Maximum Focalin Dose
The maximum recommended daily dose of Focalin (dexmethylphenidate) is 30 mg for pediatric patients and 40 mg for adults. 1
Dosing by Age Group
Pediatric Patients (Ages 6-17 years)
- Maximum daily dose: 30 mg 1
- Starting dose: 5 mg once daily in the morning for patients new to methylphenidate 1
- Titration: Increase weekly in 5 mg increments based on symptom response 1
- Daily doses above 30 mg have not been studied and are not recommended 1
Adult Patients (Ages 18+ years)
- Maximum daily dose: 40 mg 1
- Starting dose: 10 mg once daily in the morning for patients new to methylphenidate 1
- Titration: Increase weekly in 10 mg increments based on symptom response 1
- Daily doses above 40 mg have not been studied and are not recommended 1
Critical Dosing Considerations
Conversion from Other Methylphenidate Products
- Patients switching from racemic methylphenidate should start at half (1/2) the total daily dose of their current methylphenidate regimen 1
- Patients already on immediate-release dexmethylphenidate can convert to the same total daily dose of extended-release formulation 1
Historical Context from Older Guidelines
- The 2002 American Academy of Child and Adolescent Psychiatry guidelines for immediate-release dexmethylphenidate (DEX) suggested maximum total daily doses of 40 mg for DEX/amphetamine products 2
- However, these older recommendations apply to immediate-release formulations given multiple times daily, not the extended-release formulation 2
Important Safety Warnings
The FDA-approved maximum doses (30 mg pediatric, 40 mg adult) represent the upper limit of studied doses and should not be exceeded. 1 These limits are based on:
- Lack of safety and efficacy data beyond these doses 1
- High potential for abuse and misuse with CNS stimulants 1
- Risk of cardiovascular adverse effects at higher doses 1