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. The dose should be individualized according to the needs and response of the patient Daily doses above 30 mg in pediatrics and 40 mg in adults have not been studied and are not recommended.
The recommended dosage of 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: 30 mg daily in pediatric patients and 40 mg daily in adult patients 1 1 1
From the Research
Focalin XR, the extended-release formulation, should be given once daily in the morning, starting at 5-10 mg and can be increased weekly to a maximum of 30 mg for children and 40 mg for adults, as it has been shown to be effective and well-tolerated in the treatment of attention-deficit/hyperactivity disorder (ADHD) 2. The dosing of Focalin (dexmethylphenidate) should be individualized based on symptom control and side effects.
- The typical starting dose for children is 2.5 mg twice daily, while for adults it is 5 mg twice daily, taken in the morning and at noon.
- 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.
- Focalin works by increasing dopamine and norepinephrine levels in the brain, improving attention and reducing hyperactivity in ADHD patients.
- It should be taken consistently, with the lowest effective dose used to minimize side effects like decreased appetite, insomnia, and increased heart rate.
- Regular monitoring of blood pressure, heart rate, growth (in children), and mental health status is recommended during treatment, as supported by studies such as 3 and 4.
- A more recent study 5 provides guidance on drug regimen individualization for ADHD, including the use of methylphenidate and dexmethylphenidate formulations, which can help inform treatment decisions.