dexmethylphenidate (Rx)

Brand and Other Names:Focalin, Focalin XR
  • Print

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 2.5mg
  • 5mg
  • 10mg

capsule, extended-release

  • 5mg
  • 10mg
  • 15mg
  • 20mg
  • 25mg
  • 30mg
  • 35mg
  • 40mg

Attention Deficit Hyperactivity Disorder

Focalin

  • Initial: 2.5 PO twice daily; may increase in 2.5- to 5-mg increments qWeek if warranted
  • Not to exceed 20 mg/day

Focalin XR

  • Not taking Focalin or methylphenidate: 10 mg PO qDay initially; may increase in 10-mg increments qWeek if warranted; not to exceed 20 mg/day
  • Switch from Focalin: Administer the same total daily dose as Focalin but administer qDay
  • Switch from methylphenidate: Initiate with half total daily dose of methylphenidate and administer qDay; not to exceed 40 mg/day

Dosing Modifications

Hepatic impairment: Safety and efficacy not established

Renal impairment: Not studied; expected to have minimal effects on kinetics of dexmethylphenidate considering its extensive metabolism to inactive compounds

Dosage Forms & Strengths

tablet

  • 2.5mg
  • 5mg
  • 10mg

capsule, extended-release

  • 5mg
  • 10mg
  • 15mg
  • 20mg
  • 25mg
  • 30mg
  • 35mg
  • 40mg

Attention Deficit Hyperactivity Disorder

<6 years

  • Safety and efficacy not established

≥6 years (Focalin)

  • Initial: 2.5 PO twice daily; may increase in 2.5- to 5-mg increments qWeek if warranted
  • Not to exceed 20 mg/day

≥6 years (Focalin XR)

  • Not taking Focalin or methylphenidate: 5 mg PO qDay initially; may increase in 5-mg increments qWeek if warranted; not to exceed 30 mg/day
  • Switch from Focalin: Administer the same total daily dose as Focalin but administer qDay
  • Switch from methylphenidate: Initiate with half total daily dose of methylphenidate and administer qDay; not to exceed 30 mg/day
Next:

Interactions

Interaction Checker

and dexmethylphenidate

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (10)

            • iobenguane I 123

              dexmethylphenidate decreases effects of iobenguane I 123 by receptor binding competition. Contraindicated. If clinically appropriate, discontinue drugs that compete for NE receptor sites for at least 5 half-lives; may cause false-negative imaging results.

            • isocarboxazid

              isocarboxazid increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • linezolid

              linezolid increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • phenelzine

              phenelzine increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • procarbazine

              procarbazine increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • rasagiline

              rasagiline increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Dexmethylphenidate use is contraindicated during treatment with MAOIs and also within a minimum of 14 days following discontinuation of treatment with an MAOI.

            • safinamide

              dexmethylphenidate, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.

            • selegiline

              selegiline increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Dexmethylphenidate use is contraindicated during treatment with MAOIs and also within a minimum of 14 days following discontinuation of treatment with an MAOI.

            • selegiline transdermal

              selegiline transdermal increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            • tranylcypromine

              tranylcypromine increases effects of dexmethylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            Serious - Use Alternative (29)

            • amitriptyline

              amitriptyline, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • amoxapine

              amoxapine, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • benzhydrocodone/acetaminophen

              benzhydrocodone/acetaminophen, dexmethylphenidate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • cabergoline

              cabergoline, dexmethylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • clomipramine

              clomipramine, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • desflurane

              desflurane increases toxicity of dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

            • desipramine

              desipramine, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • dihydroergotamine

              dihydroergotamine, dexmethylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • dihydroergotamine intranasal

              dihydroergotamine intranasal, dexmethylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • doxapram

              doxapram increases effects of dexmethylphenidate by pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive pressor effect.

            • doxepin

              doxepin, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • ergoloid mesylates

              ergoloid mesylates, dexmethylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • ergotamine

              ergotamine, dexmethylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • ether

              ether increases toxicity of dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

            • imipramine

              imipramine, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • iobenguane I 131

              dexmethylphenidate will decrease the level or effect of iobenguane I 131 by Other (see comment). Avoid or Use Alternate Drug. Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Do not administer these drugs until at least 7 days after each iobenguane dose.

            • isoflurane

              isoflurane increases toxicity of dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

            • levomilnacipran

              dexmethylphenidate and levomilnacipran both increase serotonin levels. Avoid or Use Alternate Drug.

            • lofepramine

              lofepramine, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • maprotiline

              maprotiline, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • methoxyflurane

              methoxyflurane increases toxicity of dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

            • methylergonovine

              methylergonovine, dexmethylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.

            • nortriptyline

              nortriptyline, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • ozanimod

              ozanimod increases toxicity of dexmethylphenidate by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.

            • protriptyline

              protriptyline, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • sevoflurane

              sevoflurane increases toxicity of dexmethylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.

            • trazodone

              trazodone, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • trimipramine

              trimipramine, dexmethylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.

            • yohimbe

              yohimbe, dexmethylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.

