A Parent’s Guide to the Daytrana Patch
The Daytrana patch contains methylphenidate, the same stimulant medication found in Ritalin, Concerta, Focalin, and other commonly prescribed ADHD medications. But its delivery system — a transdermal patch — is different. Dr. Larry Silver explains all of the other nuances of this treatment.
For children with attention deficit hyperactivity disorder (ADHD or ADD) who have trouble swallowing pills, or who want to avoid the stigma of taking medication at school, Daytrana may be a good medication option. A transdermal patch applied to the skin, it saves parents the hassle of crushing a tablet, mixing it with food, and hoping a child will swallow all of their ADHD medication. It can be conveniently removed on days when a child does not need medication for long periods of time.
Since its launch in 2006, Daytrana has faced several FDA recalls for adhesive problems, among others. In a statement on the Daytrana website, the pharmaceutical company that manufacturers the drug says: “Noven is working diligently to improve product availability, but intermittent spot retail shortages of Daytrana may be encountered.” Check with your local providers for Daytrana availability and updates on Daytrana recalls. For more information, see “Q: How can I find Daytrana?” below.
Generally speaking, parents have many questions about how Daytrana works, its effectiveness and benefits, and its side effects, as well as how to apply it. Here’s what they should know about this ADHD medication, and answers to common inquiries.
Daytrana Patch Basics: How This ADHD Medication Works
The Daytrana patch contains methylphenidate, the same stimulant medication found in Ritalin, Concerta, Focalin, and other commonly prescribed ADHD medications. But its delivery system — a transdermal patch — is different.
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With pills, the medication is ingested, released in the digestive system, and absorbed into the bloodstream. With the patch, the medication passes directly through the skin, and is absorbed into the bloodstream without going through the digestive system. Each area of the patch contains the same amount of medication. The patch is available in several different doses; patients can also adjust the dose by wearing the patch for shorter or longer periods of time.
Daytrana Patch Dosages
The Daytrana patch comes in 10, 15, 20, and 30 mg. dosages. (Each number represents the number of milligrams released over nine hours.) The 10 mg. patch releases 1.1 mg. of methylphenidate per hour and contains 27.5 mg. per patch; the 15 mg. patch delivers 1.6 mg. per hour and contains 41.3 mg.; the 20 mg. patch delivers 2.2 mg. per hour and contains 55 mg.; and the 30 mg. patch delivers 3.3 mg. per hour and contains 82.5 mg. of methylphenidate.
The manufacturer recommends that a child start with a 10 mg. patch. If this is not effective, the dose should be increased weekly until a doctor determines that the medication is reducing symptoms. The patch takes up to two hours to start working and can be worn for up to nine hours. The effects will continue for one to three hours after removing it. Although there haven’t been any large-scale studies conducted on the benefits and risks of treating adult ADHD with Daytrana, the patch should also work for teens and adults with the condition.
Daytrana Patch Usage Guidelines
The pharmaceutical manufacturer recommends adhering the Daytrana patch to the patient’s hip for efficient medication absorption; a new patch should be applied each day. The full surface of the patch must be exposed to the skin for the proper amount of medication to be absorbed.
Before attaching the Daytrana patch, be sure the area of the hip that you apply it to is clean and dry. Avoid putting it at the waistline, since the patch may be dislodged by clothing rubbing against it. When putting on the patch, firmly press it with your hand for 30 seconds, being sure the edges fully adhere. Tell your child not to play with the patch during the day.
Some patients may experience skin irritation at the patch site. Mild redness is considered normal and can be minimized by ensuring that the patch site is free of cuts or irritation and placing the patch in a different spot each day (that is, alternating hips). If contact dermatitis (swelling, itching, severe redness, small bumps) develops and does not improve within 48 hours, or spreads beyond the patch site, stop using the patch and consult a dermatologist.
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Disposing of the patch correctly is as important as applying it correctly. To prevent young children from accidentally coming into contact with the medicine, fold it in half, so that it sticks to itself, and throw it away in a safe place.
Daytrana Patch Side Effects
A child using the Daytrana patch will experience many of the same ADHD medication side effects that they would experience from taking oral medications. For instance, children may lose their appetite and have difficulty going to sleep; they may also develop headaches, stomachaches, and tics. As with methylphenidate pills, a child may experience irritability, anger, and flatness of personality if the dose is too high. There are also side effects unique to the patch — namely, skin irritation and/or a rash at the site of the patch.
