Concerta Dosage/Direction for Use

Pretreatment Screening: Prior to treating patients with CONCERTA, assess: for the presence of cardiac disease (i.e., perform a careful history, family history of sudden death or ventricular arrhythmia, and physical exam) [see Risks to Patients with Serious Cardiac Disease under Precautions]; the family history and clinically evaluate patients for motor or verbal tics or Tourette's syndrome before initiating CONCERTA [see Motor and Verbal Tics, and Worsening of Tourette's Syndrome under Precautions].
Recommended Dosage: CONCERTA should be administered orally once daily in the morning with or without food.
CONCERTA must be swallowed whole with the aid of liquids, and must not be chewed, divided, or crushed [see Patient Counselling Information].
Patients New to Methylphenidate: The recommended starting dose of CONCERTA for patients who are not currently taking methylphenidate or stimulants other than methylphenidate is 18 mg once daily for children and adolescents and 18 or 36 mg once daily for adults (see Table 2).

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Patients Currently Using Methylphenidate: The recommended dose of CONCERTA for patients who are currently taking methylphenidate twice daily or three times daily, at doses of 10 to 60 mg/day, is provided in Table 3. Dosing recommendations are based on current dose regimen and clinical judgment. Conversion dosage should not exceed 72 mg daily. (See Table 3.)

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Other methylphenidate regimens: Clinical judgment should be used when selecting the starting dose.
Dose Titration: Doses may be increased in 18 mg increments at weekly intervals for patients who have not achieved an optimal response at a lower dose. Daily dosages above 54 mg in children and 72 mg in adolescents have not been studied and are not recommended. Daily dosages above 72 mg in adults are not recommended.
A 27 mg dosage strength is available for physicians who wish to prescribe between the 18 mg and 36 mg dosages.
Maintenance/Extended Treatment: There is no body of evidence available from controlled trials to indicate how long the patient with ADHD should be treated with CONCERTA. It is generally agreed, however, that pharmacological treatment of ADHD may be needed for extended periods.
The effectiveness of CONCERTA for long-term use, i.e., for more than 7 weeks, has not been systematically evaluated in controlled trials. The physician who elects to use CONCERTA for extended periods in patients with ADHD should periodically re-evaluate the long-term usefulness of the drug for the individual patient with trials off medication to assess the patient's functioning without pharmacotherapy.Improvement may be sustained when the drug is either temporarily or permanently discontinued.
Dosage Reduction and Discontinuation: If paradoxical aggravation of symptoms or other adverse reactions occur, reduce dosage or, if necessary, discontinue CONCERTA.
If improvement is not observed after appropriate dosage adjustment over a one-month period, discontinue CONCERTA.