Quillivant XR

Forms/Strengths

Age: ≥ 6 y/o
Onset: ~ 45 min
Duration: ~ 12 hours
Release Profile: 20% IR, 80% ER
Considerations: Fruit-flavored; Shake bottle vigorously for at least 10 seconds before administering. May be taken with or without food. Store at room temperature. Suspension expires four months after reconstitution.
Initial Dose: 20 mg
Titration: 10-20 mg weekly
Max Dose: 60 mg/day

Blocks dopamine/norepinephrine reuptake; enhances focus, attention, and impulse control
Extended-release oral suspension with dual-phase release for immediate and sustained effect
Unique liquid formulation ideal for patients who have difficulty swallowing pills
Common side effects: decreased appetite, insomnia, stomach upset, headache

Take once daily in the morning to minimize the risk of insomnia.
Shake the bottle well for at least 10 seconds before each dose to ensure proper mixing.
Measure the dose accurately using the provided oral dosing syringe—do not use household spoons.
Can be taken with or without food; high-fat meals may delay absorption.
Avoid taking late in the day to prevent sleep disturbances.

Common: Decreased appetite, insomnia, nausea, vomiting, abdominal pain, weight loss, anxiety, dizziness, irritability, tachycardia, increased blood pressure.
Serious: Cardiac events, psychiatric symptoms, priapism, peripheral vasculopathy, growth suppression, glaucoma, tics.

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.
- 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 caffeine and other stimulants, which may amplify side effects.
- Ensure adequate hydration and nutrition, as appetite suppression is common.
- Tapering may be required if discontinuing after long-term use.
Parent Tips for Pediatric Patients:
- Encourage a nutrient-dense diet to counteract appetite suppression.
- Administer in the morning before school for optimal effect.
- Monitor school performance and behavioral changes.
- Observe for sleep disturbances; adjust timing if necessary.
- 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).