It may be divided into a morning and an evening dose, particularly if need higher doses. Usually started in the morning, but may be changed to evening. The targeted clinical dose is approximately 1.2 mg/kg. Same as for Dexedrine Spansules except that it has documented efficacy when sprinkled on applesauce. Less likely rebound than with long acting dextroamphetamine. May last longer than most other sustained release stimulants. May swallow whole or sprinkle ALL contents on a spoonful of applesauce. Onset in 60-90 minutes (possibly sooner). Wears off more gradually than dextroamphetamine alone, so rebound is less likely and more mild. May be adjusted in 5-10 mg increments up to 30 mg per day. Starting dose is 5 or 10 mg each morning (age 6 and older). Less likely to be abused intranasal or IV than short acting. Increase total daily dose by 5 mg per week until reach optimal dose to maximum of 40 mg/day. In chldren 6 and older who can swallow whole capsule, morning dose of capsule equal to sum of morning and noon short acting. High abuse potential particularly in tablet form. Somewhat longer action than short acting methylphenidate. Rebound agitation or exaggeration of pre-medication symptoms as it is wearing off. Over 6 years, one or two additional doses may be given at 4-6 hour intervals. May increase total daily dose by 5 mg per week until reach optimal level. Increase by 2.5 mg at weekly intervals, increasing first dose or adding/increasing a noon dose, until effective.įor 6 years and over, start with 5 mg once or twice daily. *2004 PDR does not list short acting Dexedrine tabletsįor ages 3 -5 years: starting dose is 2.5 mg of tablet. Wears off more gradually than short acting, so less rebound. Doesn't risk mid-day gap or rebound since medication is released gradually throughout the day. Starting dose is 18 mg or 36 mg once daily. If beads are chewed, may release full dose at once, giving entire contents in first 4 hours. Starts quickly, avoids mid-day gap unless student metabolizes medicine very rapidly. Insomnia, decreased appetite, weight loss, headache, irritability, stomachache, and rebound potential. May add short acting dose in AM or 8 hours later in PM if needed. May be adjusted weekly in 10 mg increments to maximum of 60 mg taken once daily. Note: If crushed or cut, full dose may be released at once, giving twice the intended dose in first 4 hours, none in the second 4 hours.ģ0% immediate release and 70% delayed release beads Wears off more gradually than short acting so less risk of rebound. Duration supposed to be 6-8 hours, but can be quite individual and unreliable. Insomnia, decreased appetite, weight loss, headache, irritability, stomachache. May combine with short acting for quicker onset and/or coverage after this wears off. Possibly better for use for evening needs when day's long acting dose is wearing off.Įxpensive compared to other short acting preparations. Only formulation with isolated dextro-isomer. Most helpful when need rapid onset and short duration. There is suggestion that Focalin (dextro-isomer) may be less prone to causing sleep or appetite disturbance.Ībout 3-4 hours. Dose may be adjusted in 2.5 to 5 mg increments to a maximum of 20 mg per day (10 mg twice daily). Start with half the dose recommended for normal short acting mehtylphenidate above. Use cautiously in patients with marked anxiety, motor tics or with family history of Tourette syndrome, or history of substance abuse. Insomnia, decreased appetite, weight loss, headache, irritability, stomachache, and rebound agitation or exaggeration of pre-medication symptoms as it is wearing off.Ībout 3-4 hours. Daily dosage above 60 mg not recommended. Adjust timing based on duration of action. Add third dose about 4 hours after second. Starting dose for children is 5 mg twice daily, 3-4 hours apart.
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