Generic Name: dexmethylphenidate, Oral capsule

Focalin XR

All Brands

  • Focalin XR
SECTION 1 of 4

Highlights for dexmethylphenidate

Oral capsule
1

Dexmethylphenidate is an oral medication used to treat attention deficit hyperactivity disorder (ADHD) in people ages 6 years and older.

2

This medication comes in two forms, an immediate-release tablet and an extended-release capsule. Your dose will depend on the form you take.

3

This medication can affect a child’s growth. If your child isn’t growing or gaining weight as expected, your doctor may stop this medication.

4

Common side effects include stomach pain, loss of appetite, weight loss, and difficulty falling asleep or staying asleep.

5

Be careful with this medication if you have a history of drug dependence or alcoholism. Long-term abuse can lead to addiction and serious changes in your behavior.

IMPORTANT INFORMATION

FDA Warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Abuse and dependence. Be careful with this drug if you have a history of drug dependence or alcoholism. Long-term abuse can lead to addiction and serious changes in your behavior. When you stop this drug after abusing it, you’re at increased risk of severe depression.

May slow a child’s growth

Your child’s height and weight should be monitored while taking this medication. Children taking it long-term may have temporary slowed growth. If your child isn’t growing or gaining weight as expected, your doctor may stop this medication.

May cause heart problems

If you’re an adult with heart problems, this medication can increase your risk of stroke and heart attack. The drug can also raise your heart rate and blood pressure. It may also cause sudden death in adults and children. Tell your doctor if you have any heart problems before starting dexmethylphenidate.

May worsen psychiatric problems

If you have psychiatric problems, this drug can make them worse. It can also worsen bipolar disorder, aggressive behavior, and hostility. If your child starts having new symptoms, such as hearing voices or believing things that aren’t true, tell their doctor right away. Tell your doctor if you have any psychiatric problems before starting dexmethylphenidate.

Drug Features

Dexmethylphenidate is a controlled substance. It’s available as an oral tablet and oral extended-release capsule. It’s also available in a generic version. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This drug may be used as part of a combination therapy. That means you may need to take it with other drugs.

Why It's Used

Dexmethylphenidate is used to help control the symptoms of attention deficit hyperactivity disorder (ADHD) in people ages 6 years and older.

How It Works

Dexmethylphenidate works by increasing the amount of certain chemicals in your brain needed to focus, pay attention, and control your actions.

More Details

How It Works

Dexmethylphenidate works by increasing the amount of certain chemicals in your brain needed to focus, pay attention, and control your actions.

It belongs to a class of drugs known as central nervous system stimulants.

SECTION 2 of 4

dexmethylphenidate Side Effects

Oral capsule

Most Common Side Effects

The most common side effects that occur with dexmethylphenidate include:

  • stomach pain

  • loss of appetite

  • nausea or vomiting

  • heartburn

  • weight loss

  • dry mouth

  • difficulty falling asleep or staying asleep

  • dizziness

  • nervousness

  • headache

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • heart problems. Symptoms may include:

    • fast, pounding, or irregular heartbeat
    • chest pain
  • psychiatric problems. Symptoms may include:

    • aggressive behavior
    • seeing or hearing things that don’t exist
    • mood changes
    • depression
    • excessive tiredness
  • allergic reaction. Symptoms may include:

    • swelling of your face, throat, tongue, lips, or eyes
    • fever
    • rash, hives, or itching
    • difficulty breathing
  • circulation problems. Symptoms may include:

    • joint pain
    • arms and legs feeling numb or weak
    • wounds on your fingers and toes
    • sensitivity to temperature in your fingers or toes
  • seizures

  • shortness of breath

  • slow or difficult speech

  • changes in vision or blurry vision

  • frequent, painful erections or erection lasting longer than 4 hours
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Mild side effects may go away within a few days or a couple of weeks. Talk to your doctor or pharmacist if they’re more severe or don’t go away.

Dexmethylphenidate doesn’t cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

dexmethylphenidate May Interact with Other Medications

Oral capsule

Dexmethylphenidate can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can lower your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Food Interactions

You can take dexmethylphenidate with or without food.