The FDA warns that permanent loss of skin color may occur with use of the Daytrana patch; it added a warning in 2015 to the drug label to describe this skin condition, which is known as chemical leukoderma. See the FDA Drug Safety Communication for more information.
Q: How can I avoid Daytrana’s side effects?
A: Alternate the hip on which the patch is worn every day to reduce potential irritation, placing it in a different spot on the child’s hip each time. Don’t apply the patch to irritated or damaged skin; doing so may increase the amount of medication that goes into your child’s bloodstream.
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Q: How Can I Find Daytrana?
A: Noven has been forced to recall hundreds of thousands of Daytrana patches due to issues found with the protective lining that covers the medicated part of the patch and patient-reported problems opening the patch for application. Following these incidents, there have been widespread shortages of Daytrana across the country.
On the Daytrana website, the pharmaceutical company advises parents looking for access to this medication to use the “Pharmacy Locator Service (1-800-420-2719),” which “can potentially identify a pharmacy that might have Daytrana in stock. If you are unable to find a pharmacy that has Daytrana in stock, please contact your healthcare provider.”
Q: I have difficulty removing the protective cover from the Daytrana before applying it. I tried using scissors to remove the cover, and accidentally cut the patch. Can I use a damaged Daytrana patch?
A: Many families have told me that they keep the patches in the refrigerator. Apparently, it is easier to remove the protective covering when the patch is cold. If you accidentally cut the patch, the manufacturer recommends that you throw it away and use a new one.
Q: What happens if I touch the sticky part of the ADHD patch?
A: No significant amount of medicine is lost. If you do touch the sticky part with your fingers, it’s a good idea to wash your hands immediately after application, to avoid absorbing any of the medicine.
Q: What should I do if the Daytrana patch gets wet?
A: When properly applied, the patch will stay on and keep delivering medicine, though exposure to water from bathing, swimming, or showering may affect its adhesion. If the patch falls off, discard it and apply a new patch to a different area of the same hip, making sure that the total daily length of use doesn’t exceed nine hours. Do not use tape, bandages, or other household adhesives to reapply the patch.
Q: My child behaves great once her ADHD medication starts to work in the morning. But until then, she runs around screaming. What can I do?
A: Go into her bedroom about two hours before you want to wake her up, and gently place the patch on her hip without disturbing her. When she awakes, the medication should be working, and she will be less impulsive and inattentive. If you decide to do this, discuss with your doctor how to get all-day coverage and when to remove the patch.
Q: Is Daytrana more expensive than oral medication?
A: Medications often remain expensive as long as the manufacturer’s patent remains in effect. When the patent expires, however, and a generic form of the medication is produced, the price goes down. At this point, Daytrana’s patent remains in effect, and there are no immediate plans to release a generic form of Daytrana.
In 2014, Noven Pharmaceuticals (the manufacturer of Daytrana) reached a deal with Actavis PLC to allow it to develop a generic methylphenidate patch. However, Actavis was subsequently acquired by Teva Pharmaceuticals in 2016, and Teva has not announced its intention to market a generic version of Daytrana. Noven sued to stop another company, Mylan Inc., from making a generic version of the Daytrana patch in 2015.
Since no generics yet exist, Daytrana is more expensive than generic forms of oral medication. However, it may be no more expensive than oral ADHD medications that are still covered by a patent.
Q: My teenage son wears the Daytrana patch and it works well. But he is embarrassed when his friends see it when he changes or showers in P.E.. What can I do to relieve his embarrassment?
A: I can understand his not wanting others to see the patch. Perhaps he could seek more privacy when changing or in the shower. Or you could help him devise an explanation that will satisfy curious classmates. He might say, “I have a medical problem, and this is how the medicine is released into my body.”
Q: Can my child use the ADHD patch for most of the day, but add a short-acting tablet to boost the effect when taking an exam, say, or when he is in a difficult class?
A: This approach would require in-depth knowledge of both medications, as well as of the individual patient’s absorption/peak, effect/fade cycle. Discuss this with your child’s prescribing doctor before trying it.
Q: Can the Daytrana patch be abused?
The Daytrana patch is less likely to be abused than some oral ADHD medications because it releases the methylphenidate very slowly. People who wish to abuse stimulants prefer pills, which can be ingested with a rapid onset of action.
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This article was originally published in 2008 and updated in 2020.