methylphenidate hydrochloride CD 50 mg Capsule, Extended Release, 100-count
Other active recalls for Methylphenidate Hydrochloride (different manufacturers) — 1 · tap to view
🆔 Identity & classification
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🏷️ RxNorm drug class
This medicine belongs to the Central Nervous System Stimulant class.
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🏭 Manufacturer & labeler
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🩺 Clinical
Methylphenidate is used to control symptoms of attention deficit hyperactivity disorder (ADHD; condition that makes it hard to pay attention, control your behavior, and remain still or quiet) and to treat narcolepsy (condition that causes people to be very sleepy during the day and to fall asleep suddenly). Methylphenidate is in a class of medications called central nervous system (CNS) stimulants. It works by changing the amounts of certain natural substances in the brain.
Read the full MedlinePlus article ↗- Methylphenidate helps boost two brain chemicals — dopamine and norepinephrine — that play a big role in attention, focus, and impulse control. When those chemicals are more availab...
- What exactly is methylphenidate supposed to do for my ADHD?
- Methylphenidate is a controlled substance, and it does have a real potential for abuse and dependence — that's something the FDA takes seriously enough to put a boxed warning on th...
- The most common ones — decreased appetite, some trouble sleeping, headache, and a slightly faster heartbeat — are annoying but usually manageable and tend to improve over time. For...
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Supplement & herbal interactions
Some supplements/herbs that may interact with Methylphenidate Hydrochloride — tap one for details:
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💊 What it looks like
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🧪 Inactive Ingredients / Excipients
Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.
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UNII 4W5IH7FLNY
A clear, oily liquid derived from sebacic acid and butanol. It works as a plasticizer and solvent in pharmaceutical coatings and films, helping them stay flexible and smooth.
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UNII L06K8R7DQK
A synthetic blue dye approved by the FDA for use in medications and foods. It serves as a colorant to make pills and liquids visually distinct and easier to identify.
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UNII 1K09F3G675
Ferric oxide red is an inorganic iron compound used as a colorant in medicines. It gives tablets, capsules, or other dosage forms a red or reddish tint for identification and appearance.
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UNII 3NXW29V3WO
Hypromellose is a plant-based thickener made from cellulose. It's used in medicines as a binder to hold ingredients together, a coating for tablets, and a thickener for liquids.
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UNII 3WJQ0SDW1A
Polyethylene glycol is a synthetic liquid or solid polymer used in medicines as a solvent, lubricant, and humectant. It helps dissolve active ingredients, reduces friction during manufacturing, and retains moisture in the final product.
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UNII FZ989GH94E
Povidone is a synthetic polymer made from a plastic-like material. It acts as a binder to hold tablet ingredients together and as a disintegrant to help the tablet break apart in your stomach so the medicine can be absorbed.
6 inactive ingredients listed in the exact product block matched to this NDC.
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ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.Inactive ingredient FAQ
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💲 Pricing
A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.
| Price system | Per ea | Per package |
|---|---|---|
| Retail pharmacies payNADAC · weekly | $1.462 | $146.17 / 100 capsules |
| Medicaid paysCMS SDUD · 12 mo | $1.98 | $198.20 / 100 capsules |
| Medicare drug plans payPart D · Q2 2026 | $3.50 | $349.58 / 100 capsules |
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🔁 Therapeutic equivalents
| Product | Labeler | Pack | NADAC/unit | TE | Status | Price vs. this |
|---|---|---|---|---|---|---|
| Methylphenidate Hydrochloride 50 mg 00115-1740-01 | Amneal | 100 capsules | $1.462 | AB2 | Availability likely | — |
| Methylphenidate Hydrochloride Extended-Release 50 mg 00406-1850-01 | SpecGx | 100 capsules | $1.462 | AB2 | Availability likely | — |
| methylphenidate hydrochloride CD 50 mgthis 00527-4583-37 | Lannett | 100 capsules | $1.462 | AB2 | Availability likely | — |
| Methylphenidate Hydrochloride 50 mg 42858-0080-45 | Rhodes | 90 capsules | $4.447 | AB3 | FDA listed | +204% |
| methylphenidate hydrochloride 50 mg 00591-3895-19 | Actavis | 90 capsules | $4.447 | AB3 | FDA listed | +204% |
| Metadate Cd 50 mg 69654-0583-30 | Aytu | 30 capsules | — | AB2 | FDA listed | — |
| Metadate Cd 50 mg 00527-6583-30 | Lannett | 30 capsules | — | AB2 | FDA listed | — |
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⏳ Availability & generic status
FDA-approved generic versions are listed, and recent pricing/market data suggests they may be available — see Therapeutic equivalents.
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🗺️ Medicaid utilization & spend
📦 Packaging — all sizes for this product
| Package NDC | Description | Marketing start | Status |
|---|---|---|---|
| 00527-4583-37 You're viewing this | 100 CAPSULE, EXTENDED RELEASE in 1 BOTTLE (0527-4583-37) | 2006-03-21 | Active |
📄 Full prescribing information FDA SPL
🚨 Boxed Warning ▾
WARNING: ABUSE, MISUSE, AND ADDICTION Methylphenidate HCl Extended-Release Capsules CD has a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CNS stimulants, including Methylphenidate HCl Extended-Release Capsules CD, can result in overdose and death [see Overdosage ( 10 )] , and this risk is increased with higher doses or unapproved methods of administration, such as snorting or injection. Before prescribing Methylphenidate HCl Extended-Release Capsules CD, assess each patient’s risk for abuse, misuse, and addiction.
Educate patients and their families about these risks, proper storage of Methylphenidate HCl Extended-Release Capsules CD, and proper disposal of any unused drug. Throughout Methylphenidate HCl Extended-Release Capsules CD treatment, reassess each patient’s risk of abuse, misuse, and addiction and frequently monitor for signs and symptoms of abuse, misuse, and addiction [see Warnings and Precautions ( 5.1 ) and Drug Abuse and dependence ( 9.2 )] . WARNING: ABUSE, MISUSE, AND ADDICTION See full prescribing information for complete boxed warning.
