Medication and Treatment Reviews

Focalin XR

Generic Name: Dexmethylphenidate HCL

Uses

Focalin XR is a once-daily central nervous system stimulant primarily used to treat attention deficit hyperactivity disorder (ADHD) in children ages 6-12, adolescents, and adults. Focalin XR may improve focus, and decrease impulsivity and hyperactive behavior, hallmark symptoms for some patients with the condition. It contains the same active ingredient as medications like Ritalin and Daytrana. According to the FDA, Focalin XR is a federally controlled substance (CII) because it can be abused or lead to dependence. It has not been studied in children under the age of 6.

The American Academy of Pediatrics recommends treatment with behavioral therapy before medication for children under the age of 6. For children ages 6 to 11, the AAP says “The primary care clinician should prescribe US Food and Drug Administration–approved medications for ADHD and/or evidence-based parent- and/or teacher-administered behavior therapy as treatment for ADHD, preferably both.” Likewise, the National Institute of Mental Health finds the most successful treatment plans use a combination of ADHD medication, like Focalin XR, and behavior therapies.

Focalin XR can also be used to treat narcolepsy.

How to Use Focalin XR

Before starting or refilling a Focalin XR prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage

As with all medications, follow your Focalin XR prescription instructions exactly. Focalin XR is taken orally, with or without food, once daily. The medication is typically taken first thing in the morning; it should be taken at the same time each day for the best results.

Capsules should be swallowed whole with water or other liquids. If your child is unable to swallow the capsule, it can be opened and sprinkled over a spoonful of applesauce. Taken this way, the mixture should be swallowed whole without chewing, followed by a drink of water or other liquid. Capsules should never by crushed or chewed.

Tablets are available in 5mg, 10mg, 20mg, 25mg, 30mg, 35mg and 40mg dosages. The time-release formulation is designed to maintain a steady level of medication in your body throughout the day.

During treatment, your doctor may periodically ask you to stop taking Focalin XR so that he or she can monitor ADHD symptoms; check vital statistics including blood, heart, and blood pressure; or evaluate height and weight. If any problems are found, your doctor may recommend discontinuing treatment.

Some patients report developing a tolerance to Focalin XR after long-term use. If you notice that your dosage is no longer controlling your symptoms, talk to your doctor to plan a course of action.

Side Effects

The most common side effects of Focalin XR are as follows: stomach ache, headache, nausea, decreased appetite, sleep disturbances, anxiety, dry mouth, and dizziness.

Other serious side effects include: serious allergic reaction, slowing of growth in children, seizures, eyesight changes or blurred vision, and priapism.

Taking Focalin XR may impair your or your teenager’s ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor. Most people taking this medication do not experience any of these side effects.

Report to your doctor any heart-related problems or a family history of heart and blood pressure problems before beginning any new prescription. Patients with structural cardiac abnormalities and other serious heart problems have experienced sudden death, stroke, heart attack, and increased blood pressure while taking Focalin XR. Stimulants can increase blood pressure and heart rate. Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you or your child experiences warning signs such as chest pain, shortness of breath, or fainting while taking Focalin XR.

Also disclose to your physician all mental health issues including any family history of suicide, bipolar illness, tics, or depression. Focalin XR may create new or exacerbate existing behavior problems, bipolar illness, or Tourette’s syndrome. It can cause psychotic or manic symptoms in children and teenagers. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including hallucinations or sudden suspicions.

Discuss circulation problems with your doctor before taking Focalin XR, which has been known to cause numbness, coolness, or pain in fingers or toes, including Raynaud’s phenomenon. Report to your doctor any new blood-flow problems, pain, skin color changes, or sensitivities to temperature while taking Focalin XR.

