Maximum Recommended Dose of Focalin (Dexmethylphenidate)
The maximum recommended daily dose of Focalin (dexmethylphenidate) is 30 mg for pediatric patients and 40 mg for adults. 1
Dosing Guidelines by Age Group
Pediatric Patients
- Starting dose: 5 mg once daily in the morning with or without food
- Titration: Weekly increments of 5 mg
- Maximum daily dose: 30 mg
- Administration: Can be taken as a whole capsule or opened and sprinkled on applesauce
Adult Patients
- Starting dose: 10 mg once daily in the morning with or without food
- Titration: Weekly increments of 10 mg
- Maximum daily dose: 40 mg
- Administration: Same options as pediatric patients
Dosing Considerations
For Patients New to Methylphenidate
- Begin with the recommended starting doses listed above
- Titrate based on clinical response and tolerability
For Patients Currently on Methylphenidate
- If switching from regular methylphenidate: Use half (1/2) the total daily dose of racemic methylphenidate
- If switching from immediate-release dexmethylphenidate: Use the same daily dose for extended-release formulation
Administration Options
- Oral administration as a whole capsule
- Contents may be sprinkled on applesauce (should be consumed immediately without chewing)
- The dose of a single capsule should not be divided
Monitoring and Safety
- Prior to treatment, assess for:
- Cardiac disease (careful history, family history of sudden death or ventricular arrhythmia)
- History of motor or verbal tics or Tourette's syndrome
- Monitor for signs of abuse, misuse, and addiction throughout treatment
- If paradoxical aggravation of symptoms or other adverse reactions occur, reduce the dosage or discontinue if necessary
- If no improvement is observed after appropriate dosage adjustment over a one-month period, consider discontinuation
Important Cautions
- Dexmethylphenidate is a Schedule II controlled substance with high potential for abuse and misuse
- The FDA label explicitly warns about the risk of abuse, misuse, and addiction
- Doses above the maximum recommended amounts have not been studied and are not recommended
- Careful dose titration is essential to find the optimal dose that provides symptom control with minimal side effects
Remember that the maximum dose represents an upper limit, not a target. The optimal dose is the one that provides adequate symptom control with minimal side effects, which may be lower than the maximum recommended dose.