Methylphenidate HCl Extended-Release Capsules CD has a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CNS stimulants, including Methylphenidate HCl Extended-Release Capsules CD, can result in overdose and death ( 5.1 , 9.2 , 10 ): Before prescribing Methylphenidate HCl Extended-Release Capsules CD, assess each patient’s risk for abuse, misuse, and addiction. Educate patients and their families about these risks, proper storage of Methylphenidate HCl Extended-Release Capsules CD, and proper disposal of any unused drug.
Throughout treatment, reassess each patient’s risk and frequently monitor for signs and symptoms of abuse, misuse, and addiction.
🎯 Indications and Usage ▾
1 INDICATIONS AND USAGE Methylphenidate HCl Extended-Release Capsules CD is indicated for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in pediatric patients 6 to 15 years of age. Limitations of Use The use of Methylphenidate HCl Extended-Release Capsules CD is not recommended in pediatric patients younger than 6 years of age because they had higher plasma exposure and a higher incidence of adverse reactions (e.g. weight loss) than patients 6 years and older at the same dosage [see Warnings and Precautions ( 5.7 ), Use in Specific Populations ( 8.4 )] .
Methylphenidate HCl Extended-Release Capsules CD is a central nervous system (CNS) stimulant indicated for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in pediatric patients 6 to 15 years of age. ( 1 ) Limitations of Use The use of Methylphenidate HCl Extended-Release Capsules CD is not recommended in pediatric patients younger than 6 years of age because they had higher exposure and a higher incidence of adverse reactions (e.g., weight loss) than patients 6 years and older at the same dosage. ( 5.7 , 8.4 )
⏱️ Dosage and Administration ▾
2 DOSAGE AND ADMINISTRATION Prior to initiating Methylphenidate HCl Extended-Release Capsules CD treatment, assess each patient’s risk for ( 2.1 ): Abuse, misuse, and addiction ( 5.1 ) Presence of cardiac disease ( 5.2 ) Developing a manic episode ( 5.4 ) A family history of tics or Tourette syndrome and clinically evaluate patients for motor or verbal tics or Tourette syndrome ( 5.10 ) Take orally once daily in the morning, before breakfast. Swallow whole with the aid of liquids, or sprinkle contents onto a small amount of applesauce and give immediately.
Do not crush or chew the capsule or capsule contents ( 2.1 ) Recommended starting dose is 20 mg once daily. Dosage may be increased 10-20 mg at weekly intervals; do not exceed 60 mg per day ( 2.2 )
2.1Pretreatment Screening Prior to treating patients with Methylphenidate HCl Extended-Release Capsules CD, assess: The risk for abuse, misuse, and addiction [see Warnings and Precautions ( 5.1 )] . For the presence of cardiac disease (e.g., perform a careful history, family history of sudden death or ventricular arrhythmia, and physical exam) [see Warnings and Precautions ( 5.2 )] . The risk for developing a manic episode (e.g., history of depressive symptoms or a family history of suicide, bipolar disorder, or depression) [see Warnings and Precautions ( 5.4 )] .
For a family history for tics or Tourette syndrome and clinically evaluate patients for motor or verbal tics or Tourette’s syndrome [see Warnings and Precautions ( 5.10 )] .
2.2Dosage Recommendations The recommended starting dose of Methylphenidate HCl Extended-Release Capsules CD is 20 mg once daily. Dosage may be adjusted in weekly 10 mg to 20 mg increments to the maximum recommended dose of 60 mg per day. Dosage should be individualized according to the needs and responses of the patient.
2.3Administration Instructions Administer Methylphenidate HCl Extended-Release Capsules CD orally once daily in the morning, before breakfast. Swallow the capsule whole with the aid of liquids. Alternatively, open the capsule and sprinkle the contents onto a small amount (tablespoon) of applesauce and administer immediately.
Do not store for future use. Drink fluids following the intake of the sprinkled capsule contents with applesauce. The capsules and the capsule contents must not be crushed or chewed.
2.4Dosage Reduction and Discontinuation If paradoxical aggravation of symptoms or other adverse reactions occur, reduce dosage or, if necessary, discontinue Methylphenidate HCl Extended-Release Capsules CD. If improvement is not observed after appropriate dosage adjustment over a one-month period, discontinue Methylphenidate HCl Extended-Release Capsules CD.
2.5Switching from a Monoamine Oxidase Inhibitor Must wait at least 14 days after stopping a monoamine oxidase (MAO) inhibitor before starting Methylphenidate HCl Extended-Release Capsules CD [see Contraindications ( 4 ) and Drug Interactions ( 7 )] .
💊 Dosage Forms and Strengths ▾
3 DOSAGE FORMS AND STRENGTHS Methylphenidate HCl Extended-Release Capsules CD extended-release capsules are available in the following dosage strengths (see Table 1): Table 1: Strengths and Identifying Characteristics of Methylphenidate HCl Extended-Release Capsules CD Strength Capsule Color (cap/body) Imprinting on Capsule Cap Imprinting on Capsule Body 10 mg green/white “LANNETT 4579” in white letters “10 mg” in black letters 20 mg blue/white “LANNETT 4580” in white letters “20 mg” in black letters 30 mg reddish-brown/white “LANNETT 4581” in white letters “30 mg” in black letters 40 mg yellow ivory/white “LANNETT 4582” in black letters “40 mg” in black letters 50 mg purple/white “LANNETT 4583” in white letters “50 mg” in black letters 60 mg white/white capsules “LANNETT 4584” in black letters “60 mg” in black letters Extended-release capsules: 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg ( 3 )
⛔ Contraindications ▾
4 CONTRAINDICATIONS Methylphenidate HCl Extended-Release Capsules CD is contraindicated in patients with: Known hypersensitivity to methylphenidate or other component of Methylphenidate HCl Extended-Release Capsules CD. Angioedema has been reported in patients treated with Methylphenidate HCl Extended-Release Capsules CD. Anaphylactic reactions have been reported in patients treated with other methylphenidate products [see Adverse Reactions ( 6 )] .