Stimulants like Focalin XR have a high potential for abuse and addiction, especially among people who do not have ADHD. It is a “Schedule II” stimulant, a designation that the Drug Enforcement Agency uses for drugs with a high potential for abuse. Other Schedule II drugs include Dexedrine, Ritalin, and cocaine. People with a history of drug abuse should use caution when trying this medication. Taking the medication exactly as prescribed can reduce potential for abuse.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions and Safety

Store Focalin XR in a secure place out of reach of children, and at room temperature. Do not share your Focalin XR prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal, and can cause harm.

You should not take Focalin XR if you or your child have:

  • glaucoma
  • tics or Tourette’s syndrome
  • a history of drug abuse
  • severe feelings of anxiety, tension, or agitation
  • an allergy to stimulant medications or any other ingredients in Focalin XR
  • taken or plan to take a monoamine oxidase inhibitor (MAOI) within 14 days

If you are thinking of becoming pregnant, discuss the use of Focalin XR with your doctor. Animal studies indicate potential harm to a fetus. It is not known if Focalin XR is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

Interactions

Before taking Focalin XR, discuss all other active prescription medications with your doctor. Focalin XR can have a dangerous, possibly fatal, interaction with antidepressants including MAOIs.

Tell your doctor if you are taking seizure medications, blood thinners, blood pressure medication, antacids, or any medication containing a decongestant.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking Focalin XR before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

Sources:

http://www.fda.gov/downloads/drugs/drugsafety/ucm088600.pdf
https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/focalinXR_PPI.pdf
https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/focalinXR.pdf

17 reviews

  1. The first ADD medication we tried for my daughter was Vyvanse. Her concentration improved, but her emotions were right on the surface and she would frequently burst into tears over the most insignificant things. We switched her to Focalin XR and had much better (less emotional) results, but by the time we got to homework the medication had worn off and it took 90 minutes to complete 2 workbook pages. Because she’s already so petite her doctor didn’t want to add a booster dose. We have switched to Intuniv over the summer; we will see how she does once school starts.

  2. My 13 year old switched to Focalin last year from Concerta, which he was on since he was 6. His doctor switched him because, even though the Concerta worked fine, he had horrible insomnia and the doctor said the side effects were better with Focalin. So far it’s been great. One pill at 6:30 am lasts until about 4 pm. He takes 15mg of Focalin XR.

  3. My son started Focalin when he was diagnosed at 6 years old. He is on 5mg of Focalin XR daily (taken in the morning). He cried easily when we first put him on it, so we decided to try Ritalin and then Adderall. Both had terrible side effects. He would go into fits of rage that would last for hours. We then put him back on the Focalin but also gave him 1.5 mg. of Tenex with it. The combination has been great. He does sometimes take a quick little catnap in the afternoon at school. We tried to give him short acting pill of Focalin when he got home from school to give him little boost while doing his homework. After 3 days, he went back to throwing huge fits (one was at school). We immediately took him off of it and decided to just deal with the homework after school.

  4. Focalin XR works very well for me. I was recently diagnosed with ADHD as a middle-aged woman and use 5 mg of Focalin XR daily, often supplemented with 2.5 mg of regular Focalin in the afternoon if I know I’m going to have a long evening or it’s been an unusually stressful day. If I have to get up very early or know I will be up late, I take an additional 5 mg of XR in early afternoon.

    From the first dose, there was a clarity and quietness of mind that I had never experienced before. I tried Vyvanse and found that it made me feel jittery and gave me a “roller coaster effect” of feeling odd then better.

    Higher doses of Focalin XR make me feel a little hyper and talkative. For well over 6 months now, I’ve done just fine at the 5 mg level.

  5. Both my kids have been prescribed Focalin XR. My son is 17 and my daughter is 12. My daughter’s creativity doesn’t seem to be impacted; however, my son, who was a very creative, outside the box thinker will no longer take his meds because he isn’t as creative when on them. More organized and less forgetful, yes, but not as creative.

  6. Our son was on Focalin during 1st grade. We noticed major tics in his eyes, and later on, he chewed his nails and twirled his hair. After switching to Concerta, all of that stopped.

