II. Indications

  1. Attention Deficit Hyperactivity Disorder (ADHD)
    1. No longer available in United States
    2. Not recommended for use due to hepatotoxicty

III. Pharmacokinetics

  1. Onset: 2 hours
  2. Duration: 6 to 10 hours
  3. Half-Life: 12 hours
  4. Steady state reached in 2 to 3 days
  5. Titrate dose every 3 to 4 weeks
    1. Delayed onset of therapeutic effect up to 3 to 4 weeks after being started

IV. Dosing

  1. Range: 0.5 - 2.5 mg/kg/dose (Up to 112.5 mg/day)
  2. Start: 18.75 mg orally each morning
  3. Frequency: Once to twice daily

V. Monitoring

  1. Alanine Aminotransferase (ALT)
    1. Obtain baseline
    2. Repeat testing every 2 weeks
  2. Symptom inquiry at every visit
    1. Anorexia
    2. Malaise
    3. Gastrointestinal symptoms
    4. Dark Urine

VI. Precautions

  1. Informed Consent from parents required prior to use (due to hepatotoxicity)

VII. Adverse Effects

  1. Hepatic failure of dysfunction
  2. Choreoathetoid movements
  3. Other adverse effects similar to Methylphenidate

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