            Monitor Closely (169)

            • albuterol

              albuterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              albuterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • alfentanil

              alfentanil increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • alprazolam

              alprazolam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • amitriptyline

              amitriptyline increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • amobarbital

              amobarbital increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • amoxapine

              amoxapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • arformoterol

              arformoterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              arformoterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • aripiprazole

              aripiprazole increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • armodafinil

              armodafinil and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

            • azelastine

              azelastine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • belladonna and opium

              belladonna and opium increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • benperidol

              benperidol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • benzphetamine

              dexmethylphenidate and benzphetamine both decrease sedation. Use Caution/Monitor.

              benzphetamine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • bromocriptine

              bromocriptine, dexmethylphenidate. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Hypertension, V tach.

            • brompheniramine

              brompheniramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • buprenorphine buccal

              buprenorphine buccal increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • buprenorphine subdermal implant

              dexmethylphenidate, buprenorphine subdermal implant. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

            • buprenorphine, long-acting injection

              dexmethylphenidate, buprenorphine, long-acting injection. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Concomitant use could result in life-threatening serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation, and during dose adjustment of the serotonergic drug. Discontinue buprenorphine if serotonin syndrome is suspected.

            • butabarbital

              butabarbital increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • butalbital

              butalbital increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • butorphanol

              butorphanol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • caffeine

              caffeine and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

            • captopril

              dexmethylphenidate decreases effects of captopril by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effect of captopril.

            • carbinoxamine

              carbinoxamine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chloral hydrate

              chloral hydrate increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlordiazepoxide

              chlordiazepoxide increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlorpheniramine

              chlorpheniramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • chlorpromazine

              chlorpromazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              chlorpromazine, dexmethylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • cimetidine

              cimetidine will increase the level or effect of dexmethylphenidate by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Applies only to extended release formulation

            • cinnarizine

              cinnarizine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • citalopram

              dexmethylphenidate increases effects of citalopram by decreasing metabolism. Use Caution/Monitor. Potential risk for serotonin syndrome or neuroleptic malignant syndrome-like reactions, caution should be observed during coadministration.

            • clemastine

              clemastine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clomipramine

              clomipramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clonazepam

              clonazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clonidine

              dexmethylphenidate increases toxicity of clonidine by unknown mechanism. Use Caution/Monitor.

            • clorazepate

              clorazepate increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • clozapine

              clozapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • codeine

              codeine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cyclizine

              cyclizine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • cyproheptadine

              cyproheptadine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • desipramine

              desipramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dexchlorpheniramine

              dexchlorpheniramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dexfenfluramine

              dexmethylphenidate and dexfenfluramine both decrease sedation. Use Caution/Monitor.

              dexfenfluramine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dexmedetomidine

              dexmedetomidine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dextroamphetamine

              dexmethylphenidate and dextroamphetamine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and dextroamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dextromoramide

              dextromoramide increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diamorphine

              diamorphine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diethylpropion

              dexmethylphenidate and diethylpropion both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and diethylpropion both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • difenoxin hcl

              difenoxin hcl increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dimenhydrinate

              dimenhydrinate increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diphenhydramine

              diphenhydramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • diphenoxylate hcl

              diphenoxylate hcl increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dipipanone

              dipipanone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dobutamine

              dobutamine and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              dobutamine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dopamine

              dexmethylphenidate and dopamine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and dopamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • dopexamine

              dopexamine and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              dopexamine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • doxepin

              doxepin increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • droperidol

              droperidol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • droxidopa

              dexmethylphenidate and droxidopa both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. May increase risk for supine hypertension

            • ephedrine

              ephedrine and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              ephedrine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • epinephrine

              epinephrine and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              epinephrine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • epinephrine inhaled

              dexmethylphenidate, epinephrine inhaled. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • epinephrine racemic

              epinephrine racemic and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              epinephrine racemic and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • escitalopram

              dexmethylphenidate increases effects of escitalopram by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • esketamine intranasal

              esketamine intranasal, dexmethylphenidate. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. .

            • eslicarbazepine acetate

              dexmethylphenidate increases effects of eslicarbazepine acetate by decreasing metabolism. Use Caution/Monitor.

            • estazolam

              estazolam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ethanol

              ethanol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • famotidine

              famotidine will increase the level or effect of dexmethylphenidate by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Applies only to extended release formulation

            • fenfluramine

              dexmethylphenidate and fenfluramine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and fenfluramine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • fluphenazine

              fluphenazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              fluphenazine, dexmethylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • flurazepam

              flurazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • formoterol

              formoterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              formoterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • haloperidol

              haloperidol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • hydralazine

              hydralazine, dexmethylphenidate. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Sympathomimetics can antagonize the activity of some antihypertensive agents.

