Ok, so, I don’t know what would be the best dose for your son, that should be a conversation you have with his specialist, and you should not, EVER decide that on your own, even if your doctor says it’s ok.
Pills cannot be extended release. Capsules are extended release. Here in Norway, I was started on instant release capsules for lower doses, then once we increased my dose past a certain threshold, I’ve switched over to extended release capsules. We’re gradually heading towards the ideal dose for my height and body weight, which is about 60-70mg. Instead of taking one pill every 4 hours, I’m taking one pill per day. The medication keeps working throughout the day. However, for some people, extended release is simply not suitable. It’s more convenient taking just one pill per day that lasts the entire day, but that doesn’t always gel with the way your body works.
By any chance, did your son’s issues coincide almost perfectly with the day he took the capsules for the first time, or only a couple of days after he took the capsules? Because if so, that’s a sign that the delivery mechanism (extended release) is not suitable for him at the dose he’s on.
You should never accept substituted medications if you’ve been on a specific medication for an extended period of time. While generics and capsule versions use the same active ingredient (methyphenidate), the delivery mechanism is different. It can be metabolised faster or slower in your son’s body, and the effect he gets from his medication will change, as you’ve noted. To put it a different way, my SO is on birth control. One month, the pharmacy gave her a ‘bioequivalent’ medication (same active ingredient, different brand), and she broke out, her mood was all over the place, and so on, and so. That is because, while the active ingredient remained the same, the way her body processed it was fundamentally different. It’s not usually a problem for things like antibiotics or sleep aids, anything that you’re only on for a short time, but if it’s a long term medication, changing brands can have negative effects. Not harmful ones, necessarily, just that the medication might not be as effective, or might show more side effects. This possibility is exacerbated if you switch from an instant release pill to an extended release capsule, and is manifesting in your son’s difficulties managing his symptoms.
I’d recommend either having the prescription refilled now (explain the situation to your doctor), return the capsules, and get the medication your son is used to being on, or continue with the capsules until they run out, and then refill the prescription, MAKING SURE you get the old ones. Don’t increase the dose without consulting your specialist, and DO NOT give your son two of the capsules to increase the dose. XR capsules are dispensed containing the appropriate dosage, you’re not meant to take multiple of them.
Hope this helps.
- This reply was modified 2 years, 7 months ago by Spaceboy 99. Reason: Edited for clarity