Dexmethylphenidate

Overview

Dexmethylphenidate and Dexmethylphenidate XR (extended release) are psychostimulants, sometimes known as stimulants. Dexmethylphenidate is mainly used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy, a disease characterized by daytime somnolence in which the patient occasionally slips into a deep slumber throughout the day. Narcolepsy is a condition of the brain’s sleep-wake regulation processes that interact with daytime wakefulness and nocturnal slumber.

Labeled usage refers to using a medicine for its authorized indications. In clinical practice, however, doctors often prescribe drugs for unlabeled (“off-label”) applications when publishing clinical research, case reports. Alternatively, their own clinical experiences confirm the effectiveness and safety of the therapy. Dexmethylphenidate has shown significant improvement in various clinical trials and extensive clinical experience in children with ADHD. Dexmethylphenidate boosts the child’s capacity to focus and expands their attention span. It reduces hyperactivity. 

Dexmethylphenidate treatment is also beneficial for adults with ADHD. Dexmethylphenidate improves concentration and focus on activities, enhances attention span, and reduces impulsivity and hyperactivity.
Dexmethylphenidate (dexmethylphenidate) and Ritalin (methylphenidate) are chemically similar. Methylphenidate has two mirror-image forms known as isomers (d- and l-isomers). Dexmethylphenidate is the active isomer (d isomer) of methylphenidate, but the l-isomer has little or no action. Isomers are mirror-image compounds that are similar. They apply to both the right and left hands and are not superimposable. An advantage of Dexmethylphenidate is that the patient takes the active isomer of methylphenidate, although at comparable doses, there is minimal difference between Dexmethylphenidate and Ritalin. Because Dexmethylphenidate and Dexmethylphenidate XR are stimulants, they are strictly restricted drugs. Every time a prescription is delivered, the physician must write a new one, and it cannot be renewed.

Dosing Information

The suggested beginning dose of Dexmethylphenidate for persons who are not already taking methylphenidate (Ritalin, Metadate) is 2.5 mg twice a day (5 mg/day). The dose is modified in 2.5 to 5 mg daily intervals. At weekly intervals, with a maximum dose of 10 mg twice a day (20 mg/day). Dexmethylphenidate XR may be administered once per day. Dexmethylphenidate may be switched to the XR formulation at an equal daily dosage. Instead of taking Dexmethylphenidate 2.5 mg twice.

For example, it may be more convenient to take Dexmethylphenidate XR 5 mg once daily in the morning. Dexmethylphenidate XR 5 mg, 10 mg, 15 mg, and 20 mg are comparable to Dexmethylphenidate 2.5 mg, 5 mg, 7.5 mg, and 10 mg taken twice daily. If you are presently using methylphenidate and want to switch to Dexmethylphenidate or Dexmethylphenidate XR, the initial dose is to take half the amount of methylphenidate.
Dexmethylphenidate dose in adults is tailored depending on the patient’s clinical presentation, Response and reporting of adverse effects. Dosage for children is also determined by their age and weight. Another consideration in dosing is choosing a formulation with a duration of action that is customized to the patient’s requirements.

Dexmethylphenidate is a short-acting medication that starts working within 30-60 minutes after injection and lasts for 2-5 hours. The benefit is that it works immediately, but the duration of effect is brief and takes two or three times every day.

Common Side Effects

Common adverse effects of using Dexmethylphenidate include high heart rate, palpitations, agitation, and restlessness, fatigue, insomnia, dry mouth, constipation, nausea, diarrhea, lack of appetite, weight loss, and elevation of Blood pressure.

Adverse effects and precautions 

Dexmethylphenidate has a significant risk of misuse. Individuals with a history of alcohol and drug misuse might be at danger for misusing stimulants. Individuals who overuse Dexmethylphenidate acquire tolerance and psychological dependency, which might lead to addiction. Long-term Dexmethylphenidate misuse, and the subsequent restless nights, the person may develop psychotic symptoms.

Dexmethylphenidate may raise blood pressure. People having a history of high blood pressure or heart disease should exercise caution while using Dexmethylphenidate since it might worsen these symptoms. Uncontrollable high blood pressure may lead to significant repercussions such as a stroke or a heart attack. Patients who use Dexmethylphenidate should monitor their blood pressure on a regular basis. Individuals with a history of seizure disorder should be careful when using dexmethylphenidate, since it may reduce the seizure threshold and increased vulnerability to seizures.

Dexmethylphenidate may inhibit linear growth in growing children and teenagers. Physicians sometimes halt therapy on weekends and holidays when children are not in school, for development.
Children and adolescents on Dexmethylphenidate must be closely monitored for growth suppression, as well as have their height measured at regular intervals. This impact is not of concern in the adult population. Dexmethylphenidate may exacerbate tics in those with a tic condition (i.e., twitching of a muscle area, particularly In the face). Patients diagnosed with schizophrenia or bipolar disorder should avoid or use Dexmethylphenidate with care. Stimulants are widely overused in this demographic, and large doses of Dexmethylphenidate may cause psychosis and madness.

Use in Pregnancy and Breastfeeding: Category C

Dexmethylphenidate has not been studied in women to confirm its safety during pregnancy. The medication’s impact on the growing fetus in pregnant mothers remains unclear. Women who are pregnant or could become pregnant. they should address this with their doctor.

Nursing women should not use any stimulants since tiny doses will pass into breast milk and be swallowed by the infant. If discontinuing the stimulant is not an option, breastfeeding should not be started or Should be terminated.

Possible Drug Interactions

Dexmethylphenidate should not be administered in conjunction with monoamine oxidase inhibitors (MAOI). The combination may cause elevated blood pressure. This and other followings summarize the drug interactions documented with amphetamine and methylphenidate.

• MAOIs should not be used with methylphenidates or dexmethylphenidate (such as Concerta, Ritalin and Focalin). The combination may cause dangerously high blood pressure. 
• Weight-loss drugs (e.g., Meridia) Weight-loss drugs, both prescription and non-prescription, should not be used with methylphenidates or dexmethylphenidate. The combination might raise blood pressure or cause irritation, sleeplessness, and other negative responses from overstimulation. 
• Coumadin (Warfarin) Methylphenidate and Dexmethylphenidate may Increase Coumadin’s anticoagulant activity.

Overdose

The severity of Dexmethylphenidate overdose is determined on the quantity eaten. Symptoms of an acute overdose may include restlessness, anxiety, irritability, sleeplessness, and hyperactivity, disorientation, increased blood pressure, fast heart rate, psychosis, hallucinations, irregular heartbeat, convulsions, coma, cardiovascular collapse, and death.

Any suspected overdose should be considered an emergency. The individual should be rushed to the emergency. There is space for observation and therapy. The prescription bottle of medicine (and any additional drug implicated in the overdose) should also be presented, since the information on the prescription label is beneficial to the treating physician in knowing the number of tablets consumed.

Special Considerations

• To prevent sleeplessness, the final dosage of Dexmethylphenidate should be administered early in the evening, rather than close to bedtime. 

• Dexmethylphenidate may be used with meals to prevent stomach distress.
  • Do not take more than prescribed by your doctor.
  • If Dexmethylphenidate causes severe anxiety, restlessness, sleeplessness, lack of appetite, or weight loss, inform Your physician.
  • If you miss a dosage, take it right away. If it is near to the next scheduled dosage, skip the missed one. Continue with your normal dose regimen. Do not take two doses.
  • Keep the medicine in the original labeled, light-resistant container, away from heat and moisture. Heat Moisture may promote the breakdown of your drug, causing it to lose its therapeutic effects.
  • Keep your medications out of reach of youngsters.