  7. We have had tremendous success with Focalin. The only troubling part is that typically the more effective the medicine, the more likely you will also experience side effects. So we have made accommodations for our son since Focalin is the most effective as noticed by family, us as parents, school, and even my son. At 85 pounds, my son takes 25mg XR with 7.5 mg (regular) at lunch for a boost that lasts through homework time.

  8. My son is 11 and is on a 25 mg dosage of Focalin XR. He has done very well on it. The teachers and I have noticed that the meds have been starting to wear off late in the afternoon, which is causing some problems with missing assignments that impact his grades. His doctor is prescribing a 5 mg dose of regular Focalin to be taken after lunch that will get him through the rest of the day.

  9. My 8-year-old daughter has been on Focalin XR 10 mg for about a year now. By the end of the last school year she was on 15 mg. and doing really well. But I was concerned about how much weight she had lost. She had dropped almost 10 lbs., and while all the blood work came back okay and she was still in ‘healthy guidelines,’ I was concerned. So for the summer our neurologist brought her back down to 10 mg. And that was fine for the summer, but now that school is back in I’m finding that the 10 mg. isn’t quite “holding” (for lack of a better word) her through the day and I’m going to request that she be brought back up to 15 mg. My girl is also very active in extra curricular activities in the evenings and we are considering opening up the discussion to maybe giving her Intuniv in the evenings.

  10. My 8-year-old son has been on Focalin XR for almost a year at 10mg (morning dose only), paired with 1mg of Intuniv. He seems to be doing okay at school, but the effects seem to wear off by the afternoon.

  11. My son, at 8, was on Focalin XR. He started at 10mg (which the pediatrician said was a low dose) and went up to 30mg. It was wonderful. Unfortunately, we had to switch to another med after about a year, because the Focalin started to wear off way too soon and the rebound effect became really bad.

  12. My daughter, 9, also takes Focalin XR. We just increased her dosage to 15 mg a couple of weeks ago due to her inattention and hyperactivity increasing. She had been doing very well on the 10 mg dosage for quite some time. She also has sleep issues. Our pediatrician prescribed 0.1 mg of Clonidine to help her sleep. We also give her 6 mgs of melatonin with the Clonidine (okayed by the pediatrician) before we want her to go to sleep.

  13. My son, 12, currently is taking 15 mg of Focalin XR. Since he only takes 1 dose fairly early in the day (around 7:00 a.m.), it wears off by the time he goes to bed. However, sometimes he still has trouble going to sleep and on those nights, he takes valerian root.

  14. This worked well short-term but caused our daughter many side effects (loss of appetite, significant weight loss, anxiety, sleeplessness, irritability). After taking since Sep 2013, we took her off the medication in January of this year. This medication did nothing to help with impulse control. We are now doing supplements, mindfulness, and restricting electronic devices substantially. The issues we were facing previously are still there (distractedness, hyperactivity, impulse control issues) but my child is not irritable all the timei, she is willing to try new foods, is eating and sleeping better, and is willing to try new things. It continues to be a long road, but for us medication was not the answer.

  15. My 13 yrs old was switched to this in January after 7 years of different doses of Vyvanse and the issues we were seeing, crying, zombie,tics, picking off skin, roller coasters..all changed, it’s all gone and he has even gained too much weight at this point. He takes a 20 mg dose about 7:45 a.m, but it is gone before the end of the school day at 2:55. We have added and afternoon 5 mg of Focalin, to try and get him through homework. He still cannot sit long enough to get work done or stay on track, but the extra efforts I have to do to help him, far outway the side effects of the other medicine and he can tell a huge difference also.

  16. I’m 19 years old and was switched to Vyvanse from this medication after realizing I had a rare allergic reaction to it. I had trouble breathing and my face broke out in a horrific rash. My doctor told me it wasn’t the Focalin XR but I later learned that it was. There isn’t much about this adverse reaction online– so I’m confirming it exists! This medication works very well for a lot of people, but if you or your child decides to start it please be mindful of rare reactions like mine!!

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