Beginning in January, physicians will have the new option of a liquid long-acting methylphenidate treatment that requires only once-daily dosing. The medication, made by NextWave Pharmaceuticals (which will be sold to Pfizer), is called Quillivant XR and will be available at a 25mg/5ml (5mg/ml) concentration.
The recommended starting dose for children 6 years old and above will be 20mg and can be increased in 10-20mg increments per week up to a maximum of 60mg per day. In many ways, this dosing is similar to Concerta. The side effect profile is comparable to other stimulants. Peak plasma levels occur approximately 5 hours after dosing with effects marketed to last for up to 12 hours.
Short acting liquid methylphenidate has been available for many years. While these liquid preparations can be useful, some other longer acting stimulants such as Metadate CD and Adderall XR come in capsules that can be opened and sprinkled onto food. In addition, parents can help children learn how to swallow pills so that these types of preparations are not necessary. One technique I learned from our Director, Jim Hudziak, was to instruct parents to practice with mini M&Ms (the regular ones might be too big) and let children eat a few M&Ms for each one they swallow whole. A little practice is often all it takes.