Concomitant treatment with monoamine oxidase inhibitors (MAOIs), or within 14 days following discontinuation of treatment with an MAOI, because of the risk of hypertensive crisis [see Drug Interactions ( 7 )] . Methylphenidate HCl Extended-Release Capsules CD contains sucrose. Therefore, patients with hereditary problems of fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltase insufficiency should not take this medicine.
Pheochromocytoma or a history of pheochromocytoma. Serious reactions, including elevated blood pressure and tachyarrhythmia, have been reported in patients with pheochromocytoma or a history of pheochromocytoma who received a methylphenidate product. Methylphenidate HCl Extended-Release Capsules CD is contraindicated in: Known hypersensitivity to methylphenidate or other components of Methylphenidate HCl Extended-Release Capsules CD ( 4 ) Concurrent treatment with a monoamine oxidase inhibitor (MAOI), or use of an MAOI within the preceding 14 days ( 4 ) Use in patients with patients with hereditary problems of fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltase insufficiency ( 4 ) Patients with pheochromocytoma or a history of pheochromocytoma ( 4 )
⚠️ Warnings and Cautions ▾
5 WARNINGS AND PRECAUTIONS Risks to Patients with Serious Cardiac Disease: Avoid use in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmias, coronary artery disease, or other serious cardiac disease. ( 5.2 ) Increased Blood Pressure and Heart Rate: Monitor blood pressure and pulse. ( 5.3 ) Psychiatric Adverse Reactions: If new psychotic or manic symptoms occur, consider discontinuing Methylphenidate HCl Extended-Release Capsules CD.
( 5.4 ) Priapism: If abnormally sustained or frequent and painful erections occur, patients should seek immediate medical attention. ( 5.5 ) Peripheral Vasculopathy, including Raynaud’s Phenomenon: Careful observation for digital changes is necessary during Methylphenidate HCl Extended-Release Capsules CD treatment. Further clinical evaluation (e.g., rheumatology referral) may be appropriate for patients who develop signs or symptoms of peripheral vasculopathy.
( 5.6 ) Long-Term Suppression of Growth in Pediatric Patients: Closely monitor growth (height and weight) in pediatric patients. Pediatric patients not growing or gaining height or weight as expected may need to have their treatment interrupted. ( 5.7 ) Acute Angle Closure Glaucoma: Methylphenidate HCl Extended-Release Capsules CD-treated patients considered at risk for acute angle closure glaucoma (e.g., patients with significant hyperopia) should be evaluated by an ophthalmologist.
( 5.8 ) Increased Intraocular Pressure (IOP) and Glaucoma: Prescribe Methylphenidate HCl Extended-Release Capsules CD to patients with open-angle glaucoma or abnormally increased IOP only if the benefit of treatment is considered to outweigh the risk. Closely monitor patients with a history of increased IOP or open angle glaucoma. ( 5.9 ) Motor and Verbal Tics, and Worsening of Tourette’s Syndrome: Regularly monitor patients for the emergence or worsening of tics or Tourette’s syndrome.
Discontinue treatment if clinically appropriate. ( 5.10 )
5.1Abuse, Misuse, and Addiction Methylphenidate HCl Extended-Release Capsules CD has a high potential for abuse and misuse. The use of Methylphenidate HCl Extended-Release Capsules CD exposes individuals to the risks of abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CNS stimulants, including Methylphenidate HCl Extended-Release Capsules CD, can result in overdose and death [see Overdosage ( 10 )] , and this risk is increased with higher doses or unapproved methods of administration, such as snorting or injection.
Before prescribing Methylphenidate HCl Extended-Release Capsules CD, assess each patient’s risk for abuse, misuse, and addiction. Educate patients and their families about these risks and proper disposal of any unused drug. Advise patients to store Methylphenidate HCl Extended-Release Capsules CD in a safe place, preferably locked, and instruct patients to not give Methylphenidate HCl Extended-Release Capsules CD to anyone else.
Throughout Methylphenidate HCl Extended-Release Capsules CD treatment, reassess each patient’s risk of abuse, misuse, and addiction and frequently monitor for signs and symptoms of abuse, misuse, and addiction.
5.2Risks to Patients with Serious Cardiac Disease Sudden death has been reported in patients with structural cardiac abnormalities or other serious cardiac disease who were treated with CNS stimulants at the recommended dosage. Prior to treating patients with Methylphenidate HCl Extended-Release Capsules CD, assess for the presence of cardiac disease (e.g., perform a careful history, family history of sudden death or ventricular arrhythmia, and physical exam). Avoid Methylphenidate HCl Extended-Release Capsules CD use in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmia, coronary artery disease, or other serious cardiac problems.
