How long does the effect of Focalin (dexmethylphenidate) last in a patient with Attention Deficit Hyperactivity Disorder (ADHD)?

Duration of Focalin (Dexmethylphenidate) Effect

Focalin immediate-release (IR) lasts approximately 4-6 hours, while Focalin XR (extended-release) provides symptom control for up to 12 hours after a single morning dose. 1, 2

Immediate-Release Focalin Duration

• Focalin IR begins working within 30 minutes of ingestion and maintains therapeutic effects for 4-6 hours. 3, 4
• Peak behavioral effects occur 1-3 hours after administration, with effects diminishing by 4-6 hours post-dose. 3
• The 6-hour duration of action has been confirmed in placebo-controlled withdrawal studies, showing significant differences from placebo at the 6-hour timepoint on both symptom ratings and math test performance. 4
• Due to this relatively short duration, most patients require twice-daily dosing (morning and midday) to maintain symptom control throughout the school or work day. 5

Extended-Release Focalin XR Duration

• Focalin XR provides symptom control from as early as 0.5 hours after administration up to 11-12 hours post-dose. 2
• The extended-release formulation uses bimodal delivery technology: 50% of the medication releases immediately, and 50% releases approximately 4 hours later, mimicking two separate IR doses given 4 hours apart. 1, 2
• Analog classroom studies demonstrate maintained efficacy throughout a 12-hour period, allowing once-daily morning dosing to cover the entire school day and homework time. 1
• The rapid onset (within 30 minutes) combined with the prolonged duration eliminates the need for midday dosing at school, improving compliance and reducing stigma. 2

Comparative Duration Considerations

• Focalin (dexmethylphenidate) may have a slightly longer duration of action compared to standard d,l-methylphenidate (Ritalin) at equivalent doses, particularly evident in late afternoon assessments. 5
• When compared head-to-head with OROS methylphenidate (Concerta), Focalin XR shows superior efficacy in the first half of the day (0-6 hours), while OROS methylphenidate may have an advantage in the 10-12 hour timeframe. 2
• The dexmethylphenidate formulation achieves comparable efficacy to racemic methylphenidate at approximately half the total daily dose (average 18.25 mg/day d-MPH versus 32.14 mg/day d,l-MPH). 5

Clinical Implications for Dosing Schedule

• For IR formulations, plan for twice-daily dosing: one dose in the morning and a second dose 4 hours later to maintain coverage through the school day. 3, 4
• For XR formulations, a single morning dose typically suffices for full-day coverage, though some patients may require a small IR booster dose in late afternoon for homework completion. 2
• When medication effects cease (after 4-6 hours for IR or 11-12 hours for XR), ADHD symptoms return immediately—there is no carryover effect once the medication is eliminated. 6
• Avoid scheduling important activities or assessments during predictable "wear-off" periods when medication effects are waning. 3

Administration Flexibility

• Focalin XR capsules can be opened and sprinkled on applesauce for patients unable to swallow capsules whole, without affecting the extended-release properties. 2, 7
• This flexibility maintains the 12-hour duration of action even when administered via the sprinkle method. 7