ADHD Medication and Treatment Reviews

Focalin

Focalin is a stimulant ADHD medication used to treat symptoms of attention deficit hyperactivity disorder in children and adults. Learn about it uses, side effects, dosages, and warnings here.
Generic: Dexmethylphenidate HCL

By Janice Rodden Medically reviewed by William Dodson, M.D., LF-APA Reviewed on May 24, 2024
Click to Read 21 Comments & Reviews 💬

What is the ADHD Medication Focalin?

Focalin (Generic Name: dexmethylphenidate HCL) is a central nervous system stimulant ADHD medication primarily used to treat attention deficit hyperactivity disorder (ADHD or ADD) in children ages 6-12, adolescents, and adults. Focalin may improve focus, and decrease impulsivity and hyperactive behavior, hallmark ADHD symptoms in some patients with the condition. It contains the same active ingredient as medications like Ritalin and Daytrana.

Whenever methylphenidate is produced, it’s possible to produce equal amount of four different ways of arranging the methlyphenidate atoms called isomers or enantiomers.  With methylphenidate, only one of these four isomers (the right-handed or dextro-threo methylphenidate) has benefits for the impairments of ADHD. The other three isomers actually make the features of ADHD significantly worse. Two of these detrimental isomers were removed when Ritalin was brought to the market in 1956. The single active, beneficial isomer was brought to the market as Focalin IR (the immediate-release formulation that lasts 4 to 5 hours) and as Focalin XR (the extended-release formulation that lasts 8 to 10 hours).

Research has demonstrated that  having only the active isomer and none of the detrimental isomers makes Focalin more potent with fewer side effects compared to all other methylphenidate delivery systems such as Ritalin.

Focalin can also be used to treat narcolepsy.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Focalin vs. Adderall

Focalin is the brand name for the generic drug called dexmethylphenidate; Adderall is the brand name for dextroamphetamine/levoamphetamine salts. Both are stimulant medications prescribed to treat ADHD. Dexmethylphenidate is the active part of methylphenidate, which is why Focalin is considered twice as strong — on a mg-for-mg basis — as drugs such as Ritalin and Concerta.

What Is the Best Dosage of Focalin?

Nothing predicts the optimal dose of Focalin. Each person has a preference for one ADHD stimulant over another but nothing predicts in advance which molecule will work best. The dosage is adjusted to the individualized response of each person and to their tolerance of side effects. Focalin was the first ADHD stimulant not to receive arbitrary dosage maximums from the FDA; it rather emphasizes that there is a wide range of individual responses to stimulant medications.

For updated information about dosages, interactions, and precautions, see the Focalin drug monograph on WebMD.

As with all medications, follow your Focalin prescription instructions exactly.

During treatment, your doctor should check vital statistics including blood, heart, and blood pressure; or evaluate height and weight.

Some patients believe that they develop a tolerance to Focalin after long-term usage. There is little evidence that this occurs. If you think that your dosage is no longer controlling your symptoms, do not try to adjust your dosage on your own. Talk to your doctor to plan a course of action.

What Are the Side Effects of Taking Focalin?

Most people taking Focalin do not experience any side effects. That said, the most common side effects associated with Focalin are as follows:

  • stomach ache
  • nausea
  • decreased appetite
  • heart racing or palpitations
  • hand tremors

Serious Side Effects of Focalin

  • serious allergic reaction
  • possible slowing of growth in children
  • eyesight changes or blurred vision
  • priapism (a penis erection that does not go away after more than four hours)

Focalin and Heart- or Blood-Pressure Related Problems

Report to your doctor any heart-related problems or a family history of heart and blood pressure problems. Patients with structural cardiac abnormalities and other serious heart problems have experienced sudden death, stroke, heart attack, and increased blood pressure while taking Focalin although a casual relationship has never been found. Stimulants can increase blood pressure and heart rate. Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you or your child experiences warning signs such as chest pain, shortness of breath, or fainting while taking Focalin.

Focalin and Familial Mental Health

Also, disclose to your physician all mental health issues including any family history of suicide, bipolar illness, tics, or depression. Focalin may create new or exacerbate existing behavior problems, bipolar illness, or Tourette’s syndrome. It can cause psychotic or manic symptoms in children and teenagers. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including hallucinations or sudden suspicions.

Focalin and Circulation Problems

Discuss circulation problems with your doctor before taking Focalin, which has been known to cause numbness, coolness, or pain in fingers or toes, including Raynaud’s phenomenon. Report to your doctor any new blood-flow problems, pain, skin color changes, or sensitivities to temperature while taking Focalin.

Focalin and Substance Abuse

Stimulants like Focalin have a potential for abuse, especially among people who do not have ADHD. It is a “Schedule II Stimulant,” a designation that the Drug Enforcement Agency uses for drugs with a high potential for abuse. Other Schedule II drugs include Dexedrine, Ritalin, and cocaine. People with a history of drug abuse should use caution when trying this medication. Taking the medication exactly as prescribed can reduce potential for abuse.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

FDA Approval

The safety of Focalin for children under age 6 has not been studied by the FDA and so it is not FDA-approved for preschoolers. It has been extensively studied, however, by other governmental agencies and found to be both effective and safe down to 3 years of age. The effects of Focalin on adults over age 65 have not been studied.

What Precautions Are Associated with Focalin?


You should not take Focalin if you or your child have:

  • untreated glaucoma
  • tics or Tourette’s syndrome
  • a history of drug abuse
  • severe feelings of tension or agitation
  • an allergy to stimulant medications or any other ingredients in Focalin
  • taken or plan to take a monoamine oxidase inhibitor (MAOI) within 14 days

If you are thinking of becoming pregnant, discuss the use of Focalin with your doctor. The FDA designates dex-MPH as a Pregnancy Risk Category C, which means that no risk of birth defects, difficulty with the pregnancy, or problems during delivery or the post-partum period have been found but cannot be absolutely ruled out either. Dex-MPH (Focalin) is passed through breast milk. Although it has never been studied, the American Academy of Pediatrics recommends that mothers do not nurse while taking methylphenidate “out of an abundance of caution.”

Store Focalin in a secure place out of reach of children,and at room temperature. Do not share your Focalin prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal and can cause harm.

What Interactions Are Associated with Focalin?

Before taking Focalin, discuss all other active prescription medications with your doctor. Focalin can have a dangerous, possibly fatal, interaction with Monoamine Oxidase Inhibitor (MAOI) antidepressants.

Tell your doctor if you are taking seizure medications, blood thinners, blood pressure medication, or any medication containing a decongestant.

Share a list of all vitamin or herbal supplements and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking Focalin before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

For updated information about dosages, interactions, and precautions, see the Focalin drug monograph on WebMD.

Focalin and Other ADHD Medications: More Information

Sources:

1Focalin. Food and Drug Administration (2013). https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/021278s018,021802s028lbl.pdf

2Focalin. Food and Drug Administration (2019). https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/focalin.pdf

3Medication Guide Focalin. Food and Drug Administration (2019). https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/focalin_PPI.pdf

4Focalin vs. Adderall: What’s The Difference? (2018) https://www.drugs.com/medical-answers/focalin-adderall-difference-3120992/