Description

Simple

A medication used to treat ADHD with other therapies.

Clinical

A norepinephrine-dopamine reuptake inhibitor used in the treatment of ADHD in conjunction with other therapies.

Overview

Dexmethylphenidate is the dextrorotary form of methylphenidate introduced in 2002[2]. It is a norepinephrine-dopamine reuptake inhibitor (NDRI) and thus a psychostimulant[5]. It is used for treatment of Attention Deficit Hyperactivity Disorder (ADHD)[Label,2]. The d-isomer is thought to have greater effect with fewer side effects than the l-isomer or the racemic mixture[2].

Pharmacology

Indication

Dexmethylphenidate is used as a treatment for ADHD, ideally in conjunction with psychological, educational, behavioral or other forms of treatment[ Read more

Pharmacodynamic

Dexmethylphenidate is the d-enantiomer of methylphenidate[Label]. This enantiomer is more pharmacologically active than the racemic mixture and may block norepinephrine and dopamine reuptake in synapses[Label].

Mechanism of action

Methylphenidate inhibits dopamine and norepinephrine reuptake transporters in synapses, especially in the thalamus and striatum[ Read more

Absorption

Taking dexmethylphenidate with or without food does not affect patients in a clinically relevant way[ Read more

Protein binding

12-15% of dexmethylphenidate is protein bound[Label]. However, other studies have observed 15.2±5.2% protein binding in children and 16.2±1.1% in adults[ Read more

Volume of distribution

2.65L/kg when administered intravenously[4].

Clearance

0.40L/hr/kg following an intravenous dose and a renal clearance of 0.005L/hr/kg[ Read more

Half life

The mean terminal half life is approximately 2.2 hours[Label]. However other studies have shown 3.8-3.9 hours[ Read more

Route of elimination

Dexmethylphenidate is mainly eliminated renally[4]. After... Read more

Toxicity

There is no difference in effect across genders[ Read more

Adverse Effects

Effect Regions Age Groups Incidences Evidence Type
Headache US
  • adult
  • Kind: experimental
    • Percent: 26-39%
  • Kind: placebo
    • Percent: 19%
  • Clinical Trial
    Decreased appetite US
    • adolescent
    • pediatric
  • Kind: experimental
    • Percent: 30%
  • Kind: placebo
    • Percent: 9%
  • Clinical Trial
    Headache US
    • adolescent
    • pediatric
  • Kind: experimental
    • Percent: 25%
  • Kind: placebo
    • Percent: 11%
  • Clinical Trial
    Dry Mouth US
    • adult
  • Kind: experimental
    • Percent: 7-20%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Insomnia US
    • adolescent
    • pediatric
  • Kind: experimental
    • Percent: 5-17%
  • Kind: placebo
    • Percent: 3%
  • Clinical Trial
    Abdominal Pain US
    • pediatric
  • Kind: experimental
    • Percent: 15%
  • Kind: placebo
    • Percent: 6%
  • Clinical Trial
    Feeling jittery US
    • adult
  • Kind: experimental
    • Percent: 12%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Anxiety US
    • adult
  • Kind: experimental
    • Percent: 5-11%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Nausea US
    • pediatric
  • Kind: experimental
    • Percent: 9%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Vomiting US
    • adolescent
    • pediatric
  • Kind: experimental
    • Percent: 2-9%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Dyspepsia US
    • adult
  • Kind: experimental
    • Percent: 5-9%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Dyspepsia US
    • adolescent
    • pediatric
  • Kind: experimental
    • Percent: 8%
  • Kind: placebo
    • Percent: 4%
  • Clinical Trial
    Anorexia US
    • adolescent
    • pediatric
  • Kind: experimental
    • Percent: 5-7%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Pharyngolaryngeal pain US
    • adult
  • Kind: experimental
    • Percent: 4-7%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Anorexia US
    • pediatric
  • Kind: experimental
    • Percent: 6%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Anxiety US
    • adolescent
    • pediatric
  • Kind: experimental
    • Percent: 6%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Dizziness US
    • adult
  • Kind: experimental
    • Percent: 6%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Fever US
    • pediatric
  • Kind: experimental
    • Percent: 5%
  • Kind: placebo
    • Percent: 1%
  • Clinical Trial
    Irritability US
    • adolescent
    • pediatric
  • Kind: experimental
    • Percent: 0-5%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Nasal Congestion US
    • adolescent
    • pediatric
  • Kind: experimental
    • Percent: 0-5%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Depression US
    • adolescent
    • pediatric
  • Kind: experimental
    • Percent: 0-3%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Pruritus US
    • adolescent
    • pediatric
  • Kind: experimental
    • Percent: 0-3%
  • Kind: placebo
    • Percent: 0%
  • Clinical Trial
    Mood Swings US
    • adolescent
    • pediatric
  • Kind: experimental
    • Percent: 0-3%
  • Kind: placebo
    • Percent: 2%
  • Clinical Trial
    Peripheral vasculopathy US
    Post Marketing
    Growth suppression US
    • pediatric
    Post Marketing
    Manic Episode US
    Post Marketing
    Exacerbation of psychosis US
    Post Marketing
    Heart rate increased US
    Post Marketing
    Blood pressure increase US
    Post Marketing
    Sudden Death US
    • pediatric
    Post Marketing
    Death, Sudden US
    • adult
    Post Marketing
    Pulse decreased US
    Varying Reports
    Pulse increased US
    Varying Reports
    Nausea US
    Varying Reports
    Tachycardia US
    Varying Reports
    Angina US
    Varying Reports
    Tachycardia US
    Varying Reports
    Palpitation US
    Varying Reports
    Arrhythmia US
    Varying Reports
    Abdominal Pain US
    Varying Reports
    Loss of Appetite US
    Varying Reports
    Insomnia US
    Varying Reports
    Weight Loss US
    Varying Reports
    Hypersensitivity Reaction US
    Post Marketing
    Rhabdomyolysis US
    Post Marketing
    Anaphylaxis US
    Post Marketing
    Angioedema US
    Post Marketing
    Headache US
    Varying Reports
    Tourette’s syndrome US
    Varying Reports
    Toxic psychosis US
    Varying Reports

