Methylphenidate Oral Solution

Generic name: Methylphenidate hydrochloride

Drug class: Central nervous system stimulant

Dosage form: Oral solution

Route of administration: Oral

Dose:

• Adults: Administer in divided doses 2 or 3 times daily, preferably 30 to 45 minutes before meals. Average dosage is 20 to 30 mg daily. Some patients may require 40 to 60 mg daily. In others, 10 to 15 mg daily will be adequate. Patients who are unable to sleep if medication is taken late in the day should take the last dose before 6 p.m.
• Children (6 years and over): Start with 5 mg twice daily (before breakfast and lunch) with gradual increments of 5 to 10 mg weekly. Daily dosage above 60 mg is not recommended. If improvement is not observed after appropriate dosage adjustment over a one-month period, the drug should be discontinued.

Mechanism of action: Methylphenidate is thought to block the reuptake of norepinephrine and dopamine into the presynaptic neuron and increase the release of these monoamines into the extraneuronal space.

Drug usage cases:

• Attention deficit hyperactivity disorder (ADHD)
• Narcolepsy

Drug contraindications:

• During or within 14 days of monoamine oxidase inhibitors (MAOIs) therapy
• Known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac disease

Side effects:

• Common side effects: headache, decreased appetite, upset stomach, nervousness, trouble sleeping, nausea
• Serious side effects: hives, difficulty breathing, swelling of face, lips, tongue, or throat, chest pain, lightheadedness, hallucinations, new behavior problems, aggression, hostility, paranoia, numbness, pain, cold feeling, unexplained wounds, skin color changes in fingers or toes, painful or prolonged erections

Warnings:

• High potential for abuse, misuse, and addiction; assess patient’s risk before prescribing
• Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who were treated with CNS stimulants at the recommended ADHD dosage
• Monitor for signs and symptoms of abuse, misuse, and addiction throughout treatment
• Patients should not give methylphenidate hydrochloride oral solution to anyone else

Use during pregnancy or breastfeeding: Methylphenidate is classified as a Category C drug during pregnancy, indicating that risk to the fetus cannot be ruled out. It should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Methylphenidate is excreted in breast milk; caution should be exercised when administering to a nursing woman.