            • hydromorphone

              hydromorphone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • hydroxyzine

              hydroxyzine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ibuprofen/famotidine

              ibuprofen/famotidine will increase the level or effect of dexmethylphenidate by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Applies only to extended release formulation

            • iloperidone

              iloperidone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • imipramine

              imipramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • isavuconazonium sulfate

              dexmethylphenidate will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • isoproterenol

              isoproterenol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              isoproterenol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • ketotifen, ophthalmic

              ketotifen, ophthalmic increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • levalbuterol

              levalbuterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              levalbuterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • levorphanol

              levorphanol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lisdexamfetamine

              dexmethylphenidate and lisdexamfetamine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and lisdexamfetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • lofepramine

              lofepramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lofexidine

              lofexidine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • loprazolam

              loprazolam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lorazepam

              lorazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lormetazepam

              lormetazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • loxapine

              loxapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • loxapine inhaled

              loxapine inhaled increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • maprotiline

              maprotiline increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • marijuana

              marijuana increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • melatonin

              melatonin increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • meperidine

              meperidine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • meprobamate

              meprobamate increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • metaproterenol

              metaproterenol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              metaproterenol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • methadone

              methadone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • methamphetamine

              dexmethylphenidate and methamphetamine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and methamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • methyldopa

              methyldopa increases effects of dexmethylphenidate by unknown mechanism. Use Caution/Monitor.

            • methylenedioxymethamphetamine

              dexmethylphenidate and methylenedioxymethamphetamine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and methylenedioxymethamphetamine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • methylphenidate

              dexmethylphenidate increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.

            • midazolam

              midazolam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • midodrine

              dexmethylphenidate and midodrine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and midodrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • mirtazapine

              mirtazapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • modafinil

              dexmethylphenidate and modafinil both decrease sedation. Use Caution/Monitor.

            • morphine

              morphine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • motherwort

              motherwort increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • moxonidine

              moxonidine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nabilone

              nabilone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nalbuphine

              nalbuphine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nizatidine

              nizatidine will increase the level or effect of dexmethylphenidate by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. applies only to extended release formulation

            • norepinephrine

              norepinephrine and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              norepinephrine and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • nortriptyline

              nortriptyline increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • olanzapine

              olanzapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • opium tincture

              opium tincture increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxazepam

              oxazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxycodone

              oxycodone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxymorphone

              oxymorphone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • oxytocin

              oxytocin increases effects of dexmethylphenidate by pharmacodynamic synergism. Use Caution/Monitor.

            • paliperidone

              paliperidone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • papaveretum

              papaveretum increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pentazocine

              pentazocine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pentobarbital

              pentobarbital increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • perphenazine

              perphenazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              perphenazine, dexmethylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • phendimetrazine

              dexmethylphenidate and phendimetrazine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and phendimetrazine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • phenobarbital

              phenobarbital increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phentermine

              dexmethylphenidate and phentermine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and phentermine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • phenylephrine

              dexmethylphenidate and phenylephrine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and phenylephrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • phenylephrine PO

              dexmethylphenidate and phenylephrine PO both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and phenylephrine PO both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • pholcodine

              pholcodine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pimozide

              pimozide increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pirbuterol

              pirbuterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              pirbuterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • primidone

              primidone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • prochlorperazine

              prochlorperazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              prochlorperazine, dexmethylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • promazine

              promazine, dexmethylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • promethazine

              promethazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              promethazine, dexmethylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • propylhexedrine

              dexmethylphenidate and propylhexedrine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and propylhexedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • protriptyline

              protriptyline increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • pseudoephedrine

              dexmethylphenidate and pseudoephedrine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • quazepam

              quazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • quetiapine

              quetiapine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • risperidone

              risperidone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • salmeterol

              salmeterol and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              salmeterol and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • scullcap

              scullcap increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • secobarbital

              secobarbital increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • shepherd's purse

              shepherd's purse increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • sodium zirconium cyclosilicate

              sodium zirconium cyclosilicate will increase the level or effect of dexmethylphenidate by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate. Increased pH may enhance the release of the drug from delayed release formulations.

            • solriamfetol

              dexmethylphenidate and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • sufentanil

              sufentanil increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • tapentadol

              tapentadol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • temazepam

              temazepam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • terbutaline

              terbutaline and dexmethylphenidate both decrease sedation. Use Caution/Monitor.

              terbutaline and dexmethylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • thioridazine

              thioridazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              thioridazine, dexmethylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • thiothixene

              thiothixene increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • topiramate

              topiramate increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.

            • tramadol

              tramadol increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • trazodone

              trazodone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • triazolam

              triazolam increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • triclofos

              triclofos increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • trifluoperazine

              trifluoperazine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              trifluoperazine, dexmethylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only.

            • trimipramine

              trimipramine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • triprolidine

              triprolidine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • xylometazoline

              dexmethylphenidate and xylometazoline both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and xylometazoline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • yohimbine

              dexmethylphenidate and yohimbine both decrease sedation. Use Caution/Monitor.

              dexmethylphenidate and yohimbine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.

            • ziconotide

              ziconotide increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ziprasidone

              ziprasidone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            Minor (62)

            • acetazolamide

              dexmethylphenidate increases effects of acetazolamide by decreasing metabolism. Minor/Significance Unknown.

