Ritalin/Ritalin LA Dosage/Direction for Use

Pre-treatment screening: Treatment should only be initiated by specialist physicians with experience in the use of the drug. Before initiating Ritalin 10/Ritalin LA treatment, patients should be assessed for pre-existing cardiovascular and psychiatric disorders and a family history of sudden death, ventricular arrhythmia and psychiatric disorders. Weight and height should also be measured before treatment and documented on a growth chart (see Contraindications and Precautions).
Dosage regimen: The dosage of Ritalin 10/Ritalin LA should be individualized according to the patient's clinical needs and responses.
Treatment with Ritalin 10/Ritalin LA should be initiated at a low dose, with increments at weekly intervals.
ADHD: In the treatment of ADHD, an attempt should be made to time administration of the drug to coincide with periods of greatest academic, behavioural, or social difficulties for the patient.
If symptoms do not improve after dose titration over a one-month period, the drug should be discontinued.
If symptoms worsen or other adverse effects occur, the dosage should be reduced or, if necessary, the drug discontinued.
If the effect of the drug wears off too early in the evening, disturbed behaviour and/or inability to go to sleep may recur. A small evening dose of Ritalin 10 mg tablet may help solve this problem.
Periodic assessment of the treatment in ADHD: Drug treatment does not need to be indefinite. Physicians should periodically re-evaluate the treatment with trial periods off medication to assess the patient's functioning without pharmacotherapy. Improvement may be sustained when the drug is either temporarily or permanently discontinued. When used in children with ADHD, treatment can usually be discontinued during or after puberty.
If therapy is interrupted for reasons other than those stated previously, it should not be restarted at the dose that had been reached prior to treatment interruption, but should be re-titrated.
Children and adolescents (6 years and over): Ritalin 10 tablets: Start with 5 mg once or twice daily (e.g. at breakfast and at lunch) with gradual increments of 5 or 10 mg weekly. The total daily dosage should be administered in divided doses.
In some children with ADHD, sleeplessness may occur as the effect of the drug wears off. On rare occasions, an additional dose at about 8.00 p.m. may help; a trial dose may help to clarify the issue in an individual case, if the symptom warrants treatment.
Ritalin LA capsules: Maximum daily doses: Daily doses above 60 mg are not recommended for the treatment of ADHD in children and adolescents.
Patients new to methylphenidate: The recommended starting dose of Ritalin LA who are currently not taking methylphenidate is 20 mg once daily.
Patients currently using methylphenidate: Treatment may be continued with the same daily dose. If the patient was previously treated with an immediate release formulation, a switch to an appropriate recommended dose of Ritalin LA should be made (see Switching patient's treatment from Ritalin 10 to Ritalin LA capsules as follows).
Adults: Only the Ritalin LA formulation should be used for the treatment of ADHD in adults.
Ritalin LA capsules: Maximum daily doses: Daily doses above 80 mg are not recommended for the treatment of ADHD in adults.
Patients new to methylphenidate: The recommended starting dose of Ritalin LA who are currently not taking methylphenidate is 20 mg once daily.
Patients currently using methylphenidate: Treatment may be continued with the same daily dose. If the patient was previously treated with an immediate release formulation, a conversion to an appropriate recommended dose of Ritalin LA should be made (see Switching patient's treatment from Ritalin 10 to Ritalin LA capsules as follows).
There are no differences recommended in dosing between male and female adult patients.
Use in Geriatric patients (65 years or above): Use of Ritalin LA in patients over 60 years of age has not been studied in controlled trials.
Switching patient's treatment from Ritalin 10 to Ritalin LA capsules: The recommended dose of Ritalin LA should be equal to the total daily dose of the immediate-release formulation not exceeding a total dose of 60 mg in children and 80 mg in adults. Examples involving switch from Ritalin 10 immediate-release tablets are provided in Table 4. (See Table 4.)

Click on icon to see table/diagram/image

For other methylphenidate regimens, clinical judgement should be used when selecting the starting dose.
Ritalin LA dosage may be adjusted at weekly intervals in 10 mg increments for children and in 20 mg increments for adults.
Narcolepsy: Ritalin 10: Adults: Administer the tablets in divided doses 2 or 3 times daily. The average dose is 20 to 30 mg daily. Some patients may require 40 to 60 mg daily. In others, 10 mg to 15 mg daily will be adequate. Patients who are unable to sleep if Ritalin 10 tablets are taken late in the day should take the last dose before 6 p.m.
Dosing for each patient requires titration to control symptoms. Single doses greater than 20 mg are associated with sympathomimetic side effects. Therefore, the average single dose should be less than 20 mg. A maximum total dose of 60 mg/day may be required.
Maximum daily doses: A maximum daily dose of 60 mg should not be exceeded for the treatment of narcolepsy.
Administration: Ritalin 10 tablets: The rate of absorption and, therefore, onset of action is faster when Ritalin 10 tablets are taken with food. Dosage should, therefore, be standardized in relation to food to ensure consistency of effect.
Doses should be administered 1-2 hours before the maximum effect is required.
Ritalin LA: Ritalin LA capsules should be administered orally once daily in the morning.
Ritalin LA may be swallowed as whole capsules or alternatively may be administered by sprinkling the capsule contents on a small amount of soft food (see specific instructions as follows).
Ritalin LA capsules and/or their contents should not be crushed, chewed or divided.
The capsules may be administered with or without food. A high fat breakfast may slow the rate of absorption and therefore onset of action. Dosage should, therefore, be standardised in relation to food to ensure consistency of effect.
Ritalin LA administered as a single daily dose provides comparable overall exposure (AUC) of methylphenidate compared to the same total dose of immediate-release tablets administered twice daily.
Sprinkling Ritalin LA capsule contents on food: Carefully open the Ritalin LA capsule(s) and sprinkle the beads over applesauce. The food should not be warm because it could affect the modified-release properties of the formulation. All of the mixture of drug and food should be immediately swallowed, unchewed. The drug and food mixture should not be stored for future use.