Generic name: Dexmethylphenidate hydrochlorideBrand names: Focalin
Focalin is a mild central nervous system stimulant used to treat Attention Deficit Hyperactivity Disorder (ADHD) in children. The drug is a modified version of methylphenidate (a common medication for attention disorders) and contains only the most active component of methylphenidate. Because of this special formulation, the usual dose of Focalin is half the amount of the methylphenidate dose.
Focalin should be given as part of a total treatment program that includes psychological, educational, and social measures. Symptoms of attention deficit disorders include continual problems with moderate to severe distractibility, short attention span, hyperactivity, emotional changeability, and impulsiveness.
Excessive doses of Focalin over a long period of time can produce addiction. It is also possible to develop tolerance to the drug, so that larger doses are needed to produce the original effect. Because of these dangers, be sure to check with your doctor before making any change in dosage; and withdraw the drug only under your doctor's supervision.
Focalin can be taken with or without food. The drug is usually taken twice a day, at least 4 hours apart, but your doctor may adjust the schedule depending on your child's response.
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for your child to continue taking Focalin.
The most common side effects reported for drugs that are similar to Focalin (including methylphenidate) are nervousness and the inability to fall asleep or stay asleep. In children, loss of appetite, stomach pain, weight loss during long-term treatment, inability to fall asleep or stay asleep, and abnormally fast heartbeat are the more common side effects.
Focalin should not be used by people who suffer from anxiety, tension, and agitation, since the drug may aggravate these symptoms.
If Focalin, or similar drugs such as methylphenidate, cause an allergic reaction, the drug should be avoided. It should not be taken by anyone with the eye condition known as glaucoma. It should also be avoided by anyone who suffers from motion tics (repeated, uncontrollable twitches) or verbal tics (uncontrollable repetition of words or sounds), or someone who suffers from, or has a family history of, Tourette's syndrome (severe and multiple tics).
Focalin should not be taken with drugs classified as monoamine oxidase (MAO) inhibitors, such as the antidepressants phenelzine and tranylcypromine, or within 14 days of stopping this type of medication.
Your doctor will do a complete history and evaluation before prescribing Focalin. It is important to remember that the drug is only part of the overall management of ADHD, and your doctor may also recommend counseling or other therapy.
There is no information about the safety and effectiveness of long-term Focalin treatment in children. However, suppression of growth has been seen with the long-term use of stimulants, so your doctor will watch your child carefully while he or she is taking Focalin. If your child is not growing or gaining weight as expected, the doctor may stop Focalin treatment. This drug should not be given to children under 6 years of age; safety and effectiveness in this age group have not been established.
Blood pressure should be monitored in anyone taking Focalin, especially those with high blood pressure or abnormal heart rate or rhythm. Caution is also advised in those with heart or thyroid problems.
Be sure to tell the doctor if your child has blurred vision while taking Focalin; some people have reported visual disturbances while taking stimulants similar to Focalin.
The use of Focalin by anyone with a seizure disorder or psychosis (abnormal thinking and hallucinations) is not recommended. Caution is also advisable for anyone with a history of emotional instability or substance abuse, due to the danger of addiction. Focalin should not be used for the prevention or treatment of normal fatigue, nor should it be used for the treatment of severe depression.
Do not share Focalin with anyone else, and give your child only the number of tablets prescribed by your doctor. Keep track of the number of tablets in a bottle so you will notice if any are missing. Not using Focalin correctly can lead to dependence; call the doctor immediately if you seem to be using more than the prescribed amount.
If Focalin is taken with certain other drugs, the effects of either can be increased, decreased, or altered. It is especially important to check with your doctor before combining Focalin with the following:Antidepressant drugs, including MAO inhibitors, tricyclics, and serotonin reuptake inhibitorsAntiseizure drugs such as phenobarbital, phenytoin, and primidoneBlood pressure drugs such as clonidineBlood thinners such as warfarinHerbal remedies such as ephedra and St. John's wort
The effects of Focalin during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, tell your doctor immediately. Focalin should be used during pregnancy only if clearly needed.
It is not known whether Focalin appears in breast milk. Caution is advised if you are nursing a baby.
For people who are not currently taking methylphenidate, the usual starting dose is 5 milligrams a day. For those who are switching from methylphenidate, the starting Focalin dose is half the amount of the methylphenidate dose. In either case, the total daily dose of Focalin should be divided into 2 doses taken at least 4 hours apart.
Depending on the response, your doctor may increase the dose by 2.5 to 5 milligrams a day, up to a maximum daily dose of 20 milligrams (10 milligrams twice a day). Increases are usually made at weekly intervals.
If you suspect an overdose, seek medical attention immediately.