Options for the Management of Attention Deficit/Hyperactivity (ADHD)

Marcia L. Buck, Pharm.D., FCCP, FPPAG

Disclosures

Pediatr Pharm. 2011;17(3) 

In This Article

Once-daily Methylphenidate Capsules

Like Concerta® tablets, all of the once-daily capsule products are considered to have a double pulse or biphasic release, producing a rapid initial peak as well as a second later peak in serum concentrations following a single dose. There are considerable differences, however, in how these products are absorbed.[1–3] Two capsule products are available that deliver methylphenidate over approximately an 8 to 10 hour period, Metadate CD® and Ritalin LA®.[7,8] Metadate CD® is a Diffucaps® formulation, a mix of 30% immediate-release beads and 70% delayed-release beads. The delayed-release beads dissolve more slowly and are typically absorbed in the intestine, providing a later second peak in serum concentrations.[1–3,7]

Ritalin LA® differs in that the coated beads are designed to release drug in two relatively equal amounts.[1–3,8] With the spheroidal oral drug absorption system (SODAS®) technology used for this preparation, 50% of the beads are immediate-release and 50% are enteric-coated delayed-release beads that dissolve more slowly in the intestine. This provides an initial peak serum concentration shortly after administration and a second peak at 4 hours. With a larger percentage of drug released immediately compared to Concerta® and Metadate CD®, Ritalin LA® may be a better choice for patients needing early morning symptom control.

Dexmethylphenidate, the active d-enantiomer of methylphenidate, is also available in a once-daily capsule formulation (Focalin XR®) which uses SODAS® technology.[1–3,9] This product provides drug release over an 8 to 12 hour period, with an initial peak at approximate 1½ hrs and a second peak at 6.5 hrs (range 4.5–7 hrs). All three capsule products can be opened and the beads mixed with a spoonful of applesauce. As long as the beads are not chewed or crushed, the delayed-release properties will be retained.

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