5.3 Increased Blood Pressure and Heart Rate CNS stimulants cause an increase in blood p…
🤒 Adverse Reactions ▾
6 ADVERSE REACTIONS The following are discussed in more detail in other sections of the labeling: Abuse, Misuse, and Addiction [see Warnings and Precautions ( 5.1 ), Drug Abuse and Dependence ( 9.2 , 9.3 )] Hypersensitivity to Methylphenidate and Other Component of Methylphenidate HCl Extended-Release Capsules CD [see Contraindications ( 4 )] Hypertensive Crisis when Used Concomitantly with MAOIs [see Contraindications (4) and Drug Interactions ( 7 )] Risks to Patients with Serious Cardiac Disease [see Warnings and Precautions ( 5.2 )] Increased Blood Pressure and Heart Rate [see Warnings and Precautions ( 5.3 )] Psychiatric Adverse Reactions [see Warnings and Precautions ( 5.4 )] Priapism [see Warnings and Precautions ( 5.5 )] Peripheral Vasculopathy, including Raynaud’s Phenomenon [see Warnings and Precautions ( 5.6 )] Long-Term Suppression of Growth in Pediatric Patients [see Warnings and Precautions ( 5.7 )] Acute Angle Closure Glaucoma [see Warnings and Precautions ( 5.8 )] Increased Intraocular Pressure and Glaucoma [see Warnings and Precautions ( 5.9 )] Motor and Verbal Tics, and Worsening of Tourette’s Syndrome [see Warnings and Precautions ( 5.10 )] The most common adverse reactions (≥ 5% and twice the rate of placebo) were anorexia and insomnia ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Lannett Company, Inc. at 1-844-834-0530 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch
6.1Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Clinical trials experience with Methylphenidate HCl Extended-Release Capsules CD included 188 pediatric patients 6 to 15 years old with ADHD exposed to Methylphenidate HCl Extended-Release Capsules CD. Patients received Methylphenidate HCl Extended-Release Capsules CD 20 mg, 40 mg, and/or 60 mg per day.
The 188 patients were evaluated in the following studies: Study 1, a 3-week placebo-controlled clinical study consisting of a total of 314 pediatric patients (ages 6 to 15 years; Methylphenidate HCl Extended-Release Capsules CD n=155); Study 2, a placebo-controlled, crossover clinical study consisting of 25 pediatric patients (ages 7 to 12 years); and Study 3, an uncontrolled clinical study consisting of 8 pediatric patients (ages 6 to 10 years). Adverse Reactions Leading to Discontinuation of Treatment In the 3-week placebo-controlled, parallel-group trial, two Methylphenidate HCl Extended-Release Capsules CD-treated patients (1%) and no placebo-treated patients discontinued due to an adverse reaction (rash and pruritus; and headache, abdominal pain, and dizziness, respectively).
Most Common Adverse Reactions The most common adverse reactions that occurred in 5% or more of patients treated with Methylphenidate HCl Extended-Release Capsules CD in a pool of Studies 1, 2 and 3 (ages 6 to 15 years) where the incidence in patients treated with Methylphenidate HCl Extended-Release Capsules CD was at least twice the incidence in placebo-treated patients were anorexia and insomnia. Adverse reactions that occurred in ≥5% of patients treated with Methylphenidate HCl Extended-Release Capsules CD and greater than placebo in pooled Studies, 1, 2, and 3 are presented in Table 2: Table 2: Adverse Reactions (≥5% and Greater than Placebo) in Pediatric Patients Ages 6 to 15 Years Receiving Methylphenidate HCl Extended-Release Capsules CD in Pooled Three to Four Week Trials Body System Preferred Term Methylphenidate HCl Extended-Release Capsules CD (n=188) % Placebo (n=190) % General Headache 12 8 Abdominal Pain (stomachache) 7 4 Digestive System Anorexia 9 2 Nervous System Insomnia 5 2
6.2Postmarketing Experience The following adverse reactions have been identified during postmarketing use of Methylphenidate HCl Extended-Release Capsules CD and other methylphenid…
🔄 Drug Interactions ▾
7 DRUG INTERACTIONS Table 3 describes clinically significant drug interactions with Methylphenidate HCl Extended-Release Capsules CD. Table 3: Clinically Significant Drug Interactions Monoamine Oxidase Inhibitors Prevention or Management Concomitant use of Methylphenidate HCl Extended-Release Capsules CD with MAOIs or within 14 days after discontinuing an MAOI is contraindicated. Mechanism and Clinical Effect(s) Concomitant use of MAOIs and CNS stimulants, including Methylphenidate HCl Extended-Release Capsules CD, can cause hypertensive crisis.
Potential outcomes include death, stroke, myocardial infarction, aortic dissection, ophthalmological complications, eclampsia, pulmonary edema, and renal failure. Antihypertensive Drugs Prevention or Management Increase monitoring for blood pressure and adjust the dosage of the antihypertensive drug, as needed. Mechanism and Clinical Effect(s) Methylphenidate HCl Extended-Release Capsules CD may decrease effectiveness of drugs used to treat hypertension [see Warnings and Precautions ( 5.3 )] .
Halogenated Anesthetics Prevention or Management Avoid use of Methylphenidate HCl Extended-Release Capsules CD in patients being treated with anesthetics on the day of surgery. Mechanism and Clinical Effect(s) Concomitant use of halogenated anesthetics and Methylphenidate HCl Extended-Release Capsules CD may increase the risk of sudden blood pressure and heart rate increase during surgery. Risperidone Prevention or Management Monitor for signs of extrapyramidal symptoms.
Mechanism and Clinical Effect(s) The risk of risperidone-associated extrapyramidal symptoms may increase in patients taking concomitant Methylphenidate HCl Extended-Release Capsules CD when there is a change in the Methylphenidate HCl Extended-Release Capsules CD or risperidone dosage. Antihypertensive Drugs: Monitor blood pressure. Adjust dosage of antihypertensive drug as needed ( 7 ) See Full Prescribing Information, for additional clinically significant drug interactions.
( 7 )
👥 Use in Specific Populations ▾
8 USE IN SPECIFIC POPULATIONS
8.1Pregnancy There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to ADHD medications, including Methylphenidate HCl Extended-Release Capsules CD, during pregnancy. Healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for Psychostimulants at 1-866-961-2388. Risk Summary Published studies and postmarketing reports on methylphenidate use during pregnancy have inconsistent findings about a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes.
