Methylphenidate patch

DAYTRANA

Open Methylphenidate patch in the interactive console ↗

What it isTransdermal dopamine and norepinephrine reuptake inhibitor for ADHD (DAYTRANA, 2006; approved ages 6-17).

Why this oneRemoving the patch lets exposure end earlier — wear 9 h; effects persist ~5 h after removal — while total action lasts 10-12 h (Carlat Table 1).

What limits itHeat can increase absorption; contact dermatitis and persistent skin depigmentation are patch-specific reasons to stop it.

FDA-approved for

ADHD (2006)

FDA label

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BOXED WARNING High potential for abuse, misuse, and addiction; misuse/abuse of CNS stimulants can cause overdose and death.

FDA dosing	Population	Start	Target	Max
ADHD	Pediatric 6-17 yr (new to or converting from another methylphenidate)	10 mg/9 hr patch (12.5 cm2)	titrate weekly (15, 20, 30 mg/9 hr)	30 mg/9 hr (37.5 cm2)

Titration Increase patch size weekly if response not maximized

Renal Undefined

Hepatic Undefined

Titrate wear time and dose to individual response

Instructions

Apply to hip area (alternating sites) 2 hours before effect needed; remove 9 hours after application
May remove earlier than 9 hours if shorter duration desired or late-day side effects appear
Do not cut patches; apply only intact patches; press firmly ~30 seconds
Avoid external heat sources to the application site (increases absorption, risk of overdose)
Total wear time should remain 9 hours/day regardless of number of patches used

Contraindications

During treatment with an MAOI, or within 14 days of discontinuing an MAOI (hypertensive crises)

Cautions

Serious cardiac disease — avoid (sudden death)
Increased blood pressure and heart rate — monitor
Psychiatric adverse reactions; screen for bipolar risk
Seizures (may lower convulsive threshold)
Priapism
Peripheral vasculopathy, including Raynaud's phenomenon
Long-term growth suppression in pediatric patients
Chemical leukoderma (persistent skin depigmentation)
Contact sensitization
Acute angle closure glaucoma; increased IOP
Motor/verbal tics and worsening of Tourette's

Adverse reactions

6-12 yr: appetite decreased, insomnia, nausea, vomiting, weight decreased, tic, affect lability, anorexia
13-17 yr: appetite decreased, nausea, insomnia, weight decreased, dizziness, abdominal pain, anorexia; application-site erythema common

Pregnancy Data insufficient to identify risk; CNS stimulants may reduce placental perfusion; pregnancy exposure registry available

Lactation Methylphenidate present in human milk (infant dose 0.16-0.7% of maternal); monitor infant for agitation, insomnia, anorexia, reduced weight gain

⚠ BOXED WARNING