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MEDICATION

There are 2 forms of Methylphenidate - fast acting which would normally have the brand names of Ritalin or Equasym or slow release with the brand names of Concerta or Equasym XL.

Ritalin comes in 10mg tablets, Equasym in 5mg, 10mg and 20mg, Concerta in 18mg and 36mg and Equasym XL in 10mg, 20mg and 30mg Capsules. These can be given under the consultant's guidelines and up to the various dosages, which the consultant prescribes.

As a rough idea the slow release form of Methylphenidate - Concerta works out roughly as below in comparison to the fast acting forms.

Concerta 18mg is roughly equal to 5mg of fast acting 3 times a day

Concerta 36mg is roughly equal to 10mg of fast acting 3 times a day

Concerta 54mg is roughly equal to 15mg of fast acting 3 times a day

Rough idea of how the Concerta Tablet works.



Rough graph of how Concerta works throughout the day.



A rough idea how the slow release form of Methylphenidate - Equasym XL works in comparison to the fast acting forms.

Equasym XL 10mg is roughly equal to 5mg of fast acting 2 times a day

Equasym XL 20mg is roughly equal to 10mg of fast acting 2 times a day

Equasym XL 30mg is roughly equal to 15mg of fast acting 2 times a day

This is from the information from the medication information leaflet.

Equasym XL consists of an immediate release component (30% of the dose) and a modified release component (70% of the dose). Hence Equasym XL 10mg yields an immediate-release dose of 3mg and an extended release dose of 7mg. The extended-release portion of each dose is designed to maintain a treatment response through the afternoon without the need for a midday dose. It is designed to deliver therapeutic plasma levels for a period which is consistent with the school day rather than the whole day.

Q. Can I crush the fast acting tablet if my child won't swallow it?

A. Crushing is not a good idea as the Ritalin/Equasym is bitter and swollowing is quicker as a tablet, than a powder or pieces. Try giving a quarter which is easier to swallow, placed far back on his tongue, where the bitterness is less obvious with his favourite drink. It should just wash down. When used to a quarter, try a two quarters (half) and eventually a full half and if required a whole eventually. Also compliment him when he manages to succeed. A sip of the drink before you start also helps. However crushed and mixed with something they like may be alright providing the bitter taste does not come through!

The Slow Release tablets such as Concerta XL and Equasym XL should not be crushed or opened in any way as this will make them ineffective.

^a From a question posted on adders.org forum and answered by Dr Billy Levin from South Africa

As I have said I am not medically qualified so these diagrams and explanations should be taken as very rough ideas from me and not as medical facts from either the pharmaceutical companies or the specialists.

- adders.org

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