    Contraindications

    • Route:
      • Oral
    • Dose Form:
      • Tablet
      • Tablet, extended release
    • Hypersensitivity:
      • true
    • Sex Group: all
    • Regions: US
    • Route:
      • Oral
    • Dose Form:
      • Tablet
      • Tablet, extended release
    • Regions: US
    • With Categories Coadmin:
        • Name: Monoamine Oxidase Inhibitors
        • Drugbank Id: DBCAT001004
        • Mesh Id: D008996
    • Route:
      • Oral
    • Dose Form:
      • Tablet
      • Tablet, extended release
    • Regions: US
    • Patient Conditions:
        • Name: Diagnosed tourette's syndrome
        • Drugbank Id: DBCOND0108452
    • Route:
      • Oral
    • Dose Form:
      • Tablet
      • Tablet, extended release
    • Regions: US
    • Patient Conditions:
        • Name: Family history of Tourette’s syndrome
        • Drugbank Id: DBCOND0108451
    • Route:
      • Oral
    • Dose Form:
      • Tablet
      • Tablet, extended release
    • Regions: US
    • Patient Conditions:
        • Name: Motor tics
        • Drugbank Id: DBCOND0107725
    • Route:
      • Oral
    • Dose Form:
      • Tablet
      • Tablet, extended release
    • Regions: US
    • Patient Conditions:
        • Name: Glaucoma
        • Drugbank Id: DBCOND0010013
    • Route:
      • Oral
    • Dose Form:
      • Tablet
      • Tablet, extended release
    • Regions: US
    • Patient Conditions:
        • Name: Agitation
        • Drugbank Id: DBCOND0017779
    • Route:
      • Oral
    • Dose Form:
      • Tablet
      • Tablet, extended release
    • Regions: US
    • Patient Conditions:
        • Name: Tension
        • Drugbank Id: DBCOND0018825
    • Route:
      • Oral
    • Dose Form:
      • Tablet
      • Tablet, extended release
    • Regions: US
    • Patient Conditions:
        • Name: Anxiety
        • Drugbank Id: DBCOND0018828

    Food Interactions

    Avoid alcohol. Alcohol inhibits the metabolism of dexmethylphenidate.

    Take with or without food.