Methylphenidate CD

METADATE CD

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What it isMethylphenidate CD (METADATE CD, 2001) inhibits dopamine and norepinephrine reuptake for ADHD; approved ages: 6-17, adults.

Why this oneIts 30% IR / 70% DR beads mimic BID coverage for 8-12 h (Carlat Table 1), with a smaller early pulse than Ritalin LA; capsule contents are sprinklable.

What limits itAppetite loss and insomnia are common; monitor growth, pulse and blood pressure, and protect against misuse.

FDA-approved for

ADHD (2001)

FDA label

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BOXED WARNING Abuse, misuse, and addiction: high potential for abuse/misuse that can lead to substance use disorder; misuse can cause overdose and death — assess risk and monitor.

FDA dosing	Population	Start	Target	Max
ADHD	Peds 6–15 y	20 mg QD	individualized	60 mg/day

Titration May increase after weekly intervals

Renal Undefined (not studied; minimal effect expected)

Hepatic Undefined (not studied; minimal effect expected)

Instructions

Take orally once daily in the morning before breakfast
Swallow whole with liquid, or open capsule and sprinkle onto small amount of applesauce and take immediately
Do not crush or chew capsule or contents
Allow at least 14 days after stopping an MAOI before starting

Contraindications

Concomitant treatment with monoamine oxidase inhibitors (MAOIs), or within 14 days following discontinuation of an MAOI, because of the risk of hypertensive crisis
Hereditary problems of fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltase insufficiency (contains sucrose)
Pheochromocytoma or a history of pheochromocytoma

Cautions

Risks to patients with serious cardiac disease — avoid in structural cardiac abnormalities
Increased blood pressure and heart rate — monitor
Psychiatric adverse reactions (new psychotic/manic symptoms)
Priapism
Peripheral vasculopathy, including Raynaud's phenomenon
Long-term growth suppression in pediatric patients — monitor height/weight
Acute angle closure glaucoma; increased intraocular pressure
Motor and verbal tics, worsening of Tourette's syndrome

Adverse reactions

Anorexia
Insomnia
Headache
Abdominal pain

Pregnancy Inconsistent findings on birth defects/miscarriage; CNS stimulants may cause vasoconstriction/decreased placental perfusion; pregnancy registry available

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

⚠ BOXED WARNING