Medications That Might Interact with This Drug

Antidepressant drugs
  • selective serotonin reuptake inhibitor (SSRI). Using these with dexmethylphenidate can increase the effects of the SSRI and increase your risk of side effects.
  • tricyclic antidepressants. Using these with dexmethylphenidate can increase the effects of these medications. Your doctor may have to adjust the dose of your antidepressant medication.
  • monoamine oxidase inhibitors (MAOIs). Dexmethylphenidate can’t be used during treatment with MAOIs and within at least 14 days after stopping treatment with an MAOI. Using these medications together can lead to a dangerous increase in your blood pressure.

Blood thinning drug
  • warfarin. Using dexmethylphenidate can increase the levels of warfarin in your body, possibly increasing your risk of bleeding. Your INR may need to be monitored and your dose of warfarin may be adjusted.

Heartburn drugs

This interaction may occur when taking the extended-release form of dexmethylphenidate. Examples are:

  • calcium carbonate (Tums)
  • omeprazole (Prilosec)
  • lansoprazole (Prevacid)
  • famotidine (Pepcid)
  • ranitidine (Zantac)

Separate dexmethylphenidate and heart burn medications by at least 4 hours. Using both medications together can affect how well dexmethylphenidate works in your body.

Seizure drugs
  • carbamazepine. Using this with dexmethylphenidate can decrease how well dexmethylphenidate works in your body.
  • valproic acid. Using this with dexmethylphenidate can increase the levels of both medications in your body and increase your risk of side effects.
  • other seizure medications. Using these with dexmethylphenidate can increase the levels of the seizure medication in your body and increase your risk of side effects.

Blood pressure drugs
  • blood pressure-lowering drugs. Using these with dexmethylphenidate can limit how effective these medications are at treating your high blood pressure.
  • drugs used to prevent low blood pressure. Use these medications with caution if you are taking dexmethylphenidate. Your blood pressure may increase too much.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with heart problems

If you’re an adult with a heart problem, dexmethylphenidate can increase your risk of stroke, heart attack, increased heart rate, and increased blood pressure. It may also cause sudden death in adults and children. If you or your child is going to be taking this medication, tell your doctor about any heart problems.

People with psychiatric problems

This medication can make psychiatric problems worse. It can also worsen bipolar disorder, aggressive behavior, or hostility.

People with seizures

If you have a history of seizures, dexmethylphenidate may increase your risk of having another seizure.

People with circulation problems

If you have a circulation problem, such as Raynaud’s phenomenon, dexmethylphenidate may make it worse. You may notice your fingers or toes feeling numb, cool, or painful, and they may change color from pale to blue to red.

People with history of drug abuse

If you have a history of drug dependence or alcoholism, be careful with this drug. Long-term abuse can lead to addiction and cause serious changes to your behavior.

People with glaucoma

If you have glaucoma you should not take this medication.

People with tics

If you have motor tics or a family history or diagnosis of Tourette’s syndrome, you should not take this medication.

Pregnant women

Dexmethylphenidate is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Talk to your doctor if you’re pregnant or plan to become pregnant.

Women who are nursing

It isn’t known if dexmethylphenidate passes into breast milk. If it does, it may cause side effects in a breastfeeding child. If you breastfeed while taking dexmethylphenidate, look for these side effects in the baby:

  • irritability
  • problems sleeping
  • lack of appetite

Tell your doctor if you’re breastfeeding. You may need to decide whether to stop breastfeeding or stop taking dexmethylphenidate.

For Seniors

Dexmethylphenidate hasn’t been studied in people over the age of 65 years. This medication is considered a high-risk medication for older adults.

For Children

The effectiveness and safety of this drug haven’t been established in children under the age of 6 years. This medication shouldn’t be used in children under 6 years.

Keep this drug out of the reach of children. Accidentally taking this medication can be harmful to a child.

