# Daytrana ### (methylphenidate)
[**Full Prescribing Information**](https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=2c312c31-3198-4775-91ab-294e0b4b9e7f&type=display)[**DailyMed Drug Information**](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2c312c31-3198-4775-91ab-294e0b4b9e7f)
--- **Forms/Strengths** - **Patch:** 10 mg/9 hours, 15 mg/9 hours, 20 mg/9 hours, 30 mg/9 hours --- ### **Dosing** - **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 --- ### **Quick Facts** - 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 --- ### **Indications** - ADHD** (ICD-10: F90.0) --- ### **Off-Label Uses** - **N/A** --- ### **How to Take** - 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. --- ### **Side Effects** - 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 --- ### **Monitoring / Labs** - **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. --- ### **Education** - **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. --- ### **Additional Information** - **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).