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All about: Focalin

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Generic name: Dexmethylphenidate hydrochloride
Brand names: Focalin

Why is Focalin prescribed?

Focalin is a mild central nervous system stimulant used to treat Attention Deficit Hyperactivity Disorder (ADHD) in children. The drug is a modified version of Ritalin (a common medication for attention disorders) and contains only the most active component of Ritalin. Because of this special formulation, the usual dose of Focalin is half the amount of the Ritalin dose.

Focalin should be given as part of a total treatment program that includes psychological, educational, and social measures. Symptoms of attention deficit disorders include continual problems with moderate to severe distractibility, short attention span, hyperactivity, emotional changeability, and impulsiveness.

Most important fact about Focalin

Excessive doses of Focalin over a long period of time can produce addiction. It is also possible to develop tolerance to the drug, so that larger doses are needed to produce the original effect. Because of these dangers, be sure to check with your doctor before making any change in dosage; and withdraw the drug only under your doctor's supervision.

How should you take Focalin?

Focalin can be taken with or without food. The drug is usually taken twice a day, at least 4 hours apart, but your doctor may adjust the schedule depending on your child's response.

--If you miss a dose...

Give it to the child as soon as you remember. If it is almost time for the next dose, skip the one you missed and return to your regular schedule. Never give 2 doses at the same time.

--Storage instructions...

Keep out of reach of children. Store below 86 degrees Fahrenheit in a tightly closed, light-resistant container. Do not store in hot, damp, or humid places.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for your child to continue taking Focalin.

  • More common side effects may include:
    Fever, insomnia, loss of appetite, nausea, nervousness, stomach pain

The most common side effects reported for drugs that are similar to Focalin (including Ritalin) are nervousness and the inability to fall asleep or stay asleep. In children, loss of appetite, stomach pain, weight loss during long-term treatment, inability to fall asleep or stay asleep, and abnormally fast heartbeat are the more common side effects.

Why should Focalin not be prescribed?

Focalin should not be used by people who suffer from anxiety, tension, and agitation, since the drug may aggravate these symptoms.

If Focalin, or similar drugs such as Ritalin, cause an allergic reaction, the drug should be avoided. It should not be taken by anyone with the eye condition known as glaucoma. It should also be avoided by anyone who suffers from motion tics (repeated, uncontrollable twitches) or verbal tics (uncontrollable repetition of words or sounds), or someone who suffers from, or has a family history of, Tourette's syndrome (severe and multiple tics).

Focalin should not be taken with drugs classified as monoamine oxidase (MAO) inhibitors, such as the antidepressants Nardil and Parnate, or within 14 days of stopping this type of medication.

Special warnings about Focalin

Your doctor will do a complete history and evaluation before prescribing Focalin. It is important to remember that the drug is only part of the overall management of ADHD, and your doctor may also recommend counseling or other therapy.

There is no information about the safety and effectiveness of long-term Focalin treatment in children. However, suppression of growth has been seen with the long-term use of stimulants, so your doctor will watch your child carefully while he or she is taking Focalin. If your child is not growing or gaining weight as expected, the doctor may stop Focalin treatment. This drug should not be given to children under 6 years of age; safety and effectiveness in this age group have not been established.

Blood pressure should be monitored in anyone taking Focalin, especially those with high blood pressure or abnormal heart rate or rhythm. Caution is also advised in those with heart or thyroid problems.

Be sure to tell the doctor if your child has blurred vision while taking Focalin; some people have reported visual disturbances while taking stimulants similar to Focalin.

The use of Focalin by anyone with a seizure disorder or psychosis (abnormal thinking and hallucinations) is not recommended. Caution is also advisable for anyone with a history of emotional instability or substance abuse, due to the danger of addiction. Focalin should not be used for the prevention or treatment of normal fatigue, nor should it be used for the treatment of severe depression.

Do not share Focalin with anyone else, and give your child only the number of tablets prescribed by your doctor. Keep track of the number of tablets in a bottle so you will notice if any are missing. Not using Focalin correctly can lead to dependence; call the doctor immediately if you seem to be using more than the prescribed amount.

Possible food and drug interactions when taking Focalin

If Focalin is taken with certain other drugs, the effects of either can be increased, decreased, or altered. It is especially important to check with your doctor before combining Focalin with the following:

Antidepressant drugs, including MAO inhibitors (Nardil, Parnate), tricyclics (Elavil, Tofranil), and serotonin reuptake inhibitors (Prozac, Paxil)
Antiseizure drugs such as phenobarbital, Dilantin, and Mysoline
Blood pressure drugs such as Catapres
Blood thinners such as Coumadin
Herbal remedies such as ephedra and St. John's wort

Special information if you are pregnant or breastfeeding

The effects of Focalin during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, tell your doctor immediately. Focalin should be used during pregnancy only if clearly needed.

It is not known whether Focalin appears in breast milk. Caution is advised if you are nursing a baby.

Recommended dosage

For people who are not currently taking Ritalin, the usual starting dose is 5 milligrams a day. For those who are switching from Ritalin, the starting Focalin dose is half the amount of the Ritalin dose. In either case, the total daily dose of Focalin should be divided into 2 doses taken at least 4 hours apart.

Depending on the response, your doctor may increase the dose by 2.5 to 5 milligrams a day, up to a maximum daily dose of 20 milligrams (10 milligrams twice a day). Increases are usually made at weekly intervals.

Overdosage

If you suspect an overdose, seek medical attention immediately.

  • Symptoms of Focalin overdose may include:
    Abnormal reflexes, agitation, confusion, convulsions (may be followed by coma), delirium, dryness of mucous membranes, enlarged pupils in the eyes, exaggerated feeling of elation, extremely elevated body temperature, flushing, hallucinations, headache, high blood pressure, irregular or rapid heartbeat, muscle twitching, palpitations, sweating, tremors, vomiting

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