Methylphenidate preparations

A variety of preparations of stimulants are available but they can be grouped into the methylphenidate group and the amphetamine group.Methylphenidate is a central nervous system stimulant. The methylphenidate group preparations can be divided into the short-acting and long-acting preparations, both of which can be useful in different situations.

The short-acting preparations in the methylphenidate group that are available in the US are:

1. Methylphenidate immediate-release tablets (Ritalin^® and generic)

2. Methylphenidate oral solution (Methylin® and generic)

3. Methylphenidate chewable tablets (Methylin® and generic)

4. Dexmethylphenidate immediate-release (Focalin®)

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The long-acting preparations in the methylphenidate group are:

1. Methylphenidate sustained-release (Ritalin SR®, Methylin ER®, Metadate ER®)

2. Methylphenidate extended release (Concerta® and generic)

3. Methylphenidate extended-release (Aptensio XR®)

4. Methylphenidate long-acting (Ritalin LA®)

5. Methylphenidate biphasic extended-release (Metadate CD)

6. Methylphenidate extended-release oral suspension (Quillivant XR®)

7. Methylphenidate extended-release chewable tablets (Quillichew ER®)

8. Methylphenidate extended-release transdermal patch (Daytrana®)

9. Dexmethylphenidate extended-release (Focalin XR®)

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Here is basic information about the different preparations of this medication.

Short-acting preparations of methylphenidate

(Ritalin® oral tablets, Methylin® oral solution, Methylin® chewable tablets)

FDA-approved indications

1. Attention deficit disorders

2. Narcolepsy

Dosage

1. Children and adolescents (ages 6-17)

Initial: 5 mg twice daily (before breakfast and lunch)
Titration: 5—10 mg increments weekly
Maximum: 60 mg daily

2. Adults

10—60 mg daily in 2-3 divided doses before meals (titrate to effect and tolerance)
Average dose: 20—30 mg daily

Should be taken 30-45 minutes before meals. If sleeping problems occur, last dose should be taken before 6 pm.

Dosage forms and strengths

Tablets (US brand name Ritalin® and generic): 5 mg, 10 mg (scored), and 20 mg (scored)

Chewable tablets (generic): 2.5 mg, 5 mg, and 10 mg

Oral solution (Methylin® and generic): 5 mg/ 5mL, 10 mg/ 5mL

Please refer to Prescribing Information (see link below) for complete discussion of dosage, administration, warnings and precautions, contraindications, etc.

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Long-acting preparations of methylphenidate

(Ritalin SR®, Metadate ER®, Methylin ER®, Ritalin LA®, Quillivant XR®, Quillichew ER®, Aptensio XR™, Concerta®, Daytrana®)

FDA-approved indications

1. Attention deficit hyperactivity disorder (ADHD) in children, adolescents, and adults*

2. Narcolepsy (Ritalin SR®, Metadate ER®, and Methylin ER® only)

(*Note: Daytrana® is not approved for treatment in adults)

Dosage

1. Ritalin SR® (Including Methylin ER®, Metadate ER®) tablets

Ritalin-SR® tablets may be used in place of Ritalin® tablets in children (ages 6-12), adolescents (ages 13-17), and adults when the 8-hour dosage of Ritalin-SR® corresponds to the titrated 8-hour dosage of Ritalin®.

Tablets should not be chewed or crushed.

2. Ritalin LA® and Metadate CD® capsules, Quillivant XR® oral suspension, Quillichew ER® chewable tablets

Initial: 20 mg once daily
Titration: 10—20 mg increments per week
Maximum: 60 mg once daily in the morning

Capsules may be opened and the contents sprinkled over applesauce and consumed immediately. Quillichew ER® tablets may be taken with or without food.

3. Aptensio XR™ oral capsules

Starting: 10 mg once daily with or without food in the morning
Titration: 10 mg increments per week
Maximum: 60 mg once daily

Capsules may be swallowed whole or opened and the entire contents sprinkled onto applesauce.

4. Concerta® tablets

a) Children (ages 6-12) and adolescents (ages 13-18) who are new to methylphenidate

Starting: 18 mg once daily in the morning
Titration: 18 mg increments weekly
Maximum: 54 mg/day (children) and 72 mg/day (adolescents)

b) Adults who are new to methylphenidate

Starting: 18 or 36 mg once daily with or without food
Titration: 18 mg increments weekly
Maximum: 72 mg/day

c) For patients currently using methylphenidate
Dosing is based on dosing regimen and clinical judgment

Concerta® tablets should not be chewed or crushed and swallowed whole with the aid of liquids

5. Daytrana® transdermal patch

Initial: 10 mg
Titrate to need and response of the patient

Daytrana® is approved for treatment in children and adolescents (ages 6-17) only.

Should be applied to the hip area (using alternating sites) 2 hours before an effect is needed and  removed 9 hours after application. May be removed earlier if a shorter duration of effect is desired or late day side effects appear.

Dosage forms and strengths

Extended-release tablets (Ritalin SR®, Metadate ER®, and generic): 20 mg

Extended-release tablets (Methylin ER® and generic) : 10 mg and 20 mg

Extended-release tablets (Concerta® and generic): 18 mg, 27 mg, 36 mg, and 54 mg

Extended-release chewable tablets (Quillichew ER®): 20 mg, 30 mg, and 40 mg

Extended-release capsules (Ritalin LA®, Metadate CD®, and generic): 10 mg, 20 mg, 30 mg, 40 mg, and 60 mg. Aptensio XR™ available in 15 mg strength also.

Extended-release oral suspension (Quillivant XR®): 5 mg/ mL

Extended-release transdermal patch (Daytrana®): 10 mg/9 hr, 15 mg/9 hr, 20 mg/9 hr, and 30 mg/9 hr

Please refer to Prescribing Information (see link below) for complete discussion of dosage, administration, warnings and precautions, contraindications, etc.

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References

Ritalin® and Ritalin SR® Prescribing Information

Ritalin LA® Prescribing Information

Aptensio XR™ Prescribing Information

Concerta® Prescribing Information

Daytrana® Prescribing Information

Quillichew ER® Prescribing Information

Quillivant XR® Prescribing Information

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