Dexmethylphenidate
- Atc Codes:N06BA11
- CAS Codes:19262-68-1#40431-64-9
- PHARMGKB ID:19262-68-1#40431-64-9
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
North America
USA: Dexmethylphenidate, Focalin.
Drug combinations
Chemistry
Dexmethylphenidate Hydrochloride: C~14~H~19~NO~2~ HCl. Mw: 269.77. (1) 2-Piperidineacetic acid, α-phenyl-, methyl ester, hydrochloride, (αR,2R)-; (2) Methyl (2R)-phenyl[(2R)-piperidin-2-yl]acetate hydrochloride. CAS-19262-68-1; CAS-40431-64-9 (dexmethylphenidate)(2002).
Pharmacologic Category
Anorexigenic Agents and Respiratory and Cerebral Stimulants, Miscellaneous. Central Nervous System Stimulant. (ATC-Code: N06BA11).
Mechanism of action
Dexmethylphenidate is the most active D-threo-enantiomer of racemic methylphenidate. It is a CNS stimulant, blocks the reuptake of norepinephrine and dopamine, and increases their release into the extraneuronal space.
Therapeutic use
Treatment of attention-deficit hyperactivity disorder (ADHD) alone or combined with behavioral treatment in children ≥6 years, adolescents and adults.
Pregnancy and lactiation implications
Teratogenic effects in animal studies. Use only if the potential benefit to the mother outweighs the possible risks to the fetus. Use with caution during lactation.
Unlabeled use
Contraindications
Hypersensitivity to dexmethylphenidate, methylphenidate, or any component of the formulation. Marked anxiety, tension, and agitation (may aggravate these symptoms). Glaucoma, motor tics, family history or diagnosis of Tourette’s syndrome. Use with or within 14 days following MAO inhibitor therapy.
Warnings and precautions
CNS stimulants should generally not be used in children, adolescents, or adults with known serious structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, or other serious cardiac conditions. Stimulants cause modest increases in average blood pressure and heart. Caution is advised in patients with underlying medical conditions which might be affected by increases in blood pressure or heart rate (e.g. hypertension, heart failure, recent MI, ventricular arrhythmia). Risk of drug abuse. Use with caution in pre-existing psychiatric disorders (psychotic or manic symptoms, aggressive behavior and hostility are frequently observed). Prolonged administration of stimulants in children with ADHD may cause a temporary suppression of normal weight and/or height. May cause difficulty in accommodation and blurred vision. Abrupt discontinuation should be avoided (may unmask severe depression). May lower the seizure threshold in history of seizures leading to new onset or breakthrough seizure activity. The drug should not be used in children <6 years of age (safety and efficacy not established).