From the FDA Drug Label
2.2 Recommended Dosage Patients New to Methylphenidate The recommended starting dosage of dexmethylphenidate hydrochloride extended-release capsules for patients who are not currently taking dexmethylphenidate or racemic methylphenidate, or for patients who are on stimulants other than methylphenidate are: • Pediatric patients: Start with 5 mg orally once daily in the morning with or without food • Adult patients: Start with 10 mg orally once daily in the morning with or without food.
Patients Currently on Methylphenidate The recommended starting dose of dexmethylphenidate hydrochloride extended-release capsules for patients currently using methylphenidate is half (1/2) the total daily dose of racemic methylphenidate Patients currently using dexmethylphenidate hydrochloride immediate-release tablets may be given the same daily dose of dexmethylphenidate hydrochloride extended-release capsules.
Titration Schedule The dose may be titrated weekly in increments of 5 mg in pediatric patients and 10 mg in adult patients.
Daily doses above 30 mg in pediatrics and 40 mg in adults have not been studied and are not recommended.
The recommended dosing for Focalin (dexmethylphenidate) is as follows:
- Pediatric patients: Start with 5 mg orally once daily in the morning
- Adult patients: Start with 10 mg orally once daily in the morning
- Titration: Increase dose weekly in increments of 5 mg in pediatric patients and 10 mg in adult patients
- Maximum dose: Do not exceed 30 mg daily in pediatric patients and 40 mg daily in adult patients 1 1 1
From the Research
Focalin (dexmethylphenidate) dosing should be individualized, with the extended-release formulation, Focalin XR, given once daily in the morning, starting at 5 mg for children and 10 mg for adults, as supported by the most recent study 2. The dose can be gradually increased by 2.5-5 mg weekly as needed, with a maximum daily dose of 20 mg for children and 40 mg for adults. Some key points to consider when dosing Focalin include:
- The medication works by increasing dopamine and norepinephrine levels in the brain, improving attention and reducing hyperactivity in ADHD patients.
- It should be taken consistently, with periodic breaks to assess continued need and to minimize tolerance.
- Patients should be monitored for side effects including decreased appetite, sleep problems, increased heart rate, and blood pressure.
- Focalin should be avoided in patients with heart problems, glaucoma, or a history of stimulant abuse, as noted in earlier studies 3, 4, 5, 6. The most recent study 2 provides guidance on drug regimen individualization for attention-deficit/hyperactivity disorder, which is essential for optimizing treatment outcomes. Key considerations for individualizing Focalin dosing include:
- Starting with a low dose and gradually increasing as needed
- Monitoring for side effects and adjusting the dose accordingly
- Considering the patient's age, weight, and medical history when determining the optimal dose
- Using the extended-release formulation, Focalin XR, to minimize the need for multiple daily doses and improve patient compliance.