ISSUE 1308
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Short-acting methylphenidate (MPH) is effective for treatment of attention-deficit/hyperactivity disorder (ADHD), but its 3-5 hour duration of action usually requires mid-day dosing in school, which children may find disruptive or stigmatizing. Long-acting MPH preparations with once-daily dosing have therefore become the mainstay of clinical practice.1 Recently the FDA approved a labeling change that apparently permits Novartis to say that one of these long-acting formulations, dexmethylphenidate extended-release capsules (d-MPH ER; Focalin XR), “starts working by 30 minutes”. Dexmethylphenidate is the active enantiomer of racemic MPH.2
LONG-ACTING METHYLPHENIDATE FORMULATIONS — Single-Pulse (Ritalin-SR, Metadate ER, Methylin ER) – Single-pulse, sustained-release MPH formulations use a wax matrix to prolong release. They have a duration of action of up to
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