Dexmethylphenidate, Oral

What are other names for this medicine?

Type of medicine: stimulant

Generic and brand names: dexmethylphenidate, oral; Focalin; Focalin XR

What is this medicine used for?

This medicine is a stimulant. It is taken by mouth to treat attention deficit hyperactivity disorder (ADHD) in children and adults. It may be used along with therapy and education to treat this condition.

What should my healthcare provider know before I take this medicine?

Do not take this medicine if you have:

• a history of anxiety, tension, or agitation
• glaucoma
• epilepsy or other seizure disorders
• motor tics or Tourette's syndrome

Do not take this medicine if you have taken an MAO inhibitor within the past 14 days.

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• bipolar disorder, depression, or psychosis
• heart problems
• high blood pressure
• liver disease
• problems with alcohol or drug abuse
• thyroid problems

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

Take this medicine exactly as your healthcare provider prescribes. Check the label on the medicine for directions about your specific dose. Do not take more of it or longer than prescribed. Taking too much may be habit forming.

Do not stop taking this medicine without your healthcare provider's approval. You need to gradually reduce your dosage.

This medicine may come in different forms. If you have the extended-release capsule, do not crush, chew, or divide the capsule. Swallow the capsule whole. However, if you cannot swallow the capsule, you may open the capsule carefully and sprinkle the beads of medicine over a spoonful of applesauce and swallow the mixture right away without chewing. Ask your pharmacist if you have the extended-release capsules.

You may take this medicine with or without food. Taking it with meals may lessen the chance the drug will upset your stomach.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: dry mouth, sweating, fever, headache, flushing, vomiting, restlessness, tremors, muscle twitches, confusion, hallucinations, fast or irregular heartbeat, large pupils, seizures.

What should I watch out for?

Your healthcare provider should check blood pressure and heart rate regularly during treatment with this medicine. Call your healthcare provider right away if you or your child has any signs of heart problems such as chest pain, shortness of breath, or fainting while taking this medicine.

Call your healthcare provider right away if you notice any new or worsening mental symptoms or problems while taking this medicine, especially:

• more outgoing or aggressive behavior than normal
• hallucinations (seeing or hearing things that are not real)
• psychosis (believing things that are not real)
• paranoia (unusually suspicious)

Do not take this medicine to prevent normal tiredness.

When taken for a long time, this medicine may interfere with the growth of children. Talk to your healthcare provider about this.

This medicine may cause blurred vision and dizziness. Do not drive or operate machinery until you are fully alert and can see clearly.

You may need to have blood tests regularly to see how this medicine affects you. Keep all appointments for these tests.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine is a controlled substance. It is illegal for you to give it to anyone else.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat), seizures.

Serious (report these to your healthcare provider right away): Chest pain; irregular or fast heartbeat; anxiety or severe nervousness; blurred vision; uncontrollable head, neck, mouth, arm or leg movements; yellowing of the skin or eyes.

Other: Abdominal pain, dizziness, loss of appetite, fever, nausea, headache, trouble sleeping, dry mouth.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these medicines together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• alpha blockers such as prazosin (Minipress) and doxazosin (Cardura)
• antacids or stomach medicine such as cimetidine (Tagamet), ranitidine (Zantac), or nizatidine (Axid) (if you are taking the extended-release capsules)
• antiseizure medicines such as carbamazepine (Tegretol), phenobarbital, primidone (Mysoline), and phenytoin (Dilantin)
• beta blockers such as atenolol (Tenormin), acebutolol (Sectral), betaxolol (Kerlone), carteolol, bisoprolol (Zebeta), pindolol, metoprolol (Lopressor, Toprol XL), timolol, sotalol (Betapace), nadolol (Corgard), propranolol (Inderal), labetalol (Normodyne, Trandate), and carvedilol (Coreg)
• medicine that reduces the chance of blood clots forming such as warfarin (Coumadin)
• calcium channel blockers such as nicardipine (Cardene), nifedipine (Procardia, Adalat), isradipine (DynaCirc), felodipine (Plendil), amlodipine (Norvasc), verapamil (Calan, Isoptin, Verelan), and diltiazem (Cardizem, Dilacor, Tiamate, Tiazac)
• clonidine (Catapres, Duraclon)
• MAO Inhibitor antidepressants such as phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan) (Do not take an MAO inhibitor and this medicine within 14 days of each other.)
• sibutramine (Meridia)
• SSRI antidepressants such as fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), escitalopram (Lexapro), and citalopram (Celexa)
• tricyclic antidepressants such as amitriptyline, nortriptyline (Aventyl, Pamelor), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), and doxepin (Sinequan)
• yohimbe

Do not drink alcohol while you are taking this medicine.

Keep a list of all your medicines (prescription, supplements, natural remedies, vitamins, nonprescription) with you. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.

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