            • amantadine

              amantadine, dexmethylphenidate. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Potential for additive CNS stimulation.

            • American ginseng

              American ginseng increases effects of dexmethylphenidate by pharmacodynamic synergism. Minor/Significance Unknown.

            • amitriptyline

              dexmethylphenidate increases effects of amitriptyline by decreasing metabolism. Minor/Significance Unknown.

            • amoxapine

              dexmethylphenidate increases effects of amoxapine by decreasing metabolism. Minor/Significance Unknown.

            • antithrombin alfa

              dexmethylphenidate increases effects of antithrombin alfa by decreasing metabolism. Minor/Significance Unknown.

            • antithrombin III

              dexmethylphenidate increases effects of antithrombin III by decreasing metabolism. Minor/Significance Unknown.

            • argatroban

              dexmethylphenidate increases effects of argatroban by decreasing metabolism. Minor/Significance Unknown.

            • bemiparin

              dexmethylphenidate increases effects of bemiparin by decreasing metabolism. Minor/Significance Unknown.

            • bivalirudin

              dexmethylphenidate increases effects of bivalirudin by decreasing metabolism. Minor/Significance Unknown.

            • carbamazepine

              dexmethylphenidate increases effects of carbamazepine by decreasing metabolism. Minor/Significance Unknown.

            • clomipramine

              dexmethylphenidate increases effects of clomipramine by decreasing metabolism. Minor/Significance Unknown.

            • clonazepam

              dexmethylphenidate increases effects of clonazepam by decreasing metabolism. Minor/Significance Unknown.

            • dalteparin

              dexmethylphenidate increases effects of dalteparin by decreasing metabolism. Minor/Significance Unknown.

            • desipramine

              dexmethylphenidate increases effects of desipramine by decreasing metabolism. Minor/Significance Unknown.

            • desmopressin

              desmopressin increases effects of dexmethylphenidate by pharmacodynamic synergism. Minor/Significance Unknown.

            • diazepam

              dexmethylphenidate increases effects of diazepam by decreasing metabolism. Minor/Significance Unknown.

            • dosulepin

              dexmethylphenidate increases effects of dosulepin by decreasing metabolism. Minor/Significance Unknown.

            • doxepin

              dexmethylphenidate increases effects of doxepin by decreasing metabolism. Minor/Significance Unknown.

            • duloxetine

              dexmethylphenidate increases effects of duloxetine by decreasing metabolism. Minor/Significance Unknown.

            • enoxaparin

              dexmethylphenidate increases effects of enoxaparin by decreasing metabolism. Minor/Significance Unknown.

            • ethosuximide

              dexmethylphenidate increases effects of ethosuximide by decreasing metabolism. Minor/Significance Unknown.

            • eucalyptus

              eucalyptus increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

            • felbamate

              dexmethylphenidate increases effects of felbamate by decreasing metabolism. Minor/Significance Unknown.

            • fluoxetine

              dexmethylphenidate increases effects of fluoxetine by decreasing metabolism. Minor/Significance Unknown.

            • fondaparinux

              dexmethylphenidate increases effects of fondaparinux by decreasing metabolism. Minor/Significance Unknown.

            • fosphenytoin

              dexmethylphenidate increases effects of fosphenytoin by decreasing metabolism. Minor/Significance Unknown.

            • gabapentin

              dexmethylphenidate increases effects of gabapentin by decreasing metabolism. Minor/Significance Unknown.

            • gabapentin enacarbil

              dexmethylphenidate increases effects of gabapentin enacarbil by decreasing metabolism. Minor/Significance Unknown.

            • guarana

              guarana increases effects of dexmethylphenidate by pharmacodynamic synergism. Minor/Significance Unknown.

            • heparin

              dexmethylphenidate increases effects of heparin by decreasing metabolism. Minor/Significance Unknown.

            • imipramine

              dexmethylphenidate increases effects of imipramine by decreasing metabolism. Minor/Significance Unknown.

            • lacosamide

              dexmethylphenidate increases effects of lacosamide by decreasing metabolism. Minor/Significance Unknown.

            • lamotrigine

              dexmethylphenidate increases effects of lamotrigine by decreasing metabolism. Minor/Significance Unknown.

            • levetiracetam

              dexmethylphenidate increases effects of levetiracetam by decreasing metabolism. Minor/Significance Unknown.

            • lofepramine

              dexmethylphenidate increases effects of lofepramine by decreasing metabolism. Minor/Significance Unknown.

            • lorazepam

              dexmethylphenidate increases effects of lorazepam by decreasing metabolism. Minor/Significance Unknown.

            • maprotiline

              dexmethylphenidate increases effects of maprotiline by decreasing metabolism. Minor/Significance Unknown.

            • methsuximide

              dexmethylphenidate increases effects of methsuximide by decreasing metabolism. Minor/Significance Unknown.

            • milnacipran

              dexmethylphenidate increases effects of milnacipran by decreasing metabolism. Minor/Significance Unknown.

