Methylphenidate, extended release 

Overview

(methylphenidate, controlled release) is a psychostimulant, also known as a stimulant. Methylphenidate ER is mainly used in treating attention-deficit/hyperactivity disorder (ADHD) and narcolepsy, a disease characterized by daytime somnolence in which the patient sometimes slips into a deep slumber during the day. Narcolepsy is a sleep-wake regulation condition in the brain that interferes with both Daytime wakefulness and midnight sleep.

Labeled usage refers to using a medicine for its authorized indications. In clinical practice, Physicians often prescribe drugs for unlabeled (“off-label”) applications when published clinical research, case reports, or their own clinical experiences, provide evidence of the therapy’ effectiveness and safety. Methylphenidate ER is frequently Used in combination with antidepressants to treat resistant depression. Methylphenidate ER, when used with antidepressants, may give symptomatic relief and improvement that antidepressants alone cannot. Methylphenidate ER has been shown in several clinical trials and extensive clinical experience to enhance outcomes for children with ADHD. Methylphenidate ER improves the child’s ability to focus and Improves attention span and reduces hyperactivity. Adults with ADHD benefit from Methylphenidate ER treatment. Methylphenidate ER improves their concentration and focus on their work, extends their attention span, and reduces impulsivity and hyperactivity. Methylphenidate ER pills provide methylphenidate in two stages using innovative technology. During the initial phase, The stimulant is liberated from the tablet’s outer shell within 1-2 hours, resulting in a quick commencement of effect. In the second phase, the remaining is delivered gradually over a period of 10 to 12 hours. The tablet consists of A core containing the stimulant and is surrounded by a membrane that regulates the time-released mechanism. The center is surrounded by an outer shell made of methylphenidate. When the Methylphenidate ER tablet is swallowed, the outer shell melts within 1-2 hours, producing the first dosage of methylphenidate. The remaining stimulant is gradually released from the tablet’s core throughout its gastrointestinal transit.
The empty pill shell is eliminated via the stool. Because Methylphenidate ER is a stimulant, it is a tightly restricted drug. The doctor must write A fresh prescription is issued each time it is dispensed, and it cannot be refilled.

Dosing Information

For attention deficit hyperactivity disorder (ADHD):

For short-acting oral dosage forms (chewable tablets or solution):

• Adults: Administer 2 or 3 times a day and take 30 to 45 minutes before meals. The average dose is 20 to 30 milligrams  per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
• Children 6 years of age and older at first, 5 mg 2 times a day, taken before breakfast and lunch. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
• Children younger than 6 years of age: Use and dose must be determined by the doctor.

For short-acting oral dosage form (tablets):

• Adults: 20 to 30 milligrams  given in divided doses 2 or 3 times a day, taken 30 to 45 minutes before meals. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
• Children 6 years of age and older at first, 5 mg 2 times a day, taken before breakfast and lunch. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
• Children younger than 6 years of age: Use and dose must be determined by the doctor.

For long-acting oral dosage form (extended-release capsules):

Patients who have not been treated with methylphenidate:

• Adhansia XR®:
  • Adults and children 6 years of age and older at first, 25 milligrams  once a day, taken in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 100 mg per day for adults and 85 mg for children.
  • Children younger than 6 years of age; Use and dose must be determined by the doctor.
• Aptensio XR™, Metadate CD®, Ritalin LA®:
  • Adults and children 6 years of age and older at first, 10 to 20 milligrams  once a day, taken in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
  • Children younger than 6 years of age: Use and dose must be determined by the doctor.
• Jornay PM®:
  • Adults and children 6 years of age and older at first, 20 milligrams  once a day, taken in the evening. Your doctor may adjust your dose as needed. However, the dose is usually not more than 100 mg per day.
  • Children younger than 6 years of age: Use and dose must be determined by the doctor.

Patients who are already taking methylphenidate:

• Adults and children 6 to 12 years of age: 10 to 60 milligrams  once a day, taken in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
• Children younger than 6 years of age: Use and dose must be determined by the doctor.

For long-acting oral dosage form (extended-release suspension):

• Adults and children 6 years of age and older at first, 20 milligrams  once a day, taken in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
• Children younger than 6 years of age: Use and dose must be determined by the doctor.

For long-acting oral dosage form (extended-release chewable tablets):

• Adults and children 6 years of age and older at first, 20 milligrams  once a day, taken in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
• Children younger than 6 years of age: Use and dose must be determined by the doctor.

For long-acting oral dosage form (extended-release disintegrating tablets):

• Adults and children 6 years of age and older at first, 17.3 milligrams  once a day, taken in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 51.8 mg per day.
• Children younger than 6 years of age: Use and dose must be determined by the doctor.

For long-acting oral dosage form (extended-release tablets):

• For patients who have not been treated with methylphenidate:
  • Adults at first, 18 to 36 milligrams  once a day in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 72 mg per day.
  • Teenagers 13 to 17 years of age at first, 18 mg once a day in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 72 mg per day.
  • Children 6 to 12 years of age at first, 18 mg once a day in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 54 mg per day.
  • Children younger than 6 years of age: Use and dose must be determined by your doctor.