Allergies

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

SECTION 4 of 4

How to Take dexmethylphenidate (Dosage)

Oral capsule

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Attention deficit hyperactivity disorder (ADHD)
Form: Oral Tablet
Strength: 2.5 mg, 5 mg, and 10 mg
Form: Oral extended-release Capsule
Strength: 5 mg, 10 mg, 15 mg, 20 mg (brand name only), 25 mg (brand name only), 30 mg, 35 mg (brand name only), and 40 mg
Adult Dosage (ages 18 years and older)
  • Starting dose:
    • immediate-release tablets: 2.5 mg taken twice per day
    • extended-release capsules: 10 mg per day taken in the morning
  • When changing your dose:
    • Based on how you respond to the medication, your doctor may increase your dose.
    • immediate-release tablets: Your dose may be increased by 2.5–5 mg each week up to a maximum of 20 mg per day. This will be divided into two 10 mg doses.
    • extended-release capsules: Your dose may be increased by 10 mg each week up to a maximum of 40 mg per day.
Child Dosage (ages 6-17 years)
  • Starting dose:
    • immediate-release tablets: 2.5 mg taken twice per day
    • extended-release capsules: 5 mg per day taken in the morning
  • When changing your dose:
    • Based on how you respond to the medication, your doctor may increase your dose.
    • immediate-release tablets: Your dose may be increased by 2.5–5 mg each week up to a maximum of 20 mg per day. This will be divided into two 10 mg doses.
    • extended-release capsules: Your dose may be increased by 5 mg each week up to a maximum of 30 mg per day.
Child Dosage (ages 0-5 years)

A safe and effective dose hasn’t been established for this age group.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Dexmethylphenidate has serious risks if you don't take it as prescribed.

If You Don't Take It At All

Your symptoms of ADHD may not improve or they may get worse.

If You Stop Taking It Suddenly

If you stop taking dexmethylphenidate suddenly, your symptoms of ADHD may come back again.

If You Don't Take It on Schedule

You may not see a full benefit of this medication for the treatment of ADHD.  If you double up your dose or take it too close to your next scheduled time, you may be at higher risk of experiencing serious side effects.

What to Do If You Miss a Dose

If you miss a dose, take it as soon as you can. However, if it’s just a few hours until your next dose, skip the missed dose and take the next one on schedule.

Never try to catch up by taking two doses at once. This could result in toxic side effects.

How Can I Tell if the Drug is Working?

You may be able to tell if this drug is working if you have better focus and better control of your actions.

This is a long-term mediation.

You can take dexmethylphenidate with or without food

If you can’t swallow the extended-release capsule, you can open it and pour its contents on a spoonful of applesauce. Make sure you swallow all of the applesauce without chewing. Don’t save any for later.

Take this drug at the right time for best effects

If you’re taking the extended-release capsule once a day, take it in the morning only. If you’re taking the immediate-release tablet twice a day, make sure to take the tablets at least 4 hours apart.

You can open the extended-release capsule

If you can’t swallow the extended-release capsule, you can open it and sprinkle the medication inside on a spoonful of applesauce.

Store dexmethylphenidate in a safe place in temperatures from 59–86°F (15–30°C)

Keep it out of the reach of children.

Note: Keep your medications away from areas where they could get wet, such as bathrooms. Store them away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry it with you or in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s preprinted label to identify the medication. Keep the original prescription-labeled box with you when traveling.

Clinical Monitoring

Your doctor may take periodic blood tests if you’re taking dexmethylphenidate long term. This is to be sure you don’t develop any problems with your blood cells. 

Your child’s height and weight should be monitored while on dexmethylphenidate. Children taking this medication long term may have temporarily slowed growth rate. If your child isn’t growing or gaining weight as expected, your doctor may stop this medication.

Your doctor may monitor for changes in blood pressure and heart rate or symptoms of heart disease.

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for dexmethylphenidate.

Are There Any Alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.


Show Sources

Content developed in collaboration with Chirag S Rathod (UIC)

Medically reviewed by Anna Schreck, PharmD, RPh (Creighton) on May 15, 2015

Send us your feedback

Thank you.

Your message has been sent.

We're sorry, an error occurred.

We are unable to collect your feedback at this time. However, your feedback is important to us. Please try again later.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Read This Next

Holy Basil, Batman! 7 Potential Health Benefits
Holy Basil, Batman! 7 Potential Health Benefits
The Calming Effects of Passionflower
The Calming Effects of Passionflower
7 Creepy But (Mostly) Harmless Food and Drug Reactions
7 Creepy But (Mostly) Harmless Food and Drug Reactions
Advertisement
Advertisement
Advertisement