From the FDA Drug Label
Adults Administer orally in divided doses 2 or 3 times daily, preferably 30 to 45 minutes before meals. The maximum recommended daily dose is 60 mg. The average dosage is 20 to 30 mg daily.
The starting dose for Concerta (methylphenidate) in adults is not explicitly stated, but the average dosage is 20 to 30 mg daily, administered in divided doses 2 or 3 times daily 1.
From the Research
The starting dose of Concerta for adults with ADHD is typically 18 mg or 36 mg once daily in the morning, as recommended by recent guidelines and studies 2. Begin with 18 mg if the patient has never taken methylphenidate before or is sensitive to stimulants, while 36 mg may be appropriate for those previously treated with methylphenidate. The dose can be gradually increased by 18 mg increments at weekly intervals based on response and tolerability, up to a maximum recommended daily dose of 72 mg. Concerta should be taken in the morning with or without food and swallowed whole with liquid, never crushed or chewed, as this would disrupt the extended-release mechanism. Before starting Concerta, patients should undergo cardiovascular assessment including blood pressure and heart rate measurements, as stimulants can increase these parameters, as seen in studies such as 3. Patients should also be monitored for psychiatric symptoms, as stimulants may exacerbate anxiety, agitation, or psychosis in susceptible individuals. Concerta works by increasing dopamine and norepinephrine levels in the brain, improving attention and reducing impulsivity and hyperactivity in adults with ADHD, as supported by neurochemical studies like 4. Key considerations for treatment include:
- Monitoring for potential misuse and prescription stimulant use disorder, particularly in adults with a history of substance abuse 3
- Regular assessment of treatment efficacy and tolerability to adjust the dose as needed
- Education on the proper use and potential side effects of Concerta to ensure safe and effective treatment.