Daytrana

Forms/Strengths

Age: ≥ 6 y/o
Onset: Approximately 2 hours after application
Duration: 9-hour wear time; continuous release for 9-12 hours
Considerations: Apply the patch to the hip area (alternating sites) 2 hours before the effect is needed. The patch may be removed earlier if shorter duration is desired or if late-day side effects occur. Monitor for skin rash or sensitivity. Discard patches appropriately.
Initial Dose: 10 mg patch applied daily
Titration: 5 mg every 3 - 7 days
Max Dose: 30 mg/day

Blocks dopamine/norepinephrine reuptake; improves focus and attention
Transdermal patch delivers controlled methylphenidate absorption; bypasses gastrointestinal metabolism
Apply to a clean, dry, non-irritated area on the hip
Avoid exposure to external heat sources
Monitor for skin reactions and psychiatric symptoms
Common side effects: skin irritation, decreased appetite, insomnia, headache

Apply the patch once daily in the morning to clean, dry skin.
Preferred application sites: hip area (alternating sides daily).
Press firmly for 30 seconds to ensure proper adhesion.
Wear the patch for 9 hours unless otherwise directed.
Avoid cutting the patch, as this may alter drug release.
Dispose of used patches by folding them in half and flushing or placing in a secure disposal container.

Common: Decreased appetite, insomnia, nausea, vomiting, weight loss, tics, affect lability, anorexia.
Serious: Cardiac issues, increased blood pressure, psychiatric reactions, seizures, priapism, peripheral vasculopathy, chemical leukoderma, contact sensitization

Cardiovascular: Baseline and routine monitoring of heart rate and blood pressure.
Growth in Pediatrics: Regular monitoring of height and weight to detect growth suppression.
Psychiatric Symptoms: Observe for mood changes, anxiety, or psychosis.
Abuse Potential: Monitor for misuse or diversion.

When to Call the Doctor:
- Severe mood changes, aggression, or suicidal thoughts.
- Chest pain, rapid heartbeat, shortness of breath (cardiovascular concerns).
- Uncontrolled movements, tics, or worsening anxiety.
- Signs of skin reactions (severe redness, swelling, blistering).
- Numbness, coldness, or color changes in fingers or toes (circulatory issues).
- Unexplained weight loss or delayed growth in pediatric patients.
Safety Tips:
- Monitor blood pressure and heart rate, especially in patients with cardiovascular risk.
- Use caution in patients with anxiety, bipolar disorder, or psychosis, as symptoms may worsen.
- Avoid heat exposure (e.g., hot showers, heating pads, strenuous exercise) as it may increase drug absorption.
- Ensure adequate hydration and nutrition, as appetite suppression is common.
- If patch falls off, replace with a new one but remove at the usual time.
Parent Tips for Pediatric Patients:
- Monitor for skin irritation; rotate application sites to prevent reactions.
- Encourage a nutrient-dense diet to counteract appetite suppression.
- Administer in the morning before school for optimal effect.
- Monitor school performance and behavioral changes.
- Communicate regularly with teachers and caregivers about medication effects.

Contraindications:
- Hypersensitivity to methylphenidate or formulation components.
- Use within 14 days of MAOI therapy (risk of hypertensive crisis).
- Symptomatic cardiovascular disease, moderate-to-severe hypertension, hyperthyroidism, glaucoma.
- History of substance use disorder, unless benefits outweigh risks.
Pregnancy:
- Category C; use only if benefits outweigh risks.
- May cause neonatal withdrawal symptoms or low birth weight.
Lactation:
- Excreted in breast milk; not recommended due to potential infant exposure.
Drug Interactions:
- Serotonergic drugs (e.g., SSRIs, SNRIs, MAOIs) increase serotonin syndrome risk.
- Acidifying agents (e.g., ascorbic acid) may reduce drug absorption.
- Alkalinizing agents (e.g., sodium bicarbonate) may increase methylphenidate levels.
- May potentiate hypertensive effects of certain medications (e.g., decongestants, beta-agonists).