Methylphenidate LA

RITALIN LA

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What it isMethylphenidate LA (RITALIN LA, 2002) inhibits dopamine and norepinephrine reuptake for ADHD; approved ages: 6-17, adults.

Why this oneIts 50% IR / 50% DR beads mimic BID coverage for 8-12 h (Carlat Table 1), and the capsule is sprinklable.

What limits itAppetite loss, insomnia, blood-pressure elevation and misuse risk matter; do not crush the beads.

FDA-approved for

ADHD (2002)

FDA label

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BOXED WARNING High potential for abuse and misuse; can lead to substance use disorder including addiction, and misuse/abuse of CNS stimulants can result in overdose and death.

FDA dosing	Population	Start	Target	Max
ADHD	Peds 6–12 yr	20 mg QD (AM); 10 mg if a lower initial dose is appropriate	titrate to effect	60 mg/day

Titration Increase gradually in 10 mg increments at weekly intervals

Renal Undefined

Hepatic Undefined

Instructions

Once daily in the morning
Swallow whole, or open capsule and sprinkle beads on a small amount of cool applesauce and consume immediately (do not store)
Do not crush, chew, or divide
Do not substitute mg-per-mg for other methylphenidate products

Contraindications

Concurrent treatment with an MAOI, or use of an MAOI within the preceding 14 days, because of the risk of hypertensive crisis.

Cautions

Avoid in serious cardiac disease (sudden death risk)
Increased blood pressure and heart rate — monitor
Psychiatric reactions: may exacerbate psychosis or induce mania; screen before starting
Priapism
Peripheral vasculopathy, including Raynaud's phenomenon
Long-term growth suppression in pediatric patients — monitor
Acute angle closure glaucoma; increased intraocular pressure
May cause or worsen motor/verbal tics and Tourette's

Adverse reactions

headache
insomnia
upper abdominal pain
decreased appetite
anorexia

Pregnancy Published data have not identified drug-associated risk of major birth defects or miscarriage; CNS stimulants may decrease placental perfusion. Pregnancy 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