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Overview: Dexmethylphenidate is a stimulant medicine used to treat attention deficit hyperactivity disorder (ADHD). It may work by increasing natural chemicals in the brain called norepinephrine and dopamine. Common side effects include an upset stomach, decreased appetite, nausea, and headache. Dexmethylphenidate comes as a tablet and capsule. If you have trouble swallowing the capsule, it can be opened and sprinkled onto applesauce.

Uses

What is dexmethylphenidate used for?

Dexmethylphenidate is commonly used to treat attention deficit hyperactivity disorder (ADHD). It may help improve attention and reduce impulsivity and hyperactivity in people with ADHD.

Dexmethylphenidate may also be used for other conditions as determined by your health care provider.

How does dexmethylphenidate work (mechanism of action)?

Dexmethylphenidate belongs to a group of medicines called stimulants. It may work by increasing levels of natural brain chemicals, such as norepinephrine and dopamine. These chemicals play a role in attention, focus, and impulse control.   

How is dexmethylphenidate supplied (dosage forms)?

Brands and other names

  • Focalin
  • Focalin XR

Dosage forms and strengths

  • 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 35 mg, 40 mg extended-release oral capsules
  • 2.5 mg, 5 mg, 10 mg oral tablets

How should I store dexmethylphenidate?

Dexmethylphenidate should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when you’re transporting it. Store it in a cool, dry, and safe place, such as a locked cabinet. Protect it from light and moisture. 

Side Effects

What are the most common side effects of dexmethylphenidate?

The most common side effects of dexmethylphenidate are listed below. These side effects may vary depending on your age and the product you are taking. Tell your health care provider if you have any of these side effects that bother you.

  • Upset stomach or stomach pain
  • Decreased or loss of appetite
  • Headache
  • Anxiety
  • Dry mouth
  • Throat pain
  • Fever 
  • Nausea 

There may be other side effects of dexmethylphenidate that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of dexmethylphenidate?

While less common, the most serious side effects of dexmethylphenidate are described below, along with what to do if they happen.

Severe Allergic Reactions. Dexmethylphenidate may cause allergic reactions, which can be serious. Stop taking dexmethylphenidate and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Risk of Misuse and Addiction. Misusing dexmethylphenidate can lead to serious side effects, such as substance use problems, overdose, or death. Misuse means using a medicine in a way other than how it was prescribed. Dexmethylphenidate can also cause physical dependence, which means your body relies on the medicine. Take dexmethylphenidate exactly as prescribed. Tell your health care provider if you feel that dexmethylphenidate is not working. Call your health care provider right away or go to the nearest emergency room if you have any of the following serious symptoms.

  • Sudden confusion or feeling disoriented
  • Feeling paranoid
  • Suicidal thoughts or actions
  • Seizures
  • Trouble breathing

Increased Blood Pressure and Heart Rate. Dexmethylphenidate may increase your heart rate or blood pressure. Keep all appointments with your health care provider to check your blood pressure and heart rate before starting dexmethylphenidate and during treatment. If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Also call your health care provider or get medical attention right away if you have chest pain, a fast or irregular heartbeat, or if you faint or feel your heartbeat more than usual. 

Behavior, Thought, or Mood Changes. Dexmethylphenidate may cause or worsen psychotic-like behaviors, such as hallucinations or mania. People who already have a mental health condition, such as bipolar disorder, may be at higher risk of these side effects. Tell your health care provider right away if you have any of the following symptoms, or if you have been told by others you have these symptoms.

  • Hearing, seeing, smelling, tasting, or otherwise perceiving things that others do not
  • Delusional thoughts, such as false beliefs that you are being controlled
  • Disorganized thoughts, such as jumping between topics or having a hard time focusing
  • Sudden decline in self-care, such as personal hygiene or academic/work performance
  • Aggressive behavior
  • Highly increased energy
  • Significant trouble sleeping
  • Racing, fast-paced thoughts
  • Reckless behavior
  • Unusually grand ideas
  • Excessive happiness or crankiness
  • Talking more or faster than usual

Painful, Prolonged Erection (Priapism). Dexmethylphenidate may cause an unwanted erection that is persistent, painful, and that may happen without sexual arousal. Your penis might be permanently damaged if priapism is not treated quickly. Stop taking dexmethylphenidate and get emergency help if you have any of the following symptoms of priapism. 

  • Erection lasting for more than four hours 
  • Erection that is unrelated to sexual stimulation
  • Painful or tender penis

Blood Flow Problems. Dexmethylphenidate may cause blood flow problems, including a condition called Raynaud's phenomenon, which happens when the blood vessels in your fingers and toes overreact and lead to low blood flow. Call your health care provider right away if you have any of the following symptoms.

  • Fingers or toes feeling numb, cool, painful, or sensitive to cold
  • Fingers or toes changing color from pale, to blue, to red
  • Unexplained wounds on fingers or toes

Slowed Growth in Children. Children taking dexmethylphenidate may be at a higher risk of not gaining height and weight as expected. Keep all appointments with your health care provider to check your child’s height and weight before starting and during treatment with dexmethylphenidate.

