Dosage & Administration

A once-daily treatment with
dosing flexibility to meet your
patients’ needs¹

Learn about how to start patients on Adhansia XR, titrate the dose, and provide ongoing monitoring.

Screening your patients prior to treatment

Before prescribing Adhansia XR, assess for¹:

Presence of cardiac disease

Take a careful history
Investigate family history of sudden death or ventricular arrhythmia
Perform a physical exam

Risk of abuse

Check your state's Prescription Drug Monitoring Program to identify those at risk for misuse and patients obtaining controlled substances from multiple providers²
Use electronic prescribing for controlled substances to reduce diversion^3,4
Advise patients and their caregivers:
- That Adhansia XR is a federally controlled substance, and it can be abused and lead to dependence
- Not to give Adhansia XR to anyone else, and to store Adhansia XR in a safe place (preferably locked)
- To comply with laws and regulations on drug disposal

Note: Drugs known to have clinically important interactions with Adhansia XR are monoamine oxidase inhibitors, gastric pH modulators, antihypertensive drugs, halogenated anesthetics, and risperidone.¹

Six strengths allow for titration to the optimal dose¹

One capsule. Once daily.¹

Recommended starting dose: 25 mg once daily

Six capsule strengths including 25mg, 35mg, 45mg, 55mg, 70mg, and 85mg — Capsules shown are not actual size.

Adhansia XR capsules may be^1,5:

Swallowed whole or opened and the entire contents sprinkled onto a tablespoon of applesauce or yogurt.

The entire mixture should be eaten, without chewing, immediately or within 10 minutes (if not eaten within 10 minutes after mixing, discard and do not store).

Note: The dose of a single capsule should not be divided. Patients should not take anything less than one capsule per day. In the event of a missed dose, do not administer later in the day or administer additional medication to make up for the missed dose.¹

Initiation and Titration

Recommended starting dose for patients 6 years or older: 25 mg once daily¹

Switching to Adhansia XR

If switching from other MPH products:

Discontinue that treatment and titrate with Adhansia XR using the recommended titration schedule
Do not substitute Adhansia XR for other MPH products on a mg-per-mg basis because of different MPH base compositions and PK profile

Titrate in increments of 10 to 15 mg at intervals of ≥5 days¹

Individualize dosage adjustments based upon assessment of clinical benefit and tolerability with careful consideration of the dose-related adverse reactions.

In short-term controlled trials:

In adults - Although efficacy was demonstrated at dosages of 100 mg daily, dosages >85 mg daily were associated with a disproportionate increase in the incidence of certain adverse reactions
In pediatric patients - Efficacy was demonstrated at dosages of 70 mg daily, but dosages ≥70 mg daily were associated with a disproportionate increase in the incidence of certain adverse reactions

MPH=methylphenidate; PK=pharmacokinetic.

Monitoring your patients throughout their treatment

After prescribing Adhansia XR¹:

Dose reduction and discontiuation

Re-evaluate long-term use of Adhansia XR periodically, and adjust dosage as needed. Pharmacological treatment of ADHD may be needed for extended periods
Reduce the dosage or, if necessary, discontinue the drug if paradoxical aggravation of symptoms or other ARs occur. Adhansia XR should be periodically discontinued to assess patients' condition
Discontinue Adhansia XR if improvement is not seen after appropriate dosage adjustment over 1 month

Monitor for potential abuse and dependence

Monitor for signs of abuse and dependence, keep careful prescription records, and educate patients about abuse and diversion
Take note of increases in the amount of medication requested, or unscheduled or early refill requests²
Refer patients to receive appropriate treatment if they have developed a substance use disorder²

ARs=adverse reactions.

Drugs having clinically important interactions with Adhansia XR¹

Monoamine Oxidase Inhibitors

Clinical Impact: Concomitant use of MAOIs and CNS stimulants can cause hypertensive crisis. Potential outcomes include death, stroke, myocardial infarction, aortic dissection, ophthalmological complications, eclampsia, pulmonary edema, and renal failure
Intervention: Do not administer Adhansia XR concomitantly with MAOIs or within 14 days after discontinuing MAOI treatment

Gastric pH Modulators

Clinical Impact: May change the release, PK profiles and alter the pharmacodynamics of Adhansia XR
Intervention: Monitor patients for changes in clinical effect and use alternative therapy based on clinical response

Antihypertensive Drugs

Clinical Impact: Adhansia XR may decrease the effectiveness of drugs used to treat hypertension
Intervention: Monitor blood pressure and adjust the dosage of the antihypertensive drug as needed

Halogenated Anesthetics

Clinical Impact: Concomitant use of halogenated anesthetics and Adhansia XR may increase the risk of sudden blood pressure and heart rate increase during surgery
Intervention: Avoid use of Adhansia XR in patients being treated with anesthetics on the day of surgery

Risperidone

Clinical Impact: Combined use of methylphenidate with risperidone when there is a change, whether an increase or decrease, in dosage of either or both medications, may increase the risk of EPS
Intervention: Monitor for signs of EPS

MAOIs=monoamine oxidase inhibitors; CNS=central nervous system; PK=pharmacokinetics; EPS=extrapyramidal symptoms.