Drug class
A "central nervous system (CNS) stimulant." "Methylphenidate blocks the reuptake of norepinephrine and dopamine into the presynaptic neuron and increase[s] the release of these monoamines into the extraneuronal space," though the exact mechanism in ADHD is unknown.
Uses
Dexmethylphenidate hydrochloride tablets are indicated for the treatment of Attention Deficit Hyperactivity Disorder (ADHD).
Warnings
BOXED WARNING: Abuse, Misuse, and Addiction - "Dexmethylphenidate hydrochloride tablets have a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction." "Misuse and abuse of CNS stimulants...can result in overdose and death," particularly "with higher doses or unapproved methods of administration, such as snorting or injection." Other key warnings include sudden death reported in patients with structural cardiac abnormalities, increases in blood pressure and heart rate, psychiatric adverse reactions including new psychosis or mania, priapism, growth suppression in pediatric patients, and exacerbation of glaucoma.
Side effects
Most common reactions in pediatric trials (≥5%, twice placebo) include abdominal pain ("15% vs 6% placebo"), nausea ("9% vs 1%"), anorexia ("6% vs 1%"), and fever ("5% vs 1%"). Serious postmarketing reactions include rhabdomyolysis, hypersensitivity reactions such as angioedema and anaphylaxis, cardiac arrhythmias and sudden cardiac death, psychosis, hallucinations, mania, depression, and peripheral vasculopathy including Raynaud's phenomenon.