            • nefazodone

              dexmethylphenidate increases effects of nefazodone by decreasing metabolism. Minor/Significance Unknown.

            • nortriptyline

              dexmethylphenidate increases effects of nortriptyline by decreasing metabolism. Minor/Significance Unknown.

            • oxcarbazepine

              dexmethylphenidate increases effects of oxcarbazepine by decreasing metabolism. Minor/Significance Unknown.

            • paroxetine

              dexmethylphenidate increases effects of paroxetine by decreasing metabolism. Minor/Significance Unknown.

            • phenindione

              dexmethylphenidate increases effects of phenindione by decreasing metabolism. Minor/Significance Unknown.

            • phenobarbital

              dexmethylphenidate increases effects of phenobarbital by decreasing metabolism. Minor/Significance Unknown.

            • phenytoin

              dexmethylphenidate increases effects of phenytoin by decreasing metabolism. Minor/Significance Unknown.

            • primidone

              dexmethylphenidate increases effects of primidone by decreasing metabolism. Minor/Significance Unknown.

            • protamine

              dexmethylphenidate increases effects of protamine by decreasing metabolism. Minor/Significance Unknown.

            • protriptyline

              dexmethylphenidate increases effects of protriptyline by decreasing metabolism. Minor/Significance Unknown.

            • rufinamide

              dexmethylphenidate increases effects of rufinamide by decreasing metabolism. Minor/Significance Unknown.

            • sage

              sage increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.

            • sertraline

              dexmethylphenidate increases effects of sertraline by decreasing metabolism. Minor/Significance Unknown.

            • tiagabine

              dexmethylphenidate increases effects of tiagabine by decreasing metabolism. Minor/Significance Unknown.

            • topiramate

              dexmethylphenidate increases effects of topiramate by decreasing metabolism. Minor/Significance Unknown.

            • trazodone

              dexmethylphenidate increases effects of trazodone by decreasing metabolism. Minor/Significance Unknown.

            • trimipramine

              dexmethylphenidate increases effects of trimipramine by decreasing metabolism. Minor/Significance Unknown.

            • valproic acid

              dexmethylphenidate increases effects of valproic acid by decreasing metabolism. Minor/Significance Unknown.

            • venlafaxine

              dexmethylphenidate increases effects of venlafaxine by decreasing metabolism. Minor/Significance Unknown.

            • warfarin

              dexmethylphenidate increases effects of warfarin by decreasing metabolism. Minor/Significance Unknown.

            • yerba mate

              yerba mate increases effects of dexmethylphenidate by pharmacodynamic synergism. Minor/Significance Unknown.

            • zonisamide

              dexmethylphenidate increases effects of zonisamide by decreasing metabolism. Minor/Significance Unknown.

            Previous
            Next:

            Adverse Effects

            >10%

            Abdominal pain (15%)

            Headache (25-39%)

            Insomnia (5-17%)

            Restlessness (12%)

            Anxiety (5-11%)

            1-10%

            Anorexia (5-7%)

            Fever (5%)

            Dizziness (6%)

            Mood swings (<3%)

            Nausea (9%)

            Pruritus (<3%)

            Pharyngolaryngeal pain (4-7%)

            Irritability (5%)

            Depression (<3%)

            Dyspepsia (5-9%)

            Postmarketing Reports

            Anaphylaxis

            Hypersensitivity reactions

            Rhabdomyolysis

            Drowsiness

            Dyskinesia

            Tourette’s syndrome (rare)

            Toxic psychosis

            Serotonin syndrome in combination with serotonergic drugs

            Abnormal liver function, ranging from transaminase elevation to severe hepatic injury

            Previous
            Next:

            Warnings

            Black Box Warnings

            Chronic abuse can lead to a marked tolerance and psychological dependence with varying degrees of abnormal behavior; frank psychotic episodes can occur, especially with parenteral abuse; withdrawal from abusive use may result in depression.

            Assess risk of abuse prior to prescribing and monitor for signs of abuse and dependence while on therapy; give cautiously to patients with a history of drug dependence or alcoholism

            Withdrawal following chronic therapeutic use may unmask symptoms of the underlying disorder that may require follow-up

            Contraindications

            Hypersensitivity to methylphenidate; reactions may include angioedema and anaphylaxis

            Notable tension and agitation, glaucoma, Tourette syndrome, motor tics, anxiety

            MAOIs: Risk of severe hypertensive reaction; do not use within 14 days of taking MAOI

            Cautions

            Should be used as part of a comprehensive treatment program of attention deficit disorder

            Caution in patients with history of drug dependence or alcoholism, HTN, preexisting structural cardiac abnormalities

            Discontinue if no improvement after 1 month

            Reevaluate need for treatment q6Week

            Associated with peripheral vasculopathy, including Raynaud phenomenon; monitor for digital changes during therapy and seek further evaluation (eg, rheumatology) if necessary

            Difficulties with visual accommodation and blurring of vision have been reported with stimulant treatment

