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methylphenidate
generic
Black Box Warnings .
Abuse, Misuse, and Addiction
CNS stimulants have high potential for abuse and misuse, can lead to substance use disorder, incl. addiction; misuse and abuse can result in overdose and death, risk incr. w/ higher doses or unapproved admin. methods; assess risk for abuse, misuse, and addiction before prescribing and throughout tx; educate pts and families about risks and proper drug storage and disposal; monitor frequently for s/sx of abuse, misuse, and addiction during tx
Adult Dosing .
Dosage forms: ER CAP (qd, 50% IR/50% DR): 10 mg, 20 mg, 30 mg, 40 mg, 60 mg; ER CAP (qd, 40% IR/60% ER): 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg; ER CAP (qd, 30% IR/70% ER): 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg; TAB: 5 mg, 10 mg, 20 mg; ER TAB (qd-bid): 10 mg, 20 mg; ER TAB (qd): 18 mg, 27 mg, 36 mg, 54 mg, 72 mg; CHEWABLE: 2.5 mg, 5 mg, 10 mg; SOL: 5 mg per 5 mL, 10 mg per 5 mL
Special Note
- [strength clarification]
- Info: all strengths expressed as methylphenidate hydrochloride
- [formulation clarification]
- Info: methylphenidate ER products not interchangeable; do not substitute on a mg to mg basis
ADHD
- [immediate-release form]
- Dose: 10-60 mg/day PO divided bid-tid; Start: 5-10 mg PO bid, may incr. by 5-10 mg/day q7 days; Max: 60 mg/day; Info: duration 3-5h; give 30-45min before meals, last dose before 6pm; give chewable tab w/ full glass of water
- [qd extended-release cap (50% IR/50% ER) (off-label)]
- Dose: 20-40 mg ER PO qam; Start: 10-20 mg ER PO qam, may incr. by 10 mg/day q7 days; Max: 60 mg/day; Info: duration 6-9h; may open ER cap, but do not crush/chew contents; may convert from IR bid to ER at same total daily dose qam; retitrate if switching between methylphenidate ER products
- [qd extended-release cap (40% IR/60% ER)]
- Dose: 10-60 mg ER PO qam; Start: 10 mg ER PO qam, may incr. by 10 mg/day q7 days; Max: 60 mg/day; Info: duration 12h; give consistently w/ or w/o food; may open ER cap, but do not crush/chew contents
- [qd extended-release cap (30% IR/70% ER) (off-label)]
- Dose: 20-60 mg ER PO qam; Start: 20 mg ER PO qam, may incr. by 10-20 mg/day q7 days; Max: 60 mg/day; Info: duration 6-9h; give before meal; may open ER cap, but do not crush/chew contents
- [qd-bid extended-release tab]
- Dose: 10-20 mg ER PO qd-bid; Start: 10-20 mg ER PO qam, may incr. by 10 mg/day q7 days; Max: 60 mg/day; Info: duration 2-8h; give 30-45min before meals; do not cut/crush/chew ER tab; may convert from IR to ER at same total daily dose
- [qd extended-release tab]
- Dose: 18-72 mg ER PO qam; Start: 18-36 mg ER PO qam, may incr. by 18 mg/day q7 days; Max: 72 mg/day; Info: for pts 18-65 yo; duration 12h; do not cut/crush/chew ER tab; see pkg insert for conversion from IR form
narcolepsy
- [immediate-release form]
- Dose: 10-60 mg/day PO divided bid-tid; Start: 5-10 mg PO bid, may incr. by 5-10 mg/day q7 days; Max: 60 mg/day; Info: give 30-45min before meals, last dose before 6pm; give chewable tab w/ full glass of water
- [qd-bid extended-release tab]
- Dose: 10-20 mg ER PO qd-bid; Start: 10-20 mg ER PO qam, may incr. by 10 mg/day q7 days; Max: 60 mg/day; Info: give 30-45min before meals; do not cut/crush/chew ER tab; may convert from IR to ER at same total daily dose
