Methylphenidate ER chewable
QUILLICHEW ER
Pronunciation: meth-il-FEN-i-dayt (kwil-i-CHOO)
“Quill achoo!”
Scantron → methylphenidate product
It’s chewable
What it isExtended-release methylphenidate blocking dopamine and norepinephrine reuptake (QUILLICHEW ER, 2015); ADHD.
Why this oneThe chewable uses 30% IR / 70% ER, with 8-12 h (Carlat Table 1) of action.
What limits itAppetite loss, insomnia, cardiovascular stimulation, and abuse risk remain those of methylphenidate.
FDA-approved for
- ADHD (2015)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Attention deficit hyperactivity disorder (ADHD) | patients ≥6 years | 20 mg QD in the morning | titrate weekly by 10, 15, or 20 mg/day | 60 mg/day |
Titration Titrate weekly in increments of 10, 15, or 20 mg/day.
Renal Undefined
Hepatic Undefined
Not recommended in pediatric patients younger than 6 years.
Instructions
- Administer orally once daily in the morning, with or without food.
- Do not substitute for other methylphenidate products on a mg-per-mg basis.
- Screen for cardiac disease and for tics/Tourette's before initiating.
Available strengths
- chew tab 20, 30, 40 mg
- cap 20, 40, 60, 80, 100 mg
- tab 5, 10, 20 mg
- ER cap 10, 15, 20, 30, 40, 50, 60, 80, 100 mg
- ER tab 10, 18, 20, 27, 36, 45, 54, 63, 72 mg
- ODT 8.6, 17.3, 25.9 mg
- ER susp 600 mg/120 mL
- ER susp 750 mg/150 mL
- + 5 other marketed forms not shown
Contraindications
- Concurrent treatment with a monoamine oxidase inhibitor (MAOI), or use of an MAOI within the preceding 14 days, because of the risk of hypertensive crisis
Cautions
- Risks in serious cardiac disease
- Increased blood pressure and heart rate
- Psychiatric adverse reactions (new psychotic/manic symptoms)
- Priapism
- Peripheral vasculopathy including Raynaud's phenomenon
- Long-term growth suppression in pediatric patients
- Risks in phenylketonurics (contains phenylalanine)
- Acute angle-closure glaucoma
- Increased intraocular pressure
Adverse reactions
- Decreased appetite
- Insomnia
- Nausea
- Vomiting
- Dyspepsia
- Abdominal pain
- Weight decreased
- Anxiety
- Dizziness
- Irritability
- Affect lability
- Tachycardia
- Increased blood pressure
Pregnancy Limited data insufficient to inform drug-associated risk; no teratogenicity in animal studies at multiples of human dose.
Lactation Methylphenidate present in human milk (infant dose 0.16–0.7% of maternal weight-adjusted dose); monitor infant.
Cost
| Strength | #/mo | generic $/mo | brand $/mo | CostPlus | |
|---|---|---|---|---|---|
| 20 mg | chew tab | 4 q-wk | — | $47.60 | not offered |
| 30 mg | chew tab | 4 q-wk | — | $47.54 | not offered |
| 40 mg | chew tab | 4 q-wk | — | $47.49 | not offered |
Other forms: Methylphenidate (RITALIN) · Methylphenidate ER suspension (QUILLIVANT XR) · Methylphenidate ER (Relexxii) · Methylphenidate LA (RITALIN LA) · Methylphenidate ER (OROS) (CONCERTA) · Methylphenidate XR-ODT (COTEMPLA XR-ODT) · Methylphenidate patch (DAYTRANA) · Methylphenidate ER evening-dosed (JORNAY PM) · Methylphenidate CD (METADATE CD) · Methylphenidate oral solution (METHYLIN SOLUTION)
⚠ BOXED WARNING
- Abuse, misuse and addiction
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityHypertension, appetite/weight effects, misuse and stimulant-induced psychosis or arrhythmia.
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