Converting Adderall 30mg IR to Focalin
The recommended conversion from Adderall 30mg IR to Focalin (dexmethylphenidate) is 15mg daily, typically divided into two doses of 7.5mg twice daily.
Conversion Rationale
- Dexmethylphenidate (Focalin) is approximately twice as potent as methylphenidate, and methylphenidate is roughly equivalent to amphetamine in clinical potency 1, 2
- Based on clinical studies, Adderall (mixed amphetamine salts) should be converted to Focalin at approximately a 2:1 ratio, meaning 30mg of Adderall IR would convert to approximately 15mg of Focalin IR 2, 3
- The American Academy of Child and Adolescent Psychiatry supports this conversion ratio in clinical practice 4
Dosing Schedule Recommendations
- Focalin IR should be administered twice daily due to its 6-hour duration of action, compared to Adderall IR's similar duration 2
- The 15mg daily dose should be divided into two doses of 7.5mg, typically given in the morning and early afternoon to minimize sleep disturbances 4, 5
- If 7.5mg tablets are not available, 5mg tablets can be used with slight dose adjustment (5mg twice daily with a 5mg midday supplemental dose if needed) 6
Titration Considerations
- After initial conversion, allow at least one week to evaluate clinical response before making dose adjustments 4
- If symptom control is inadequate, the dose can be increased in 2.5-5mg increments weekly, not exceeding the maximum recommended daily dose of 20mg for Focalin IR 5, 3
- Clinical efficacy should be monitored using standardized rating scales when possible 6
Monitoring Parameters
- Blood pressure and pulse should be checked at baseline and quarterly during treatment 4, 6
- Weight should be monitored at each visit to assess for appetite suppression 4
- Evaluate for common side effects including insomnia, decreased appetite, headaches, and irritability 4, 7
Special Considerations
- Focalin IR tablets can be safely cut for precise dose titration when finding the optimal therapeutic dose 6
- For patients with difficulty swallowing tablets, Focalin XR capsules can be opened and sprinkled on applesauce as an alternative 3
- If Focalin IR is not effective at the maximum recommended dose, consider switching to Focalin XR for once-daily dosing and potentially improved adherence 5, 3
Common Pitfalls to Avoid
- Starting at too high a dose, which can lead to unnecessary side effects and decreased medication adherence 4
- Not allowing sufficient time between dose increases to evaluate response 4
- Failing to systematically assess both benefits and side effects during titration 4, 6
- Continuing to increase the dose beyond maximum recommendations when not effective - consider alternative medications instead 4, 6