Medication and Treatment Reviews

Quillichew ER

Generic Name: Methylphenidate hydrochloride

Uses

Quillichew ER is the only extended-release, chewable central nervous system stimulant primarily used to treat attention deficit hyperactivity disorder (ADHD) in children ages 6-12, adolescents, and adults. It is especially useful for the one-third of children who can’t swallow pills. Quillichew ER 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, Quillichew ER 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 Quillichew ER, and behavior therapies.

How to Use Quillichew ER

Before starting or refilling a Quillichew ER 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 Quillichew ER prescription instructions exactly. Tablets are available in 20mg, 30mg, and 40mg dosages. 20mg and 30mg tablets are scored and can be cut in half if necessary to achieve the right dose.

It is taken once daily in the morning with or without food. Chew each tablet well, and swallow with a full glass of water or another liquid. The time-release formulation is designed to maintain a steady level of medication in your body throughout the day.

The recommended starting dose of Quillichew ER for patients 6 years and above is 20 mg once daily in the morning. The dose may be titrated weekly in increments of 10 mg to 20 mg. Daily dosages above 60 mg have not been studied and are not recommended.

The optimal dosage varies patient by patient. It is not determined by age, weight, or height, but rather by how a person metabolizes the medication, and by the condition treated. Your doctor may adjust your daily dosage until you or your child experiences the best response — that is, the lowest dosage at which you experience the greatest improvement in symptoms without side effects.

During treatment, your doctor may periodically ask you to stop taking your Quillichew ER 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 Quillichew ER 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 Quillichew ER are as follows: decreased appetite, trouble sleeping, nausea, vomiting, indigestion, stomach pain, weight loss, anxiety, dizziness, irritability, mood swings, fast heartbeat, and increased blood pressure.

Other serious side effects include slowing of growth in children and priapism, which is an unwanted, persistent erection.

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 Quillichew ER. 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 Quillichew ER.

Also disclose to your physician all mental health issues including any family history of suicide, bipolar illness, tics, or depression. Quillichew ER may create new or exacerbate existing behavior problems, or bipolar illness. The manufacturer recommends evaluating patients for bipolar disorder prior to stimulant administration, which 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 Quillichew ER, 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 Quillichew ER.

Stimulants like Quillichew ER 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 the 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

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

You should not take Quillichew ER if you have any of the following conditions: allergy or hypersensitivity to methylphenidate or any of the ingredients in Quillichew ER medications, phenylketonuria, or if you are taking monoamine oxidase inhibitors (MAOIs).

You should use caution taking Quillichew ER if you have a history of heart or mental problems or circulation problems.

If you’re thinking of becoming pregnant, discuss the use of Quillichew ER with your doctor. Animal studies indicate the potential for fetal harm. Quillichew ER is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

The safety of Quillichew ER for children under 6 has not been established.

Interactions

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

Quillichew ER contains phenylalanines, which can be dangerous for patients with phenylketonuria.

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 Quillichew ER before having any surgery or laboratory tests; it can cause false positives on certain tests. The above is not a complete list of all possible drug interactions.

Sources:

https://www.quillivantxr-quillichewer.com/
https://www.quillivantxr-quillichewer.com/sites/default/themes/quillivatxr/pdf/DoctorDiscussionGuide.pdf
http://labeling.pfizer.com/ShowLabeling.aspx?id=2577

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