Kids' Health Commonly Prescribed Drugs Using Focalin XR for ADHD Treatment By Vincent Iannelli, MD Vincent Iannelli, MD Facebook Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years. Learn about our editorial process Updated on March 04, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Jonathan B. Jassey, DO Medically reviewed by Jonathan B. Jassey, DO Facebook Jonathan B. Jassey, DO, is board-certified in pediatrics. He has been in private practice at Bellmore Merrick Medical in New York since 2007 and is the co-author of "The Newborn Sleep Book." Learn about our Medical Expert Board Print Focalin XR (dexmethylphenidate hydrochloride) is an oral, extended-release stimulant approved for treatment of attention deficit hyperactivity disorder (ADHD) for children ages 6 to 12, teenagers, and adults. It is the same medication as Focalin but has therapeutic effects that typically last for 12 hours (as opposed to four). Focalin XR begins to work an average of 45 minutes after it is taken. Hero Images / Getty Images How It Works ADHD is a disorder of the brain that can cause inattention, hyperactivity, and impulsivity. The most common treatment has been prescription-strength stimulant medications, which are believed to maintain alertness and help people with ADHD concentrate and focus. It is believed that there may be a combination of genetic and environmental factors that lead to ADHD, and that stimulant drugs may reduce some of the symptoms by increasing neurotransmitter activity in certain regions in the brain. Focalin and Focalin XR are composed of dexmethylphenidate HCL, an isomer of the active ingredient in Ritalin (methylphenidate)—one of the first drugs used to treat ADHD. Isomers are nearly identical forms of a molecule that differ in the arrangement of their atoms, which can make them act differently in the body. The idea behind Focalin is that the dexmethylphenidate HCl isomer may have a more potent therapeutic effect than the methylphenidate in Ritalin and may produce fewer side effects. Because of this difference, Focalin is often prescribed at half the dose of Ritalin with equivalent therapeutic effects. Focalin XR vs. Other ADHD Stimulants Long-acting or extended-release stimulants have been considered advantageous because they can be taken fewer times per day, reducing the risk of missed doses or symptom fluctuations throughout the day. Besides Focalin XR, Adderall XR, Vyvanse, Ritalin LA, Concerta, and Daytrana (Ritalin patch) are all examples of long-acting stimulants commonly used for the treatment of ADHD. However, when you consider that Daytrana, Ritalin LA, and Concerta are all long-acting forms of Ritalin (methylphenidate), the number of choices is not quite as extensive as it appears in terms of the pharmacological action of these medications. Like other once-daily or other extended-release ADHD medications, Focalin XR lasts throughout the entire day. At this time, there have not been convincing studies proving that Focalin is better or safer than Ritalin, Adderall, or other stimulants. Generally, Focalin is most often compared to Ritalin in clinical studies, and the long-acting forms of each medication are compared with each other. So far, it appears that Focalin XR is as efficacious and safe as Ritalin LA. How It's Used Focalin XR is available in 5, 10, 15, 20, 25, 30, 35, and 40-mg capsules. The recommended dose of Focalin XR is the same as the total dose of Focalin. For example, if you or your child has taken Focalin 10 mg twice per day, then the Focalin XR dose would be 20 mg once per day. Focalin XR, as well as Ritalin LA, are capsules composed of 50 percent immediate-release beads and 50 percent delayed-release beads, trying to mimic twice-daily dosing. If you or your child is given a prescription for Focalin XR, it should be taken in the morning. It can be taken with or without food. You should not cut or chew the capsule because this will impact its ability to be properly absorbed by your body. Instead, if you have a hard time swallowing it, the capsule can be opened and the contents sprinkled on to food, which should be small enough to be swallowed without chewing. Focalin XR uses a mechanism called SODAS (Spheroidal Oral Drug Absorption System), which is what makes this possible. Side Effects, Interactions, and Contraindications Focalin XR might not be safe for you if you have a heart condition, glaucoma, psychiatric illness, thoughts of suicide, tics, high blood pressure, vascular disease, or seizures. It can potentially interact with a variety of medications, such as antidepressants, blood thinners, anticonvulsants, and blood pressure medications, so be sure that your prescribing healthcare provider is aware of anything you are taking. When you are taking Focalin XR, your healthcare provider will periodically assess its impact on your symptoms of ADHD and whether you are experiencing any of the drug's potential side effects, of which there are several. The decision as to whether you should continue to take the medication or not depends on your personal experience with it—both pros and cons. Side effects of Focalin XR include: Insomnia Restlessness Stomach aches, nausea, loss of appetite Dizziness Headaches Dry mouth Serious, but less common side effects include: Seizures Hallucinations and/or paranoia Heart rhythm problems Aggression or other behavior changes Depression, suicidal ideation (thinking about suicide) Vision changes Priapism (prolonged erection without arousal, which is often painful) Addiction, Abuse, Misuse Focalin XR is a stimulant and this category of medication does have the potential for abuse. It can be used to feel "high" or to stay awake for a prolonged period of time. The drug can be diverted and has been known to be misused by people who do not have ADHD for these same reasons, and also for weight loss. It is not clear whether Focalin XR leads to tolerance, which is a decreased response to your dose, or a need for an increased dose to achieve the same response. Most people do not need to increase the dose of Focalin XR in order to achieve therapeutic control of ADHD symptoms. A Word From Verywell There are a number of medications approved for the treatment of ADHD, and choosing the right one can be confusing. Your healthcare provider will determine which medication is most likely to be the right fit for you. However, if your symptoms do not improve or you experience side effects, your medication can be changed to another one that may have a better effect. Often, behavioral therapy is another option that can be used for the treatment of ADHD, either instead of or in addition to, prescription medications. If you're worried about the cost of medication, your healthcare provider may have a voucher for a free trial of Focalin XR. Focalin XR Savings Cards are also available online. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 3 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. FDA.gov. FOCALIN XR (dexmethylphenidate hydrochloride).Highlights of prescribing information. Revised anuary 2017 Brown KA, Samuel S, Patel DR. Pharmacologic management of attention deficit hyperactivity disorder in children and adolescents: a review for practitioners. Transl Pediatr. 2018;7(1):36-47. doi:10.21037/tp.2017.08.02 Coghill D, Banaschewski T, Zuddas A, Pelaz A, Gagliano A, Doepfner M. Long-acting methylphenidate formulations in the treatment of attention-deficit/hyperactivity disorder: a systematic review of head-to-head studies. BMC Psychiatry. 2013;13:237. doi:10.1186/1471-244X-13-237 Additional Reading Silva R, Muniz R, McCague K, Childress A, Brams M, Mao A. Treatment of children with attention-deficit/hyperactivity disorder: results of a randomized, multicenter, double-blind, crossover study of extended-releasedexmethylphenidateand D,L-methylphenidateand placebo in a laboratory classroom setting. Psychopharmacol Bull. 2008;41(1):19-33. Sugrue D, Bogner R, Ehret MJ. Methylphenidate anddexmethylphenidateformulations for children with attention-deficit/hyperactivity disorder. Am J Health Syst Pharm. 2014;71(14):1163-70. doi:10.2146/ajhp130638. Tang C, Wei Y, Zhao J, Nie J. Different developmental pattern of brain activities in ADHD: a study of resting-state fMRI. Dev Neurosci. 2018;40:246-57. doi:10.1159/000490289 U.S. Food and Drug Administration. Focalin XR Prescribing Information Sheet.