For patients already using methylphenidate:

• Adults and children 6 years of age and older at first, 18 to 72 milligrams  once a day in the morning. Your doctor may adjust your dose as needed. However, the dose is usually not more than 72 mg per day.
• Children younger than 6 years of age: Use and dose must be determined by your doctor.

For narcolepsy:

For short-acting oral dosage forms (chewable tablets or solution):

• Adults: Administer 2 or 3 times a day and take 30 to 45 minutes before meals. Average dose is 20 to 30 milligrams  per day. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
• Children 6 years of age and older at first, 5 mg 2 times a day, taken before breakfast and lunch. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
• Children younger than 6 years of age: Use and dose must be determined by the doctor.

For short-acting oral dosage form (tablets):

• Adults: 20 to 30 milligrams  given in divided doses 2 or 3 times a day, taken 30 to 45 minutes before meals (breakfast and lunch). Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
• Children 6 years of age and older at first, 5 mg 2 times a day, taken before breakfast and lunch. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day.
• Children younger than 6 years of age: Use and dose must be determined by your doctor.

Common Side Effects

Methylphenidate ER’s typical adverse effects include fast heartbeat, 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

Methylphenidate ER has a significant risk of abuse. Individuals with a history of alcohol and drug misuse can be at danger of stimulant abuse. People who misuse Methylphenidate ER develop tolerance and psychological dependency. This may lead to addiction. Long-term Methylphenidate ER misuse, along with restless nights, may lead to psychotic symptoms.

Methylphenidate ER may raise blood pressure. People having a history of high blood pressure or heart disease should exercise caution while using Methylphenidate ER since it might worsen these symptoms. Uncontrollable high Blood pressure may have catastrophic implications, such as a stroke or a heart attack. Patients taking Methylphenidate ER Should regularly check their blood pressure. Individuals with a history of seizure disorder should be careful when using Methylphenidate ER, since it might Lower the seizure threshold and increase vulnerability to seizures.

Methylphenidate ER has been shown to inhibit linear growth in children and adolescents. Physicians sometimes halt therapy on weekends and holidays when children are not in school, for development. Children and adolescents using Methylphenidate ER need strict monitoring for growth suppression, as well as frequent height measurements. This impact is not of concern in the adult population. Methylphenidate ER may exacerbate tics in people with tic disorders (twitching of a muscle group, particularly in the face). Methylphenidate ER should be avoided or taken with care by people diagnosed with schizophrenia or bipolar disorder. Stimulants are often overused in this community, and large doses of Methylphenidate ER may cause psychosis and mania.

Use in Pregnancy and Breastfeeding: Category C

Methylphenidate ER has not been studied in women to verify its safety during pregnancy. Effects of the drug. The effect on the developing fetus in pregnant women is unclear. Women who are pregnant or could become pregnant, 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:

Methylphenidate ER should not be administered in conjunction with monoamine oxidase inhibitors (MAOI). The combination may cause elevated blood pressure. This and other important the following summarize the medication interactions recorded with Methylphenidate ER.

• Monoamine Oxidase Inhibitors (MAOIs) Examples include Parnate, Emsam, Nardil, and Marplan, MAOIs shouldn’t be used with methylphenidates Or dexmethylphenidate (e.g., Concerta, Ritalin, Focalin). The combination may precipitate. High blood pressure is a serious concern. 
• Weight-loss drugs (e.g., Meridia) Weight-loss drugs, prescription and Non-prescription and should not be used with methylphenidate or dexmethylphenidate. The combination might raise blood pressure or cause irritation, sleeplessness, and other negative responses from overstimulation. 
• Coumadin (warfarin): Methylphenidate and dexmethylphenidate may enhance the anticoagulant properties of Coumadin. 

Overdose

Methylphenidate ER overdose severity is determined on the quantity eaten. Symptoms of an acute overdose may include restlessness, agitation, irritability, and sleeplessness, Hyperactivity, disorientation, increased blood pressure, fast heart rate, psychosis, hallucinations, irregular heartbeat, convulsions, coma, circulatory 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 beneficial to the treating physician in knowing the number of tablets consumed.

Special Considerations

• To prevent sleeplessness, use Methylphenidate ER early in the morning rather than late in the day.
• Methylphenidate ER may be taken with meals to reduce stomach distress.
• Do not take more than prescribed by your doctor.
• If Methylphenidate ER produces significant uneasiness, restlessness, sleeplessness, lack of appetite, or weight loss, please tell Your physician.
• If you miss a dosage, take it right away. If it’s late afternoon or evening, omit the missing dosage then resume your usual dosage regimen the following morning. Do not take two doses.
• Methylphenidate ER pills should not be chewed or crushed; instead, consume them whole. Drink with a full glass of water to assist swallow the medicine.
• Don’t be concerned about the empty pill shell in your stool.
• 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.