There are risks to the fetus associated with the use of central nervous system (CNS) stimulants during pregnancy (see Clinical Considerations ) . No effects on morphological development were observed in embryo-fetal development studies with oral administration of methylphenidate to pregnant rats and rabbits during organogenesis at doses up to 10 and 15 times, respectively, the maximum recommended human dose (MRHD) of 60 mg/day given to adolescents on a mg/m 2 basis. However, spina bifida was observed in rabbits at a dose 53 times the MRHD given to adolescents.
A decrease in pup body weight was observed in a pre-and post-natal development study with oral administration of methylphenidate to rats throughout pregnancy and lactation at doses 6 times the MRHD given to adolescents (see Data ) . The background risk of major birth defects and miscarriage in those with ADHD is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes.
In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Clinical Considerations Fetal/Neonatal Adverse Reactions CNS stimulants, such as Methylphenidate HCl Extended-Release Capsules CD, can cause vasoconstriction and thereby decrease placental perfusion. No fetal and/or neonatal adverse reactions have been reported with the use of therapeutic doses of methylphenidate during pregnancy; however, premature delivery and low birth weight infants have been reported in amphetamine-dependent mothers.
Animal Data In embryo-fetal development studies conducted in rats and rabbits, methylphenidate was administered orally at doses of up to 75 and 200 mg/kg/day, respectively, during the period of organogenesis. Malformations (increased incidence of fetal spina bifida) were observed in rabbits at the highest dose, which is approximately 52 times the MRHD of 60 mg/day given to adolescents on a mg/m 2 basis. The no effect level for embryo-fetal development in rabbits was 60 mg/kg/day (15 times the MRHD given to adolescents on a mg/m 2 basis).
There was no evidence of morphological development effects in rats, although increased incidences of fetal skeletal variations were seen at the highest dose level (10 times the MRHD of 60 mg/day given to adults on a mg/m 2 basis), which was also maternally toxic. The no effect level for embryo-fetal development in rats was 25 mg/kg/day (3 times the MRHD on a mg/m 2 basis). When methylphenidate was administered to rats throughout pregnancy and lactation at doses of up to 45 mg/kg/day, offspring body weight gain was decreased at the highest dose (6 times the MRHD of 60 mg/day given to adults on a mg/m 2 basis), but no other effects on postnatal development were observed.
The no effect level for pre-and postnatal development in rats was 15 mg/kg/day (~2 times the MRHD given to adolescents on a mg/m 2 basis).
8.2Lactation Risk Summary Limited published literature, based on milk sampling from seven mothers reports that methylphenidate is present in human milk, which resulted in infant doses of 0.16% to 0.7% of the maternal weight-adjusted dosage and a milk/plasma ratio ranging between 1.1 and 2.7. There are no reports of adverse effects on the breastfed infant and no effects on milk production. Long-term neurodevelopmental effects on inf…
🤰 Pregnancy ▾
8.1Pregnancy There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to ADHD medications, including Methylphenidate HCl Extended-Release Capsules CD, during pregnancy. Healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for Psychostimulants at 1-866-961-2388. Risk Summary Published studies and postmarketing reports on methylphenidate use during pregnancy have inconsistent findings about a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes.
There are risks to the fetus associated with the use of central nervous system (CNS) stimulants during pregnancy (see Clinical Considerations ) . No effects on morphological development were observed in embryo-fetal development studies with oral administration of methylphenidate to pregnant rats and rabbits during organogenesis at doses up to 10 and 15 times, respectively, the maximum recommended human dose (MRHD) of 60 mg/day given to adolescents on a mg/m 2 basis. However, spina bifida was observed in rabbits at a dose 53 times the MRHD given to adolescents.
A decrease in pup body weight was observed in a pre-and post-natal development study with oral administration of methylphenidate to rats throughout pregnancy and lactation at doses 6 times the MRHD given to adolescents (see Data ) . The background risk of major birth defects and miscarriage in those with ADHD is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes.
In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Clinical Considerations Fetal/Neonatal Adverse Reactions CNS stimulants, such as Methylphenidate HCl Extended-Release Capsules CD, can cause vasoconstriction and thereby decrease placental perfusion. No fetal and/or neonatal adverse reactions have been reported with the use of therapeutic doses of methylphenidate during pregnancy; however, premature delivery and low birth weight infants have been reported in amphetamine-dependent mothers.
Animal Data In embryo-fetal development studies conducted in rats and rabbits, methylphenidate was administered orally at doses of up to 75 and 200 mg/kg/day, respectively, during the period of organogenesis. Malformations (increased incidence of fetal spina bifida) were observed in rabbits at the highest dose, which is approximately 52 times the MRHD of 60 mg/day given to adolescents on a mg/m 2 basis. The no effect level for embryo-fetal development in rabbits was 60 mg/kg/day (15 times the MRHD given to adolescents on a mg/m 2 basis).
There was no evidence of morphological development effects in rats, although increased incidences of fetal skeletal variations were seen at the highest dose level (10 times the MRHD of 60 mg/day given to adults on a mg/m 2 basis), which was also maternally toxic. The no effect level for embryo-fetal development in rats was 25 mg/kg/day (3 times the MRHD on a mg/m 2 basis). When methylphenidate was administered to rats throughout pregnancy and lactation at doses of up to 45 mg/kg/day, offspring body weight gain was decreased at the highest dose (6 times the MRHD of 60 mg/day given to adults on a mg/m 2 basis), but no other effects on postnatal development were observed.
The no effect level for pre-and postnatal development in rats was 15 mg/kg/day (~2 times the MRHD given to adolescents on a mg/m 2 basis).
🧒 Pediatric Use ▾
8.4Pediatric Use The safety and effectiveness of Methylphenidate HCl Extended-Release Capsules CD have not been established in pediatric patients below the age of 6 years. In studies evaluating extended-release methylphenidate products, patients 4 to <6 years of age had higher systemic methylphenidate exposures than those observed in older pediatric patients at the same dosage. Pediatric patients 4 to <6 years of age also had a higher incidence of adverse reactions, including weight loss.
