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Adderall XR 10/ 10 mg strengths.

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Description

Buy Adderall XR 10 Online

Adderall XR 10mg Medications can be a valuable resource for ADHD. These medicines often contain the active ingredient Methylphenidate, which has a positive effect on your head, for example, if you have problems concentrating.

Methylphenidate is in the following medicines:

  • Ritalin
  • concerta
  • medikinet
  • Equasym
  • Kinectene

Dexamfetamine (or Amfexa) is also prescribed for a large number of people with ADHD. This substance has a similar effect to Methylphenidate. Finally, the doctor or psychiatrist sometimes prescribes Strattera (active ingredient: atomoxetine). Buy Adderall XR 10mg

Reimbursement basic insurance

The following ADHD medications are reimbursed from the basic insurance:

  • Ritalin
  • Medikinet (active ingredient: Methylphenidate) tablets of 5, 10 or 20 mg.

You pay your own risk for these resources.

For all other ADHD medication, for example, Strattera or dexamfetamine, you pay the full costs yourself or there is a personal contribution of up to 250 euros per year.

Requirements

  • You must have a referral from a doctor.
  • The costs for ADHD medication and pharmacy services are deducted from your deductible.

Please note: for medicines that are not insured, you pay all costs yourself

Check your compensation

You can see exactly:

  • Which ADHD medicines (and dosages) are fully reimbursed
  • Which ADHD Medication is partially reimbursed (and you have to pay extra)
  • Which medication is not reimbursed at all

Reimbursement of additional insurance

The personal contribution for ADHD medication is a maximum of 250 euros per person per year.

In 2021 you will therefore lose a maximum of 385 + 250 = 635 euros for medication that is reimbursed according to the Medicines Reimbursement System (GVS).

The personal contribution for ADHD medicines is partially or fully reimbursed by some health insurers via the additional health insurance.

These reimbursements per insurer are listed below. It is advisable to contact the relevant insurer for the exact conditions regarding the reimbursement.

The treatment of ADHD in children consists of non-pharmacological measures such as information, parenting advice and, if desired, parenting support. Behavioral therapy is also indicated if there are clear impairments in functioning. If non-drug treatment does not provide sufficient improvement, medication can be considered as support. Methylphenidate is then the first choice. In case of insufficient effect or bothersome side effects, atomoxetine or dexamfetamine may be considered.

Modafinil is recommended in narcolepsy in which daytime sleepiness is a priority. When cataplexy is paramount, sodium oxybate is the first choice. Pitolisant is effective on daytime sleepiness as well as on cataplexy. Sodium oxybate has a different mechanism of action than pitolisant and modafinil and therefore also has a positive influence on nighttime sleep. The choice of the most appropriate therapy for the individual patient is up to the doctor.

Methylphenidate is second choice for the indication narcolepsy where daytime sleepiness is the main focus.

  • ZIN report 2019 pitolisant in combination with methylphenidate – narcolepsy with and without cataplexy

Indications

Children > 6 years and adolescents: ADHD (attention deficit hyperactivity disorder), as part of a comprehensive treatment program (including psychological, educational, and social measures), if remedial education alone proves to be insufficient. Before treatment, thoroughly assess the severity and chronicity of the complaints in relation to the age of the child.

Medikinet CR: Adults: ADHD (attention deficit hyperactivity disorder), as part of a comprehensive treatment program, if remedial education alone proves to be insufficient. The diagnosis should be established through a structured patient interview with the finding of a moderate to severe functional impairment in at least two settings (such as social, academic, or occupational functioning), requiring a presence in childhood (retrospective). Treatment should not be initiated if third-party verification of childhood ADHD is uncertain.

Furthermore, only for regular tablets: narcolepsy.

  • ADHD in children

Dosage

Modified release formulations are not interchangeable due to differences in kinetics (see also Properties section).