            Do not use for depression, fatigue

            Sudden deaths, stroke, and myocardial infarction reported in adults taking stimulants at usual doses

            Patients who develop symptoms such as exertional chest pain, unexplained syncope, or other symptoms suggestive of cardiac disease during stimulant treatment should undergo a prompt cardiac evaluation

            Particular care should be taken in using stimulants to treat ADHD patients with comorbid bipolar disorder because of concern for possible induction of mixed/manic episode in such patients

            Aggressive behavior or hostility is often observed in children and adolescents with ADHD, and has been reported

            Monitor growth of children ages 7 to 10 years during treatment with stimulants; may need to interrupt therapy in patients not growing or gaining weight as expected

            Stimulants may lower convulsive threshold in patients with prior history of seizure, patients with prior EEG abnormalities in absence of seizures, and very rarely, patients without a history of seizures and no prior EEG evidence of seizures; discontinue therapy in the presence of seizures

            Use with caution in patients who use other sympathomimetic drugs

            Amphetamines may exacerbate motor and phonic tics and Tourette’s syndrome; perform clinical evaluation for tics and Tourette’s syndrome in children and their families prior to treating with stimulant medications

            Rare instances of prolonged and sometimes painful erections (priapism), sometimes requiring surgical intervention, reported with methylphenidate products; typically not reported during initiation, but often subsequent to an increase in dose; seek immediate medical attention for abnormally sustained or frequent and painful erections

            Use with caution in patients with hypertension and other vascular conditions, including heart failure, ventricular arrhythmia; recent myocardial infarction; CNS stimulants may increase heart rate and blood pressure

            Hypersensitivity reactions, including anaphylactic reactions and angioedema reported in patients treated with methylphenidate

            Use caution in patients with preexisting psychosis; stimulants may exacerbate symptoms of behavior and though disorder; use with caution in patients with bipolar disorder; stimulants may induce mixed/manic episodes; new onset of psychosis or mania may occur in children or adolescents with stimulant use; patients presenting with depressive symptoms should be screened for bipolar disorder, including family history of suicide, bipolar disorder, and depression; consider discontinuation of therapy if symptoms of psychosis develop

            Appetite suppression may occur in children; stimulant use is associated with weight loss and slowing growth rate; monitor growth rate and weight during treatment; consider interrupting therapy in patients who are not increasing in height or gaining weight as expected

            Abrupt discontinuation following high doses or prolonged periods may result in symptoms of wighdrawal including severe depression

            Avoid use in patients with known serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious cardiac problems that could increase risk of sudden death; evaluate promptly patients who develop exertional chest pain, unexplained syncope, or other symptoms suggestive of cardiac disease

            Hypersensitivity reactions, including angioedema and anaphylactic reactions reported in patients treated with methylphenidate

            Drug interaction overview

            • Therapy may decrease effectiveness of drugs used to treat hypertension; monitor blood pressure and adjust dosage of the antihypertensive drug as needed
            • Combined use of methylphenidate with risperidone when there is a change, whether an increase or decrease, in dosage of either or both medications, may increase risk of extrapyramidal symptoms (EPS); monitor for signs of EPS
            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy

            There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to ADHD medications, during pregnancy; healthcare providers are encouraged to register patients by calling the National Pregnancy registry for ADHD medications at 1-866-961-2388 or visit, https://womensmentalhealth.org/adhd­medications

            Dexmethylphenidate is the d-threo enantiomer of racemic methylphenidate; published studies and postmarketing reports on methylphenidate use during pregnancy have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes; there may be risks to fetus associated with use of CNS stimulants use during pregnancy

            CNS stimulants can cause vasoconstriction and thereby decrease placental perfusion; no fetal and/or neonatal adverse reactions have been reported with the use of therapeutic doses of methylphenidate during pregnancy; however, premature delivery and low birth weight infants have been reported in amphetamine-dependent mothers

            Animal data

            • Embryo-fetal development studies in rats showed delayed fetal skeletal ossification at doses up to 5 times maximum recommended human dose (MRHD) of 20 mg/day given to adults based on plasma levels
            • A decrease in pup weight in males was observed in a pre- and post-natal development study with oral administration of methylphenidate to rats throughout pregnancy and lactation at doses 5 times the MRHD of 20 mg/day given to adults based on plasma levels; plasma levels in adults were comparatively similar to plasma levels in adolescents

            Lactation

            Dexmethylphenidate is the d-threo enantiomer of racemic methylphenidate; Limited published literature, based on milk sampling from seven mothers reports that methylphenidate is present in human milk, which resulted in infant doses of 0.16% to 0.7% of the maternal weight-adjusted dosage and a milk/plasma ratio ranging between 1.1 and 2.7

            There are no reports of adverse effects on breastfed infant and no effects on milk production; long-term neurodevelopmental effects on infants from stimulant exposure are unknown; the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on breastfed infant from treatment or from underlying maternal condition

            Monitor breastfeeding infants for adverse reactions, such as agitation, insomnia, anorexia, and reduced weight

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

            Previous
            Next:

