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The Ritalin Patch provides smooth 15 hour coverage |
adhd - Drugs for ADHD
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| Proper application of the patch: |
| Dosing |
| Side effects |
daytrana is an adhesive methylphenidate (same as concerta, ritalin, focalin) patch. It is the patch delivery system that makes daytrana unique.
The approved wearing time is for up to 9 hours. This provide 12 hours of effective control of symptoms since the effects continue for about 3 hours after the patch is removed. However, the time can be adjusted so that it is removed 3 hours before you want its effects to wear off. The obvious advantage of this delivery system is that it allows parents to adjust how long it acts on a day-to-day basis. This can be useful when the school schedule is shortened or on nonschool days. It can also be removed earlier improve appetite at dinnertime or decrease insomnia.
The patch should be applied two hours before it needs to be effective. The effectiveness will continue for about three hours after the patch is removed. The effects are smooth while the patch is worn. The patch can be worn during swimming, bathing, or exercise. Parents can visually check that the patch is in place. However, heating the patch (like heating pads, electric blankets, heated water beds, etc.) should be avoided since this may increase the amount of methylphenidate absorbed.
Abuse potential is less because unlike pills that can be sold or shared with others, the patch, once applied, cannot be removed and used again by others.
The disadvantage of the patch is that it needs careful and accurate placement each day.
Proper application of the patch:
Apply the patch to the side of the upper leg, just below the waistline of the underwear. Each day use a different site on the body. Redness may appear at the site for up to 48 hours after the patch is removed. To apply properly, half the backing should be removed so that side of patch can be applied. The skin should be clean, dry, and hairless. Then remove the other half and press in place with the palm of the hand for 30 seconds. The combination of heat and pressure will firmly attach the patch. Effects usually begin in 1 hour but may take up to 2 hours. Pressing the patch firmly for one minute will speed up the onset.
Dosing
It is supplied in patches that will release 10, 15, 20, & 30mg in a 9 hour wearing time. Wearing them longer will cause more methyphenidate to be released. After 4-5 weeks, the dose of Daytrana may need to be reduced because in that time absorption improves and up to twice as much methylphenidate is absorbed.
Total dose should not exceed the maximum published dosing limits of .9 mg per lb. of body weight.
When switching from concerta 36mg use Daytrana 30mg. 72mg of Concerta (2 x 36mg) may initially require 2 patches of 20-30mg. After 4-5 weeks one patch will be enough.
Side effects
The side effects are the same as oral methylphenidate, except for possible skin irritation.
side-effects include: decreased appetite, sleeplessness, sadness/crying, muscle twitches, weight loss, nausea, and stomach ache
Some doctors prescribe Tenex (Guanfacine) ½ to 2mg once or twice daily to reduce side effects and reduce distractibility.
Most patients do not have any skin reaction or have mild redness that goes away quickly once the patch is removed. A few people have marked redness that persists for a few hours and some develop significant localized rash.
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