules whole with water or other liquids.

• Do not chew, crush, or divide the capsules or the beads in the capsule.
• If you cannot swallow the capsule, open it and sprinkle the small beads of medicine over a spoonful of applesauce and swallow it right away without chewing.

Dexmethylphenidate is a controlled substance because it can be abused or lead to dependence.

Since dexmethylphenidate may slow the of growth, children should have their height and weight checked often while taking dexmethylphenidate.

Dexmethylphenidate may cause a decrease in appetite. Tell your doctor if this becomes a problem for you or for your child.