The safety and effectiveness of Methylphenidate HCl Extended-Release Capsules CD for the treatment of ADHD have been established in pediatric patients 6 to 15 years of age. Long-Term Suppression of Growth Growth should be monitored during treatment with stimulants, including Metadate CD. Pediatric patients who are not growing or gaining weight as expected may need to have their treatment interrupted [see Warnings and Precautions ( 5.6 )] .
Juvenile Animal Toxicity Data In a study conducted in young rats, methylphenidate was administered orally at doses of up to 100 mg/kg/day for 9 weeks, starting early in the postnatal period (postnatal Day 7) and continuing through sexual maturity (postnatal Week 10). When these animals were tested as adults (postnatal Weeks 13 to 14), decreased spontaneous locomotor activity was observed in males and females previously treated with 50 mg/kg/day (approximately 6 times the MRHD on a mg/m 2 basis) or greater, and a deficit in the acquisition of a specific learning task was seen in females exposed to the highest dose (12 times the MRHD on a mg/m 2 basis).
The no effect level for juvenile neurobehavioral development in rats was 5 mg/kg/day (half the MRHD on a mg/m 2 basis). The clinical significance of the long-term behavioral effects observed in rats is unknown.
🧓 Geriatric Use ▾
8.5Geriatric Use Methylphenidate HCl Extended-Release Capsules CD has not been studied in patients over the age of 65 years.
🆘 Overdosage ▾
10 OVERDOSAGE Clinical Effects of Overdose Overdose of CNS stimulants is characterized by the following sympathomimetic effects: Cardiovascular effects including tachyarrhythmias, and hypertension or hypotension. Vasospasm, myocardial infarction, or aortic dissection may precipitate sudden cardiac death. Takotsubo cardiomyopathy may develop.
CNS effects including psychomotor agitation, confusion, and hallucinations. Serotonin syndrome, seizures, cerebral vascular accidents, and coma may occur. Life-threatening hyperthermia (temperatures greater than 104°F) and rhabdomyolysis may develop.
Posterior reversible encephalopathy syndrome (PRES) symptoms including headache, altered mental status, hypertension, seizures, and visual disturbances including blindness have occurred in the setting of a methylphenidate product overdose. Symptoms of PRES are usually reversible but may evolve into ischemic stroke or cerebral hemorrhage. Diagnosis of PRES should be confirmed by radiological procedure (e.g., MRI).
Overdose Management Consider the possibility of multiple drug ingestion. The pharmacokinetic profile of Methylphenidate HCl Extended-Release Capsules CD should be considered when treating patients with overdose. Because methylphenidate has a large volume of distribution and is rapidly metabolized, dialysis is not useful.
If an overdose of Methylphenidate HCl Extended-Release Capsules CD occurs, consider contacting the Poison Help line (1-800-222-1222) or a medical toxicologist for additional overdose management recommendations.
🧬 Clinical Pharmacology ▾
12 CLINICAL PHARMACOLOGY
12.1Mechanism of Action Methylphenidate hydrochloride is a central nervous system (CNS) stimulant. The mode of therapeutic action in ADHD is not known.
12.2Pharmacodynamics Methylphenidate is a racemic mixture comprised of the d - and l-threo enantiomers. The d-threo enantiomer is more pharmacologically active than the l-threo enantiomer. Methylphenidate blocks the reuptake of norepinephrine and dopamine into the presynaptic neuron and increases the release of these monoamines into the extraneuronal space.
12.3Pharmacokinetics Following one week of once-daily doses of 20 mg or 40 mg Methylphenidate HCl Extended-Release Capsules CD to children aged 7 to12 years old with ADHD, C max and AUC of methylphenidate were approximately proportional to the administered doses. Absorption Following administration of Methylphenidate HCl Extended-Release Capsules CD in children aged 7 to 12 years old with ADHD, the plasma concentration time profile of methylphenidate showed two phases of drug release with a sharp, initial slope similar to a methylphenidate immediate-release tablet (median T max1 about 1.5 hours post dose), and a second rising portion approximately three hours later (median T max2 about 4.5 hours post dose)*, followed by a gradual decline (Figure 1).
The means for C max and area under the curve (AUC) following a dose of 20 mg were slightly lower than those seen with 10 mg of the immediate-release formulation, dosed at 0 and 4 hours. *25-30% of the subjects had only one observed peak (C max ) concentration of methylphenidate. Figure 1: Comparison of Immediate Release (IR) and Methylphenidate HCl Extended-Release Capsules CD Formulations After Repeated Doses of Methylphenidate HCl in Pediatric Patients 7 to 12 Years of Age with ADHD Effect of Food Ingestion of a high-fat meal with Methylphenidate HCl Extended-Release Capsules CD increased the mean C max and AUC of methylphenidate by about 30% and 17%, respectively.
The presence of food delayed the early peak by approximately 1 hour (range -2 to 5 hours delay) [see Dosage and Administration ( 2.1 )] . The bioavailability (C max and AUC) of methylphenidate was unaffected by sprinkling the Methylphenidate HCl Extended-Release Capsules CD capsule contents on applesauce as compared to the intact capsule. Effect of Alcohol At an alcohol concentration of 40%, there was an increase in the release rate of methylphenidate in the first hour, resulting in 84% of the methylphenidate being released.
The results with the 60 mg capsule are considered to be representative of the other available capsule strengths [see Drug Interactions ( 7 )] . Distribution Plasma protein binding is 10% to 33%. The volume of distribution was 2.65 ±
1.11L/kg for d- methylphenidate and 1.80 ±
0.91L/kg for l- methylphenidate. Elimination The mean terminal half-life (t 1/2 ) of methylphenidate following administration of Methylphenidate HCl Extended-Release Capsules CD (t 1/2 =6.8 hours) is longer than the mean terminal t 1/2 following administration of methylphenidate hydrochloride immediate-release tablets (t 1/2 =2.9 hours) and methylphenidate hydrochloride extended-release tablets (t 1/2 =3.4 hours) in healthy adult volunteers. Metabolism In vitro studies showed that methylphenidate was not metabolized by cytochrome P450 isoenzymes.
