Is Concerta Extended Release?
Yes, Concerta is an extended-release formulation of methylphenidate that provides 12 hours of continuous symptom control through a once-daily osmotic pump delivery system (OROS). 1, 2
Mechanism of Extended Release
Concerta utilizes an OROS (osmotic-release oral system) technology that creates an ascending plasma drug level pattern throughout the day, designed to mimic three-times-daily dosing of immediate-release methylphenidate with a single morning dose 1, 2
The medication is formulated as a paste within the caplet that cannot be ground up or snorted, making it resistant to tampering and particularly suitable for adolescents at risk for substance misuse 1
The osmotic pump system provides continuous methylphenidate release over 12 hours, significantly longer than immediate-release formulations (4 hours) or older sustained-release preparations (4-6 hours) 1, 3, 2
Clinical Advantages Over Immediate-Release Formulations
Concerta eliminates the need for mid-day school dosing, reducing stigma, improving adherence, and preventing medication diversion 1, 4
The extended duration covers the full school day plus homework time and evening activities, addressing functional impairment across multiple settings 3, 4
Long-acting formulations like Concerta are associated with better medication adherence and lower risk of rebound effects compared to immediate-release preparations 3
Dosing Equivalence
Concerta 18 mg once daily is equivalent to immediate-release methylphenidate 5 mg three times daily 1
Concerta doses are approximately 20% higher on a total daily basis than comparable three-times-daily immediate-release regimens to achieve the necessary ascending delivery pattern 5
Available strengths include 18 mg, 36 mg, and 54 mg for once-daily morning administration 1, 5
Evidence of Efficacy
A multicenter randomized controlled trial (n=282 children) demonstrated that Concerta once daily was equally effective as immediate-release methylphenidate three times daily and superior to placebo for reducing core ADHD symptoms 6
Laboratory studies showed Concerta effects lasted at least 12 hours after dosing, with sustained improvement in classroom behavior, academic productivity, and social functioning throughout the entire day 5
Both teacher and parent ratings confirmed symptom control extending into the evening hours with once-daily Concerta dosing 6, 5