Ritalin and Other Methylphenidates - How Is It Taken?

How Is It Taken?

Methylphenidate comes in tablet, liquid, and capsule form. When used for medical purposes, it is taken by mouth. The FDA has approved methylphenidate for patients six years of age and older, but it is sometimes prescribed for children younger than six.

Illegal users of the drug usually swallow it, inhale or snort it through the nose, smoke it, or inject it by needle into a vein. Abusers typically crush the tablets into a powder to inhale or smoke the drug. To prevent abuse, some methylphenidate tablets—Concerta, for example—are made in a special way so they cannot be ground into a powder. To inject the drug, abusers usually dissolve immediate-release methylphenidate tablets in water and then inject the mixture into a vein with a needle and syringe.

Methylphenidate Formulas

Methylphenidate is available as an immediate-release tablet and liquid; an intermediate-acting (extended-release) tablet; and a long-acting (extended-release) capsule and tablet. Some of the tablets are chewable. Immediate-acting formulas have an effect that lasts approximately three to four hours; intermediate-acting formulas last about six to eight hours; and long-acting formulas last approximately eight to twelve hours. The immediate-release formulas are typically taken two to three times a day. Dexmethylphenidate (Focalin) is an immediate-release tablet that is usually taken twice a day. Ritalin and Methylin are methylphenidates that are taken two or three times a day. Longer-acting versions of the drug (such as Concerta) are becoming more popular, however. According to the CHADD fact sheet, these formulas "may cause fewer 'ups and downs' over the day and may eliminate the need for taking additional doses at school or during work."

When a person takes an extended-release formula, part of the drug is released into the body shortly after it is swallowed, while the remaining drug in the capsule or pill is released more slowly. Different extended-release formulas use different methods to deliver the medicine into the body over many hours. Packing the methylphenidate into granules called beads is one method. Metadate CD capsules use this bead-delivery system. These capsules use two different types of beads. The rapid-release beads allow the medicine to reach the bloodstream quickly. In Metadate CD, about 30 percent of the drug is released immediately. The extended-release beads, which make up the remaining 70 percent of the capsule, dissolve slowly over several hours. Ritalin LA uses the same bead delivery system, but it contains about 50 percent rapid-release beads.

Concerta is an extended-release formula of methylphenidate that uses a different method to release its medicine. The tablet has an outer methylphenidate coating that dissolves immediately when swallowed. Once that drug dissolves, an underlying membrane allows water to flow in and out of the tablet. Beneath the membrane are two more layers of drug. When water enters the tablet, it expands and pushes the drug out of the top. The delivery time can be increased by using a thicker membrane or decreased by using a thinner one.

Methylphenidate Dosages

The dose of Ritalin and other methylphenidate formulas depends on the age and size of the patient and the nature and severity of the medical disorder. The starting dose of the immediate-acting formula of methylphenidate for adults and teenagers with either ADHD or narcolepsy is generally between 5 and 20 milligrams, taken two or three times a day. The medicine can be taken with or after meals. Younger children with ADHD generally start at 5 milligrams and take the drug two times a day. Chewable tablets should be thoroughly chewed and taken with a full glass (eight ounces) of water or other liquid.

For extended-release formulas, the recommended starting dose is 20 milligrams a day for adults, teenagers, and children over six years old. The maximum dose is generally 60 milligrams per day. The medicine is taken in the morning before breakfast. Intermediateacting and long-acting extended-release tablets and capsules are designed to be swallowed whole.