Medication and Treatment Reviews

Focalin

Generic: Dexmethylphenidate HCL

Uses

Focalin is a central nervous system stimulant primarily used to treat attention deficit hyperactivity disorder (ADHD) in children ages 6-12, adolescents, and adults. Focalin may improve focus, and decrease impulsivity and hyperactive behavior, hallmark symptoms in some patients with the condition. It contains the same active ingredient as medications like Ritalin and Daytrana. According to the FDA, Focalin 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, and behavior therapies.

Focalin can also be used to treat narcolepsy.

How to Use Focalin

Before starting or refilling a Focalin 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 prescription instructions exactly. Focalin is taken orally, with or without food, twice daily. Doses should be taken at least 4 hours apart.

Tablets are available in 2.5mg, 5mg, and 10mg dosages.

During treatment, your doctor may periodically ask you to stop taking Focalin 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 after long-term usage. 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 are as follows: stomach ache, nausea, decreased appetite, and fever.

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

Taking Focalin 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. Patients with structural cardiac abnormalities and other serious heart problems have experienced sudden death, stroke, heart attack, and increased blood pressure while taking Focalin. 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.

Also disclose to your physician all mental health issues including any family history of suicide, bipolar illness, tics, or depression. Focalin 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, 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.

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

You should not take Focalin 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
  • 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 with your doctor. Animal studies indicate potential harm to a fetus. It is not known if Focalin is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

Interactions

Before taking Focalin, discuss all other active prescription medications with your doctor. Focalin 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, 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 before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

Sources:

https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/021278s018,021802s028lbl.pdf
https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/focalin.pdf
https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/focalin_PPI.pdf

14 reviews

  1. I have been a Focalin fan for several year, but suddenly have an issue and wonder if anyone else has experienced it. My 13 year old son has been on Focalin 30 mgs, for probably about 3 years and has done awesome. This medication seemed to have the least impact on his appetite in comparison to all of the others that we tried. He doesn’t take meds over the weekend or on school breaks. He gained 30 pounds and 5 inches over this past year and looks great. Since school started though, he quickly dropped 10 pounds as he runs out the door at 6:30 refusing to eat or drink breakfast, and has no appetite until nearly 7pm. He’s very active and plays sports after school. He’s been in a huge funk lately and I was really scared. He’s moody, irritable, overly sensitive to peer issues and lethargic. I wondered if this was teen hormones. He finally realized yesterday, that he is hungry and tired. I’m puzzled as he’s never had this reaction to the meds before. His doctor doesn’t think that his body would react so differently to the same medication, but I really wonder. I don’t think it’s depression as he perks back up when he’s off his meds and can eat.

  2. My 6 year old started today on 5 mg of Focalin, but I am noticing some facial tics. The doctor recommended to discontinue and try a non stimulant as the tics would likely happen on any of the stimulants. Intuniv is up next.

  3. My older son developed random tics on Focalin. Sometimes he’ll have it for a few weeks and it’ll go away, the same tic you mentioned. Chewing gum helped him stop the tic. I recently switched him to Vyvanse because the Focalin wasn’t lasting the whole school day and I was getting concerned that he was taking too many pills each day to stay focused (mid-day doses at school). So far the Vyvanse has been lasting for the whole day at school and he doesn’t seem as zoned out as he did on Focalin.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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. He is more organized and less forgetful, yes, but not as creative.

  11. 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.

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