II. Indications

  1. Attention Deficit Hyperactivity Disorder (ADHD)
    1. No longer available in United States
    2. Not recommended for use due to hepatotoxicty

III. Pharmacokinetics

  1. Onset: 2 hours
  2. Duration: 6 to 10 hours
  3. Steady state reached in 2 to 3 days
  4. Titrate dose every 3 to 4 weeks

IV. Dosing

  1. Range: 0.5 - 2.5 mg/kg/dose (Up to 112.5 mg/day)
  2. Start: 18.75 mg PO qAM
  3. Frequency: Once to twice daily

V. Monitoring

  1. Alanine Aminotransferase (ALT)
    1. Obtain baseline
    2. Repeat testing every 2 weeks
  2. Symptom inquiry at every visit
    1. Anorexia
    2. Malaise
    3. Gastrointestinal symptoms
    4. Dark Urine

VI. Precautions

  1. Informed Consent from parents required prior to use

VII. Adverse Effects

  1. Hepatic failure of dysfunction
  2. Choreoathetoid movements
  3. Other adverse effects similar to Methylphenidate

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