Drug Name Indication (include Short-acting, Notable side effects /Patient education instructions
(include if IR, XR, approved ages) intermediate-acting or
ODT, LA) Neurotransmitter(s) long-acting.
Affected Duration of action, peak (if
Target Symptoms noted)
Methylphenidate Indication (include Pharmacokinetics Notable side effects
(D/L) approved ages) • Average half-life in • Insomnia, headache, exacerbation of tics,
(Concerta, Ritalin) Attention deficit adults is 3.5 hours nervousness, irritability, overstimulation,
hyperactivity disorder (1.3–7.7 hours) tremor, dizziness Anorexia, nausea, abdominal
(ADHD) in children and • Average half-life in pain, weight loss Can temporarily slow normal
adults (approved ages vary children is 2.5 growth in children (controversial) Blurred vision
based on formulation) hours (1.5–5 hours) Transdermal: application site reactions,
Narcolepsy (Metadate ER, • First-pass including contact sensitization (erythema,
Methylin ER, Ritalin, Ritalin metabolism is not edema, papules, vesicles) and chemical
SR) extensive with leukoderma
Neurotransmitter(s) transdermal Nobable side effects link to neurotransmitter
Affected dosing, thus • Increases in norepinephrine peripherally can
dopamine, norepinephrine resulting in notably cause autonomic side effects, including tremor,
reuptake inhibitor and higher exposure to tachycardia, tachycardia, hypertension, and
releaser (DN-RIRe) methylphenidate cardiac arrhythmias
Target Symptoms and lower • Increases in norepinephrine and dopamine
Concentration, attention exposure to centrally can cause CNS side effects such as
span Motor hyperactivity metabolites as insomnia, agitation, psychosis, and substance
Impulsiveness Physical and compared to oral abuse
mental fatigue Daytime dosing Patient education instructions
sleepiness Depression • Immediate-release • Use with caution in patients with any degree of
formulations hypertension, hyperthyroidism, or history of
(Ritalin, Methylin, drug abuse
generic • Children who are not growing or gaining weight
methylphenidate) should stop treatment, at least temporarily
have 2–4 hour • May worsen motor and phonic tics
, ADHD Table
durations of clinical • May worsen symptoms of thought disorder and
action behavioral disturbance in psychotic patients
• Sustained-release • Stimulants have a high potential for abuse and
formulations such must be used with caution in anyone with a
as Methylin ER, current or past history of substance abuse or
Ritalin SR, alcoholism or in emotionally unstable patients
Metadate ER, and
generic
methylphenidate
sustained-release
all have
approximately 4–6
hour durations of
clinical action
• Sustained-release
Metadate CD has
an early peak and
an 8-hour duration
of action
• Sustained-release
Ritalin LA also has
an early peak and
an 8-hour duration
of action, with 2
pulses (immediate
and after 4 hours)
• Sustained-release
Concerta trilayer
tablet, orally
disintegrating
tablet Cotempla
XRODT, Quillivant
XR, and Aptensio
XR have 12-hour