            Pharmacology

            Mechanism of Action

            The more pharmacologically active CNS stimulant of the d-threo-enantiomers; blocks reuptake of norepinephrine and dopamine, causing an increase of their release into the extraneuronal space

            Absorption

            Bioavailability: 22-25%

            Onset of action: 12hr (extended release)

            Peak plasma time: 1-1.5 hr (Focalin XR: 2nd peak at 6.5 hr)

            Distribution

            Protein bound: 12-25%

            Vd: 1.54-3.76 L/kg

            Metabolism

            Metabolized by deesterification

            Metabolites: Inactive

            Elimination

            Half-life: 2-4.5 hr (adults); 2-3 hr (children)

            Excretion: Urine (90%)

            Previous
            Next:

            Administration

            Extended Release

            Administer once daily; do not crush, chew, or divide

            Capsules may be opened and contents sprinkled over a spoonful of applesause; do not store for future use; consume immediately

            Immediate Release

            Administer twice daily, not sooner than 4 hours apart; may administer with or without food

            Previous
            Next:

            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            Focalin XR oral
            -
            15 mg capsule
            Focalin XR oral
            -
            35 mg capsule
            Focalin XR oral
            -
            25 mg capsule
            Focalin XR oral
            -
            40 mg capsule
            Focalin XR oral
            -
            30 mg capsule
            Focalin XR oral
            -
            20 mg capsule
            Focalin XR oral
            -
            10 mg capsule
            Focalin XR oral
            -
            5 mg capsule
            dexmethylphenidate oral
            -
            15 mg capsule
            dexmethylphenidate oral
            -
            5 mg capsule
            dexmethylphenidate oral
            -
            5 mg capsule
            dexmethylphenidate oral
            -
            10 mg capsule
            dexmethylphenidate oral
            -
            20 mg capsule
            dexmethylphenidate oral
            -
            40 mg capsule
            dexmethylphenidate oral
            -
            15 mg capsule
            dexmethylphenidate oral
            -
            30 mg capsule
            dexmethylphenidate oral
            -
            35 mg capsule
            dexmethylphenidate oral
            -
            5 mg tablet
            dexmethylphenidate oral
            -
            2.5 mg tablet
            dexmethylphenidate oral
            -
            5 mg tablet
            dexmethylphenidate oral
            -
            5 mg tablet
            dexmethylphenidate oral
            -
            35 mg capsule
            dexmethylphenidate oral
            -
            20 mg capsule
            dexmethylphenidate oral
            -
            40 mg capsule
            dexmethylphenidate oral
            -
            10 mg capsule
            dexmethylphenidate oral
            -
            15 mg capsule
            dexmethylphenidate oral
            -
            30 mg capsule
            dexmethylphenidate oral
            -
            30 mg capsule
            dexmethylphenidate oral
            -
            10 mg tablet
            dexmethylphenidate oral
            -
            5 mg tablet
            dexmethylphenidate oral
            -
            2.5 mg tablet
            dexmethylphenidate oral
            -
            30 mg capsule
            dexmethylphenidate oral
            -
            25 mg capsule
            dexmethylphenidate oral
            -
            10 mg capsule
            dexmethylphenidate oral
            -
            5 mg capsule
            dexmethylphenidate oral
            -
            25 mg capsule
            dexmethylphenidate oral
            -
            30 mg capsule
            dexmethylphenidate oral
            -
            20 mg capsule
            dexmethylphenidate oral
            -
            15 mg capsule
            dexmethylphenidate oral
            -
            10 mg capsule
            dexmethylphenidate oral
            -
            5 mg capsule
            dexmethylphenidate oral
            -
            40 mg capsule
            dexmethylphenidate oral
            -
            20 mg capsule
            dexmethylphenidate oral
            -
            15 mg capsule
            dexmethylphenidate oral
            -
            10 mg capsule
            dexmethylphenidate oral
            -
            5 mg capsule
            dexmethylphenidate oral
            -
            35 mg capsule
            dexmethylphenidate oral
            -
            25 mg capsule
            dexmethylphenidate oral
            -
            35 mg capsule
            dexmethylphenidate oral
            -
            25 mg capsule
            dexmethylphenidate oral
            -
            15 mg capsule
            dexmethylphenidate oral
            -
            10 mg tablet
            dexmethylphenidate oral
            -
            2.5 mg tablet
            dexmethylphenidate oral
            -
            10 mg tablet
            dexmethylphenidate oral
            -
            35 mg capsule
            dexmethylphenidate oral
            -
            5 mg tablet
            dexmethylphenidate oral
            -
            25 mg capsule
            dexmethylphenidate oral
            -
            30 mg capsule
            Focalin oral
            -
            10 mg tablet
            Focalin oral
            -
            5 mg tablet
            Focalin oral
            -
            2.5 mg tablet

            Copyright © 2010 First DataBank, Inc.

