title: Methylphenidate and dexmethylphenidate formulations for children with attention-deficit/hyperactivity disorder.
abstract: OBJECTIVE
  Current literature on the safety and efficacy of various intermediate- and long-acting preparations of methylphenidate and dexmethylphenidate for pediatric attention-deficit/hyperactivity disorder (ADHD) is reviewed.
  
  
  CONCLUSIONS
  The efficacy of methylphenidate in controlling ADHD symptoms is firmly established. Given the drug's relatively short half-life in pediatric patients (about 2.5 hours), a number of intermediate- and long-acting products have been developed; these extended-release methylphenidate products provide the same efficacy as immediate-release (IR) formulations, with the convenience of less frequent dosing. Intermediate-acting methylphenidate preparations have effects lasting as long as 8 hours, but peak concentrations are not attained for up to 5 hours, and many patients may require twice-daily dosing. Long-acting methylphenidate products developed to address these challenges include a controlled-release tablet and bimodal-delivery capsules containing mixtures of IR and extended-release beads (durations of effect, 8-12 hours). Options for patients with difficulty swallowing tablets or capsules include a once-daily transdermal delivery system and a once-daily liquid formulation. Dexmethylphenidate (the more pharmacologically active d-isomer of racemic methylphenidate) can provide efficacy comparable to that of IR methylphenidate at half the dose; an extended-release form of dexmethylphenidate can provide less fluctuation in peak and trough concentrations than the IR form. Methylphenidate and dexmethylphenidate products in capsule form can be opened and sprinkled on applesauce.
  
  
  CONCLUSIONS
  The various formulations of IR and intermediate- and extended-release methylphenidate and dexmethylphenidate can be useful options in satisfying patients' individual needs in the management of ADHD. All are equally efficacious in controlling ADHD symptoms.
authors: David Sugrue, B.S., is a 2015 Pharm.D. candidate; Robin Bogner, M.S., Ph.D., is Associate Professor of Pharmaceutics; and Megan J. Ehret, Pharm.D., M.S., BCPP, is Associate Professor of Pharmacy Practice, School of Pharmacy, University of Connecticut, Storrs.
authors: David
authors: D
authors: Sugrue
authors: David Sugrue, B.S., is a 2015 Pharm.D. candidate; Robin Bogner, M.S., Ph.D., is Associate Professor of Pharmaceutics; and Megan J. Ehret, Pharm.D., M.S., BCPP, is Associate Professor of Pharmacy Practice, School of Pharmacy, University of Connecticut, Storrs.
authors: Robin
authors: R
authors: Bogner
authors: David Sugrue, B.S., is a 2015 Pharm.D. candidate; Robin Bogner, M.S., Ph.D., is Associate Professor of Pharmaceutics; and Megan J. Ehret, Pharm.D., M.S., BCPP, is Associate Professor of Pharmacy Practice, School of Pharmacy, University of Connecticut, Storrs. megan.ehret@uconn.edu.
authors: Megan J
authors: MJ
authors: Ehret
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D002214:Capsules; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D003692:Delayed-Action Preparations; D064699:Dexmethylphenidate Hydrochloride / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008774:Methylphenidate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013607:Tablets
chemical_list: D002214:Capsules; D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D013607:Tablets; D064699:Dexmethylphenidate Hydrochloride; D008774:Methylphenidate