Glaucoma. Dexmethylphenidate may increase pressure inside the eye and cause or worsen glaucoma, which can lead to blindness. People who have problems with close-up vision (farsightedness) may be at higher risk. Tell your health care provider right away if you have any of the following symptoms of glaucoma.

  • Changes in vision, including loss of vision
  • Eye pain or redness
  • Severe headache or vomiting
  • Seeing bright, colorful circles around lights (vision halos)

Tics. Dexmethylphenidate may cause or worsen tics, which are sudden, repetitive movements or sounds that can be hard to control. Call your health care provider right away if you have any new or worsening tics.

Warnings & Precautions

Who should not use dexmethylphenidate?

Allergies to Ingredients. People who are allergic to any of the following should not take dexmethylphenidate.

  • Dexmethylphenidate
  • Focalin
  • Focalin XR
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific dexmethylphenidate products they stock.

Drug Interactions. Dexmethylphenidate should not be taken while you are using certain other medicines. Before taking dexmethylphenidate, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about dexmethylphenidate before using it?

Do not take dexmethylphenidate unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share dexmethylphenidate with other people, even if they have the same condition as you. It may harm them.

Keep dexmethylphenidate out of the reach of children. Dexmethylphenidate is a controlled substance because it can be misused or lead to dependence. Store dexmethylphenidate in a safe, preferably locked, place to protect it from theft. It is illegal to sell or give away this medicine.

There are multiple forms of dexmethylphenidate available that are taken in different ways. Read and follow the instructions for the product you have, and make sure you understand how to prepare, take, and throw it away properly. If you have any questions, talk to your health care provider.

Throw away any unused or expired dexmethylphenidate by either taking it to a U.S. Drug Enforcement Administration (DEA) collection site or a medicine take-back program. If these are not available, you can dispose of dexmethylphenidate at home by mixing the medicine with cat litter, dirt, or used coffee grounds, placing the mixture in a sealed plastic bag, and throwing the plastic bag in the trash. Ask your pharmacist or other health care provider if you are not sure how to throw away this medicine safely.

Dexmethylphenidate capsules should be swallowed whole with water or other liquid. Do not chew, cut, or crush the capsules. If you cannot swallow the capsule whole, you can open it and sprinkle the contents onto a spoonful of applesauce. Swallow the mixture right away and do not chew it. 

Keep all appointments, including for bloodwork and heart checkups, before and during treatment with dexmethylphenidate. This will help your health care provider make sure it is safe for you to take dexmethylphenidate.

What should I tell my health care provider before using dexmethylphenidate?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if dexmethylphenidate is right for you.

In particular, make sure that you discuss any of the following.

Substance Use Disorder. Tell your health care provider if you have ever misused alcohol, prescription medicines, or street drugs. Dexmethylphenidate has a risk of being misused.

Mental Health Problems. Tell your health care provider if you or anyone in your family has had mental health problems, including psychosis, bipolar disorder, mania, depression, or suicide. Dexmethylphenidate may worsen certain mental health conditions.

Heart Problems. People who have serious heart disease or heart defects may be at risk of sudden death if they take dexmethylphenidate. Tell your health care provider if you have any heart problems, including heart disease, heart defects, cardiomyopathy, or an abnormal heart rhythm (arrhythmia). Also tell your health care provider if anyone in your family has heart problems.

Other Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following.

  • High blood pressure
  • Circulation problems in your fingers or toes
  • Eye problems, including increased pressure in your eye, glaucoma, or problems with close-up vision (farsightedness)
  • Tics (repeated movements or sounds), Tourette syndrome, or a family history of tics or Tourette syndrome

Pregnancy. It is not known if or how dexmethylphenidate could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should take dexmethylphenidate while you are pregnant or trying to get pregnant. If you become pregnant while taking dexmethylphenidate, you can sign up for the National Pregnancy Registry for ADHD Medications by calling 866-961-2388 or at womensmentalhealth.org/research/pregnancyregistry/adhd-medications. This registry collects safety information about the use of ADHD medicines during pregnancy.

Breastfeeding. Dexmethylphenidate passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take dexmethylphenidate while breastfeeding.

Interactions

Focalin (Sandoz) US Medication Guide, November 2023.

Focalin (Sandoz) US Prescribing Information, November 2023. Does dexmethylphenidate interact with foods or drinks?

There are no known interactions between dexmethylphenidate and foods or drinks. Taking dexmethylphenidate extended-release capsules with food may make it not work as quickly. Ask your pharmacist or other health care provider how to take the dexmethylphenidate form you are prescribed.

It is unknown if drinking alcohol will affect dexmethylphenidate. The risk of certain side effects may be increased if you drink alcohol while taking dexmethylphenidate.

Does dexmethylphenidate interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking dexmethylphenidate.

  • A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s disease
  • A medicine for high blood pressure
  • An anesthetic, which is a medicine that is used to put you to sleep before surgery.
  • Risperidone, which is a medicine used to treat schizophrenia, bipolar disorder, and crankiness seen with autism

This may not be a complete list of medicines that can interact with dexmethylphenidate. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much dexmethylphenidate?

If you or someone else has used too much dexmethylphenidate, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of dexmethylphenidate?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.