Methylphenidate is metabolized primarily by deesterification to alpha-phenyl-piperidine acetic acid (ritalinic acid), which has little or no pharmacologic activity. Excretion After oral administration of radiolabeled methylphenidate in humans, about 90% of the radioactivity was recovered in urine. The main urinary metabolite was ritalinic acid, accounting for approximately 80% of the dose.
Specific Populations Male and Female Patients The pharmacokinetics of methylphenidate after a single dose of Methylphenidate HCl Extended-Release Capsules CD were similar between adult men and women. Racial or Ethnic Groups The influence of race on the pharmacokinetics…
🧬 Mechanism of Action ▾
12.1Mechanism of Action Methylphenidate hydrochloride is a central nervous system (CNS) stimulant. The mode of therapeutic action in ADHD is not known.
📦 How Supplied / Storage and Handling ▾
16 HOW SUPPLIED/STORAGE AND HANDLING How Supplied Methylphenidate HCl Extended-Release Capsules CD (methylphenidate HCl, USP) extended-release capsules are available in six strengths (see Table 4): Table 4: Strengths, Identifying Characteristics, and Packaging Configurations of Methylphenidate HCl Extended-Release Capsules CD Strength Capsule Color (cap/body) Imprinting on Capsule Cap Imprinting on Capsule Body Capsules per Bottle NDC Number 10 mg green/white “LANNETT 4579” in white letters “10 mg” in black letters 100 NDC 0527-4579-37 20 mg blue/white “LANNETT 4580” in white letters “20 mg” in black letters 100 NDC 0527-4580-37 30 mg reddish-brown/white “LANNETT 4581” in white letters “30 mg” in black letters 100 NDC 0527-4581-37 40 mg yellow ivory/white “LANNETT 4582” in black letters “40 mg” in black letters 100 NDC 0527-4582-37 50 mg purple/white “LANNETT 4583” in white letters “50 mg” in black letters 100 NDC 0527-4583-37 60 mg white/white capsules “LANNETT 4584” in black letters “60 mg” in black letters 100 NDC 0527-4584-37 Storage and Handling Store at 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F) [See USP Controlled Room Temperature].
📋 Description ▾
11 DESCRIPTION Methylphenidate HCl Extended-Release Capsules CD contains methylphenidate hydrochloride, a CNS stimulant. The extended-release capsules comprise both immediate-release (IR) and extended-release (ER) beads such that 30% of the dose is provided by the IR component and 70% of the dose is provided by the ER component. Methylphenidate HCl Extended-Release Capsules CD is available in six capsule strengths containing 10 mg (3 mg IR; 7 mg ER), 20 mg (6 mg IR; 14 mg ER), 30 mg (9 mg IR; 21 mg ER), 40 mg (12 mg IR; 28 mg ER), 50 mg (15 mg IR; 35 mg ER), or 60 mg (18 mg IR; 42 mg ER) of methylphenidate hydrochloride for oral administration.
Chemically, methylphenidate HCl is d , l (racemic)- threo -methyl α-phenyl-2-piperidineacetate hydrochloride. Its empirical formula is C 14 H 19 NO 2 •HCl. Its structural formula is: Methylphenidate HCl USP is a white, odorless, crystalline powder.
Its solutions are acid to litmus. It is freely soluble in water and in methanol, soluble in alcohol, and slightly soluble in chloroform and in acetone. Its molecular weight is 269.77.
Methylphenidate HCl Extended-Release Capsules CD also contains the following inactive ingredients: Dibutyl sebacate, ethylcellulose aqueous dispersion, gelatin, hydroxypropylmethylcellulose, polyethylene glycol, povidone, sugar spheres, and titanium dioxide. The individual capsules contain the following color agents: 10 mg capsules: FD&C Blue No. 2, FDA/E172 Yellow Iron Oxide 20 mg capsules: FD&C Blue No.
2 30 mg capsules: FD&C Blue No. 2, FDA/E172 Red Iron Oxide 40 mg capsules: FDA/E172 Yellow Iron Oxide 50 mg capsules: FD&C Blue No. 2, FDA/E172 Red Iron Oxide formula
💬 Information for Patients ▾
17 PATIENT COUNSELING INFORMATION Advise the patient to read the FDA-approved patient labeling ( Medication Guide ). Abuse, Misuse, and Addiction Educate patients and their families about the risks of abuse, misuse, and addiction of Methylphenidate HCl Extended-Release Capsules CD, which can lead to overdose and death, and proper disposal of any unused drug [see Warnings and Precautions ( 5.1 )], Drug Abuse and Dependence ( 9.2 ), Overdosage ( 10 )] . Advise patients to store Methylphenidate HCl Extended-Release Capsules CD in a safe place, preferably locked, and instruct patients to not give Methylphenidate HCl Extended-Release Capsules CD to anyone else.
Administration Instructions Instruct patients and their caregivers that the Methylphenidate HCl Extended-Release Capsules CD capsules and the capsule contents must not be crushed or chewed. Instruct patients that the capsule may be swallowed whole, or alternatively, the capsule may be opened and the capsule contents sprinkled onto a small amount (tablespoon) of applesauce and given immediately, and not stored for future use [see Dosage and Administration ( 2.3 )] . Risks to Patients with Serious Cardiac Disease Advise patients that there are potential risks to patients with serious cardiac disease, including sudden death, with Methylphenidate HCl Extended-Release Capsules CD use.
