Dexmethylphenidate has a high potential for abuse. Administration of stimulants for a prolonged period of time may lead to physical and psychological drug. Focalin XR should be given cautiously to patients with a history of drug dependence or alcoholism. Chronic abusive use can lead to marked. Formulation Pearls (capsule). Duration of Effect 8–12 hours. Initial Dose 5 mg. Maximum daily dose 30 mg. Available unit dose forms 5, 10, 15, 20, 25, 30,

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Pimozide and dexmethylphenidate may interact pharmacodynamically to diminish the therapeutic effects of either agent through opposing effects on dopamine.

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Monitor for new or worsening aggressive behavior or hostility. It is possible that the administration of calcium carbonate or other acid suppressants could alter the release of extended-release dexmethylphenidate, resulting in reduced or increased absorption.

Dexmethylphenidate blocks the reuptake of norepinephrine and dopamine into the presynaptic neuron and increases the release of these monoamines into the extraneuronal space while reserpine depletes stores of serotonin and norepinephrine in the brain, adrenal medulla, and other tissues, and reduces the reuptake of catecholamines by adrenergic nerve terminals.

Although methylphenidate may be considered as an alternative to dexmethylphenidate in breast-feeding women, the medical use of stimulant medications has not been formally evaluated in controlled studies. Improved attention spans, decreased distractibility, increased ability to follow directions or complete tasks, and decreased impulsivity and aggression have been noted when stimulants are prescribed for the treatment of ADHD. Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine: Sympathomimetics can increase blood pressure, increase heart rate, and may cause vasoconstriction resulting in chest pain and shortness of breath in these patients.


Sympathomimetics counteract the medications used to stabilize pulmonary hypertension, including bosentan. Dexmethylphenidate is not recommended for use in patients with a history of anorexia nervosa or other eating disorders due to its association with reduced appetite and weight loss.

Although a direct causal relationship has not been established, aggressive behavior and hostility have been reported during use of some stimulants for ADHD in children.

Dexmethylphenidate is contraindicated ibsert patients with glaucoma, due to the ability of the drug to increase sympathetic stimulation and to raise intraocular pressure.

Dexmethylphenidate has a high potential for abuse. Severe Avoid coadministration of methylphenidate and dexmethylphenidate. Aggression, hostility, and suicidal ideation or behaviors have been reported in both clinical trials and post-marketing experience with ADHD medications.

Moderate Dexmethylphenidate can reduce the hypotensive effect of antihypertensive agents, including angiotensin II receptor antagonists. Moderate Dexmethylphenidate can reduce the hypotensive effect of antihypertensive agents. If suicide-related events emerge during treatment, consideration should be given to dose reduction or drug discontinuation, especially if symptoms are severe, abrupt in onset, or were not part of the patient’s presenting symptoms.

If paradoxical aggravation of symptoms or other adverse effects occur, reduce dosage or discontinue the drug.

Children and Adolescents 6 years and older. If seizures occur, discontinuation of therapy is recommended.

Monitor the patient for tremors, nervousness, increased heart rate, or other additive side effects. There are no adequate studies in human pregnancy. Debilitated or geriatric patients may be more susceptible to the CNS and sympathomimetic side effects of dexmethylphenidate; use with caution in elderly patients, given the greater incidence of cardiac disease or other conditions in these patients.


Administer twice daily, with doses at least 4 hours apart. Serotonin norepinephrine reuptake inhibitors: Oral dosage immediate-release formulations; e. Moderate Dexmethylphenidate can reduce the hypotensive effect of antihypertensive agents, including alpha-blockers. Initially, 10 mg PO once oackage in the morning if not currently taking methylphenidate or packagw.

Pharmacodynamic interactions cannot be ruled out, however. Angiotensin II receptor antagonists: May decrease effectiveness of antihypertensive agents. Severe Additive effects and increased toxicity may be observed when using cocaine in combination with other sympathomimetics.

Patients receiving an antacid should be monitored for adverse effects and reduced therapeutic efficacy of extended-release dexmethylphenidate.

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In patients with pre-existing psychosis e. Although convulsant effects occur primarily at high dosages, sodium oxybate should be used cautiously with psychostimulants that are pacjage to lower seizure threshold. Safety an efficacy have not been established. Attention deficit hyperactivity disorder. Absorption of immediate-release tablets: Increased risk of sudden death, stroke, and MI; assess for presence of cardiac disease before initiating.

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