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 is different. Dr. Larry Silver explains all of the other nuances of this treatment.
For parents whose children with ADHD have trouble swallowing pills, or who want to avoid the stigma of taking medication at school, the Daytrana transdermal patch may be a good option. It saves parents the hassle of crushing a tablet, mixing it with food, and hoping a child will swallow all of their ADHD medication.
What’s more, the Daytrana patch can be conveniently removed on days when a child does not need medication for long periods of time. Since the patch hit the market, in 2006, parents have had questions about how it works, its effectiveness and benefits, and its side effects, as well as how to apply it. Here’s what parents should know about this ADHD medication.
Daytrana Patch Basics: How It Works
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. You can also adjust the dose by wearing the patch for shorter or longer periods of time.
Before attaching the 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.
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.
How to Use the Daytrana Patch
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.
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.
Now that I’ve covered the basics, I’ll address questions from ADDitude readers.
Q: Are the side effects of the patch the same as those of a pill?
A: Yes. A child may lose his appetite and have difficulty going to sleep, and may develop headache, stomachache, 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-skin irritation and/or a rash at the site of the patch.
FDA is warning that permanent loss of skin color may occur with use of the Daytrana patch (methylphenidate transdermal system) for Attention Deficit Hyperactivity Disorder (ADHD). FDA 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 these 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.
Q: Why must the Daytrana patch be applied to the hip?
A: Different areas of the body absorb varying amounts of the medicine. The pharmaceutical company that developed Daytrana determined that the hip was the most effective place to apply it.
Q: What should I do if the patch gets wet while my child is wearing it?
A: When properly applied, the patch will stay on and keep delivering medicine, although 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: I have difficulty removing the protective cover from the patch before applying it. I tried using scissors to remove the cover, and accidentally cut the patch. Can I use a damaged 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 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 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: If the patch is not applied correctly, will all of the medication get into my child’s system?
A: The full surface of the patch must be exposed to the skin for the proper amount of medication to be absorbed.
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 the patch 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 them to develop a generic methylphenidate patch; however, Actavis was acquired by Teva Pharmaceuticals in 2016, and Teva has not announced their intention to market a generic version of Daytrana. Noven sued in 2015 to stop another company, Mylan Inc., from making a generic version of the Daytrana patch.
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 patch and it works well. But he is embarrassed when he has to change or shower in phys-ed class, when he is at swim practice, or other times when the patch can be seen by friends. 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 Daytrana 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 their absorption/peak, effect/fade cycle. Discuss this with your child’s prescribing doctor before trying it.
Q: Why is Daytrana so hard to find?
Noven was forced to recall hundreds of thousands of Daytrana patches in 2015, after issues were found with the protective lining that covers the medicated part of the patch. Since then, there has been a widespread shortage of Daytrana across the country. In a statement on the Daytrana website, the pharmaceutical company says: “Noven is working diligently to improve product availability, but intermittent spot retail shortages of Daytrana may be encountered. The Pharmacy Locator Service (1-800-420-2719) 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.”
This article was originally published in 2008 and updated in 2018.