Instruct patients to contact a healthcare provider immediately if they develop symptoms such as exertional chest pain, unexplained syncope, or other symptoms suggestive of cardiac disease [see Warnings and Precautions ( 5.2 )] . Increased Blood Pressure and Heart Rate Instruct patients and their caregivers that Methylphenidate HCl Extended-Release Capsules CD can cause elevations of their blood pressure and pulse rate [see Warnings and Precautions ( 5.3 )] . Psychiatric Adverse Reactions Advise patients and their caregivers that Methylphenidate HCl Extended-Release Capsules CD, at recommended doses, can cause psychotic or manic symptoms, even in patients without a prior history of psychotic symptoms or mania [see Warnings and Precautions ( 5.4 )] .
Priapism Advise patients and their caregivers of the possibility of painful or prolonged penile erections (priapism). Instruct the patient to seek immediate medical attention in the event of priapism [see Warnings and Precautions ( 5.5 )] . Circulation Problems in Fingers and Toes (peripheral vasculopathy, including Raynaud’s phenomenon) Instruct patients about the risk of peripheral vasculopathy, including Raynaud’s phenomenon, and associated signs and symptoms: fingers or toes may feel numb, cool, painful, and/or may change color from pale, to blue, to red.
Instruct patients to report to their physician any new numbness, pain, skin color change, or sensitivity to temperature in fingers or toes. Instruct patients to call their physician immediately with any signs of unexplained wounds appearing on fingers or toes. Further clinical evaluation (e.g., rheumatology referral) may be appropriate for certain patients [see Warnings and Precautions ( 5.6 )] .
Long-Term Suppression of Growth in Pediatric Patients Advise patients and their caregivers that Methylphenidate HCl Extended-Release Capsules CD can cause slowing of growth and weight loss [see Warnings and Precautions ( 5.7 )] . Increased Intraocular Pressure (IOP) and Glaucoma Advise patients what IOP and glaucoma may occur during treatment with Methylphenidate HCl Extended-Release Capsules CD [see Warnings and Precautions ( 5.9 )] . Motor and Verbal Tics, and Worsening of Tourette's Syndrome Advise patients that motor and verbal tics and worsening of Tourette’s Syndrome may occur during treatment with Methylphenidate HCl Extended-Release Capsules CD.
Instruct patients to notify their healthcare provider if emergence of new tics or worsening of tics or Tourette’s syndrome occurs [see Warnings and Precautions ( 5.10 )] . Pregnancy Registry Inform patients that there is a pregnancy exposure registry that mon…
💬 Medication Guide ▾
MEDICATION GUIDE Methylphenidate HCl (meth” il fen’ i date hye” droe klor’ ide) Extended-Release Capsules CD, CII What is the most important information I should know about Methylphenidate HCl Extended-Release Capsules CD? Methylphenidate HCl Extended-Release Capsules CD may cause serious side effects, including: Abuse, misuse, and addiction. Methylphenidate HCl Extended-Release Capsules CD has a high chance for abuse and misuse and may lead to substance use problems, including addiction.
Misuse and abuse of Methylphenidate HCl Extended-Release Capsules CD, other methylphenidate medicines, and amphetamine medicines, can lead to overdose and death. The risk of overdose and death is increased with higher doses of Methylphenidate HCl Extended-Release Capsules CD or when it is used in ways that are not approved, such as snorting or injection. Your healthcare provider should check your child’s risk for abuse, misuse, and addiction before starting treatment with Methylphenidate HCl Extended-Release Capsules CD and will monitor your child during treatment.
Methylphenidate HCl Extended-Release Capsules CD may lead to physical dependence after prolonged use, even if taken as directed by your healthcare provider. Do not give Methylphenidate HCl Extended-Release Capsules CD to anyone else because it may cause death or harm them . Keep Methylphenidate HCl Extended-Release Capsules CD in a safe place and properly dispose of any unused medicine.
See “ How should I store Methylphenidate HCl Extended-Release Capsules CD? ” for more information. Tell your healthcare provider if your child has ever abused or been dependent on alcohol, prescription medicines, or street drugs. Risks for people with serious heart disease.
Sudden death has happened in people who have heart defects or other serious heart disease. Your healthcare provider should check your child carefully for heart problems before starting treatment with Methylphenidate HCl Extended-Release Capsules CD. Tell your healthcare provider if your child has any heart problems, heart disease, or heart defects.
Call your healthcare provider or go to the nearest hospital emergency room right away if your child has any signs of heart problems such as chest pain, shortness of breath, or fainting during treatment with Methylphenidate HCl Extended-Release Capsules CD. Increased blood pressure and heart rate. Your healthcare provider should check your child’s blood pressure and heart rate regularly during treatment with Methylphenidate HCl Extended-Release Capsules CD.
Mental (psychiatric) problems, including: new or worse behavior and thought problems new or worse bipolar illness new psychotic symptoms (such as hearing voices, or seeing or believing things that are not real) or new manic symptoms Tell your healthcare provider about any mental problems your child has, or about a family history of, suicide, bipolar illness, or depression. Call your healthcare provider right away if your child has any new or worsening mental symptoms or problems during treatment with Methylphenidate HCl Extended-Release Capsules CD, especially hearing voices, seeing or believing things that are not real, or new manic symptoms.
What is Methylphenidate HCl Extended-Release Capsules CD? Methylphenidate HCl Extended-Release Capsules CD is a prescription medicine used for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in children 6 to 15 years of age. Methylphenidate HCl Extended-Release Capsules CD may help increase attention and decrease impulsiveness and hyperactivity in people with ADHD.
Methylphenidate HCl Extended-Release Capsules CD is not recommended for use in children under 6 years of age with ADHD. Methylphenidate HCl Extended-Release Capsules CD is a federally controlled substance (CII) because it contains a methylphenidate that can be a target for people who abused prescription medicines or street drugs. Who should not take Methylphenidate HCl Extended-Release Capsules CD?
Do not take Methyl…