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: ER CAP (qd, 50% IR/50% DR): 10 mg, 20 mg, 30 mg, 40 mg, 60 mg; ER CAP (qd, 40% IR/60% ER): 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg; ER CAP (qd, 30% IR/70% ER): 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg; TAB: 5 mg, 10 mg, 20 mg; ER TAB (qd-bid): 10 mg, 20 mg; ER TAB (qd): 18 mg, 27 mg, 36 mg, 54 mg, 72 mg; CHEWABLE: 2.5 mg, 5 mg, 10 mg; SOL: 5 mg per 5 mL, 10 mg per 5 mL
Special Note
- [strength clarification]
- Info: all strengths expressed as methylphenidate hydrochloride
- [formulation clarification]
- Info: methylphenidate ER products not interchangeable; do not substitute on a mg to mg basis
ADHD
- [immediate-release form, 4-5 yo (off-label)]
- Dose: 2.5-7.5 mg PO tid; Start: 2.5 mg PO bid, may incr. to 7.5 mg PO tid over 7 days; Max: 30 mg/day; Info: give 30-45min before meals, last dose before 6pm; give chewable tab w/ full glass of water
- [immediate-release form, 6 yo and older]
- Dose: 0.3-2 mg/kg/day PO divided bid-tid; Start: 0.3 mg/kg/dose PO bid or 2.5-5 mg PO bid, may incr. by 0.1 mg/kg/dose or 5-10 mg/day q7 days; Max: 2 mg/kg/day up to 60 mg/day; Info: duration 3-5h; give 30-45min before meals, last dose before 6pm; give chewable tab w/ full glass of water
- [qd extended-release cap (50% IR/50% ER), 6-12 yo]
- Dose: 20-40 mg ER PO qam; Start: 10-20 mg ER PO qam, may incr. by 10 mg/day q7 days; Max: 60 mg/day; Info: duration 6-9h; may open ER cap, but do not crush/chew contents; may convert from IR bid to ER at same total daily dose qam; retitrate if switching between methylphenidate ER products
- [qd extended-release cap (50% IR/50% ER), 13 yo and older (off-label)]
- Dose: 20-40 mg ER PO qam; Start: 10-20 mg ER PO qam, may incr. by 10 mg/day q7 days; Max: 60 mg/day; Info: duration 6-9h; may open ER cap, but do not crush/chew contents; may convert from IR bid to ER at same total daily dose qam; retitrate if switching between methylphenidate ER products
- [qd extended-release cap (40% IR/60% ER), 6 yo and older]
- Dose: 10-60 mg ER PO qam; Start: 10 mg ER PO qam, may incr. by 10 mg/day q7 days; Max: 60 mg/day; Info: duration 12h; give consistently w/ or w/o food; may open ER cap, but do not crush/chew contents
- [qd extended-release cap (30% IR/70% ER), 6-15 yo]
- Dose: 20-60 mg ER PO qam; Start: 20 mg ER PO qam, may incr. by 10-20 mg/day q7 days; Max: 60 mg/day; Info: duration 6-9h; give before meal; may open ER cap, but do not crush/chew contents
- [qd-bid extended-release tab, 6 yo and older]
- Dose: 10-20 mg ER PO qd-bid; Start: 10 mg ER PO qam, may incr. by 10 mg/day q7 days; Max: 60 mg/day; Info: duration 2-8h; give 30-45min before meals; do not cut/crush/chew ER tab; may convert from IR to ER at same total daily dose
- [qd extended-release tab, 6-12 yo]
- Dose: 18-54 mg ER PO qam; Start: 18 mg ER PO qam, may incr. by 18 mg/day q7 days; Max: 54 mg/day; Info: duration 12h; do not cut/crush/chew ER tab; see pkg insert for conversion from IR form
- [qd extended-release tab, 13-17 yo]
- Dose: 18-72 mg ER PO qam; Start: 18 mg ER PO qam, may incr. by 18 mg/day q7 days; Max: 2 mg/kg/day up to 72 mg/day; Info: duration 12h; do not cut/crush/chew ER tab; see pkg insert for conversion from IR form
renal dosing
- [not defined]
- renal impairment: not defined
- HD/PD: not defined
hepatic dosing
- [not defined]