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Side Effects of Dexmethylphenidate (Focalin)


Description: Focalin (generic name: dexmethylphenidate) is an oral medication used to treat attention deficit/hyperactivity disorder or ADHD. Focalin is available in an immediate-acting form and an extended release form. It is indicated for the treatment of adults and children six years of age or older. Dexmethylphenidate is a stimulant that works somewhat paradoxically to help people with ADHD focus and reduce their impulsiveness.

Serious Side Effects of Focalin

The most serious Focalin side effects arise in people who are allergic to it. These include anaphylaxis, angioedema, and hypersensitivity reactions to the drug. Anaphylaxis is a rapid and severe allergic reaction in which the heart rate increases, blood pressure decreases, and lung passageways tighten, leading to severe shortness of breath and dizziness. Angioedema is a severe allergic reaction in which the lips, tongue, and throat swell. This swelling can block air from passing and cause choking and death, if left untreated. Read more about serious side Focalin effects.


Furthermore, Focalin may provoke or worsen symptoms in people with existing cardiovascular diseases such as structural heart problems, serious heart arrhythmias, and coronary artery disease. One of the less discussed but certainly serious Focalin adverse effects is priapism, which is a painful erection lasting for several hours. (Focalin drug label as reported by the FDA, 2012).

Dangers of Focalin Addiction

While dependence and addiction are not technically dexmethylphenidate side effects, the drug is a stimulant, and therefore can be abused. Physicians may be reluctant to prescribe Focalin to people who have a history of drug dependence or alcoholism. People who chronically use Focalin may become dependent on the medication, need higher doses of the medicine to achieve the desired effect, and experience withdrawal symptoms is the medication is stopped. When used inappropriately, dexmethylphenidate can cause euphoria, so it is considered a potential drug of abuse. People who improperly use dexmethylphenidate are more likely to experience serious and perhaps life-threatening events such as psychosis (i.e. hallucinations, delusions, paranoia) and severe cardiac conditions. (Journal of Clinical Psychiatry, “Methylphenidate Abuse and Psychiatric Side Effects,” Oct 2001).

Common Side Effects of Focalin

According to the Focalin drug label, as reported by the FDA (2012), common Focalin side effects (e.g., side effects that occur in more than 10% of people taking the drug) include:

  • Headache
  • Anxiety
  • Insomnia (children)
  • Restlessness (adults)
  • Decreased appetite (children)
  • Dry mouth (adults)
  • Abdominal pain (children)
  • Less Common Focalin Side Effects

    According to the Focalin drug label as reported by the FDA (2012), other Focalin side effects are less common, occurring in 1 to 10% of people taking the medication include:

  • Dizziness (adults)
  • Fever (children)
  • Irritability (children)
  • Depression (children)
  • Mood swings (children)
  • Itchiness (children)
  • Nasal congestion (children)
  • Nausea (children)
  • Vomiting (children)
  • Decreased food intake to the point of weight loss (children)
  • Throat pain (adults)
  • Upset stomach or heartburn (children or adults)
  • Understand Your Risks with the Rxight® Genetic Test

    Rxight® genetic testing for ADHD medication side effects analyzes 18 genes to determine your individual metabolism of over 150 common prescription and OTC medications, including Focalin. The results of the Rxight® pharmacogenetic analysis helps determine the dosing and efficacy of these medications and thus allows patients, pharmacists and providers to devise the safest and most efficacious treatment plan. It requires a simple DNA sample from a cheek swab at your participating pharmacy which is sent to our lab for analysis, after which your results will be reviewed with you in detail.

    How Does Pharmacogenetic Testing Work?

    Pharmacogenetic testing is the study of how gene variants affect the processing of pharmaceutical agents in the body. So-called “fast metabolizers” are those individuals who process the medication quickly and thus may not receive therapeutic benefit at standard doses. In contrast, “slow metabolizers” do not process the medication at a normal rate in the liver, and thus are at risk for toxicity or side effects. With the testing results, you and your prescriber and pharmacist can determine the safest and most effective individualized medication treatment plan.


    Contributors to this Article:
    Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry

    Read more about Rxight® genetic testing for drug metabolism