            Previous
            Next:

            Patient Handout

            Patient Education
            dexmethylphenidate oral

            DEXMETHYLPHENIDATE - ORAL

            (dex-METH-il-FEN-i-date)

            COMMON BRAND NAME(S): Focalin

            WARNING: Misuse or abuse of dexmethylphenidate may result in serious (possibly fatal) heart and blood pressure problems.This medication can be habit-forming and should be used cautiously by people who have mental/mood disorders or a substance use disorder (such as overuse of or addiction to drugs/alcohol). Before using this medication, tell your doctor if you have a personal or family history of a substance use disorder. Do not increase your dose, use it more often, or use it for a longer time or in a different way than prescribed. Doing so may result in a decrease in the effect of this drug, drug dependence, or abnormal thoughts/behavior.Your doctor may monitor you for a while after the medication is stopped, especially if you have taken this drug for a long time or in high doses. (See also How to Use section.)

            USES: This medication is used to treat attention deficit hyperactivity disorder - ADHD. It works by changing the amounts of certain natural substances in the brain. Dexmethylphenidate belongs to a class of drugs known as stimulants. It can help increase your ability to pay attention, stay focused on an activity, and control behavior problems. It may also help you to organize your tasks and improve listening skills.

            HOW TO USE: Read the Medication Guide provided by your pharmacist before you start taking dexmethylphenidate and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth as directed by your doctor, usually twice a day with or without food. Take the first dose as soon as you wake up in the morning and the second dose at least 4 hours later, or take as directed by your doctor. Taking this medication late in the day may cause trouble sleeping (insomnia).The dosage is based on your medical condition and response to treatment. Your doctor may direct you to gradually increase or decrease your dose. Also, if you have used it for a long time, do not suddenly stop using this drug without consulting your doctor. The total daily dose is usually 20 milligrams or less. Carefully follow your doctor's instructions.Methylphenidate and dexmethylphenidate are different medications and do not provide the same amount of medicine. Do not switch between products unless your doctor tells you to.Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.If you suddenly stop using this medication, you may have withdrawal symptoms (such as depression, suicidal thoughts, or other mental/mood changes). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used dexmethylphenidate for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well.Though it helps many people, this medication may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Take this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details.Tell your doctor if your condition does not improve or if it worsens.

            SIDE EFFECTS: Trouble sleeping, nervousness, nausea, stomach pain, headache, loss of appetite, weight loss, or dizziness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: signs of blood flow problems in the fingers or toes (such as coldness, numbness, pain, or skin color changes), unusual wounds on the fingers or toes, fast/pounding/irregular heartbeat, mental/mood/behavior changes (such as agitation, aggression, mood swings, abnormal thoughts, thoughts of suicide), uncontrolled muscle movements (such as twitching, shaking), sudden outbursts of words/sounds that are hard to control, vision changes (such as blurred vision).Get medical help right away if you have any very serious side effects, including: fainting, seizure, symptoms of a heart attack (such as chest/jaw/left arm pain, shortness of breath, unusual sweating), symptoms of a stroke (such as weakness on one side of the body, trouble speaking, sudden vision changes, confusion).Rarely, males (including young boys and teens) may have a painful or prolonged erection lasting 4 or more hours while using this medication. Caregivers/parents should also be watchful for this serious side effect in boys. If a painful or prolonged erection occurs, stop using this drug and get medical help right away, or permanent problems could occur. Ask your doctor or pharmacist for more details.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: See also Warning section.Before taking dexmethylphenidate, tell your doctor or pharmacist if you are allergic to it; or to methylphenidate; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: high blood pressure, blood circulation problems (such as Raynaud's disease), glaucoma, heart problems (such as irregular heartbeat, heart failure, previous heart attack, problems with heart structure), family history of heart problems (such as sudden cardiac death, irregular heartbeat), mental/mood conditions (especially anxiety, tension, agitation), personal/family history of mental/mood disorders (such as bipolar disorder, depression, psychosis, suicidal thoughts), personal/family history of uncontrolled muscle movements (motor tics, Tourette's syndrome), overactive thyroid (hyperthyroidism), seizure disorder.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).If used for a long time, this drug may affect a child's growth rate, weight, and final adult height. To reduce the risk, the doctor may recommend briefly stopping the medication from time to time. Check the child's weight and height regularly, and consult your doctor or pharmacist for more details.Older adults may be more sensitive to the side effects of this drug, especially trouble sleeping, weight loss, or chest pain.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Taking MAO inhibitors with this medication may cause a serious (possibly fatal) drug interaction. Avoid taking MAO inhibitors (isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment with this medication. Most MAO inhibitors should also not be taken for two weeks before treatment with this medication. Ask your doctor when to start or stop taking this medication.Dexmethylphenidate is very similar to methylphenidate. Do not use medications containing methylphenidate while using dexmethylphenidate.This medication may interfere with certain medical/laboratory tests (including brain scan for Parkinson's disease), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: vomiting, agitation, confusion, sweating, flushing, muscle twitching, hallucinations, seizures, loss of consciousness.

            NOTES: Do not share this medication with others. Sharing it is against the law.Laboratory and/or medical tests (such as blood pressure, complete blood count, height/weight monitoring in children) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

            MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near bedtime or near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

            Previous
            Next:

            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.