Checklists (PDF files) for pre- and periodic check-ups in ADHD for physicians are available at methylphenidate-guide.eu . These checklists have been prepared by a number of methylphenidate manufacturers.

ADHD

In the case of long-term treatment (> 12 months), evaluate the use regularly (≥ 1×/year) by means of trial periods without medication. The treatment should not be indefinite; it is usually discontinued during or after puberty.

Discontinue treatment if no improvement in symptoms occurs within one month after appropriate dose adjustment.

Administration

  • Do not chew the modified-release tablet, but swallow it whole with liquid.
  • Swallow the Equasym XL and Medikinet CR capsules whole with some liquid, or open and divide the contents over a spoonful of applesauce; do not chew or crush the capsules or contents. Time of ingestion:
  • the Equasym XL capsule in the morning before breakfast;
  • the Medikinet CR capsule during or after breakfast (and lunch for adults) and with food. Do not take Medikinet CR capsule in children too late in the morning as this may cause sleep disturbances.

Side effects of Adderall XR 10mg

Very common (≥ 10%): insomnia, nervousness, headache, palpitations, decreased appetite, nausea, dry mouth.

Common (1-10%): nasopharyngitis, pharyngolaryngeal pain, upper respiratory tract infection, sinusitis, dyspnoea, anorexia, weight loss, severe retardation of weight and height gain during prolonged use in children, aggression, agitation, irritability, restlessness, anxiety, panic attack, stress, depression, decreased libido, erectile dysfunction, emotional lability, behavior abnormal, tics, tremor, mood swings, vertigo (or spinning), dyskinesia, bruxism, paraesthesia, psychomotor hyperactivity, somnolence, changes (usually increase) in blood pressure and heart rate, arrhythmia, tachycardia, hypertension upset stomach, dyspepsia, vomiting (symptoms of vomiting may be exacerbated especially in the beginning when taken with food), diarrhoea, cough, sore throat, toothache, impaired visual accommodation, alopecia, rash,itching, urticaria, arthralgia, cold extremities, hyperhidrosis, fever, fatigue, asthenia, thirst, ALT increased.

Uncommon (0.1-1%): Hypersensitivity reactions such as angioedema, anaphylactic reactions and other skin abnormalities, psychotic disorders, suicidal ideation, hallucinations, hypervigilance, increased pre-existing tics and Tourette’s syndrome, akathisia, drowsiness, lethargy tremor, blurred vision, dry eye, chest pain, hot flush, constipation, gastroenteritis, liver enzyme elevation, myalgia, twitching, muscle tension, haematuria, heart murmur.

Rare (0.01-0.1%): mania, libido disorder, disorientation, angina pectoris, visual impairment, diplopia, gynaecomastia, menstrual disorder.

Very rare (<0.01%): anaemia, leucopenia, thrombocytopenia, thrombocytopenic purpura, suicidal behavior, apathy, repetitive behavior, thought abnormal, overconcentration, convulsions (incl. grand mal convulsions), choreoathetoid movements, neuroleptic malignant syndrome, cardiac arrest, myocardial infarction, cerebral arteritis and/or occlusion, Raynaud’s phenomenon, acute liver failure, hepatic coma, exfoliative dermatitis, erythema multiforme, erythema fixatum, muscle cramps, sudden cardiac death, increased alkaline phosphatase, increased bilirubin.

Also reported: priapism, pancytopenia, cases of abuse and addiction (more common in immediate release forms), logorrhea, tension, cerebrovascular disorders (vasculitis, stroke), aphasia, migraine, dysphemia. delusions, confusion, polyphrasia, mydriasis, ocular hypertension, trismus, bradycardia, extrasystoles, cardiac complaints, dry skin, flushing, retching, chest discomfort, incontinence, flu-like picture, tinnitus, epistaxis, hyperpyrexia, TSH increase.

  • Information from Lareb about this drug
  • Report form side effects

Interactions

Administration with or shortly after the use of MAO inhibitors is contraindicated and may lead to hypertensive crisis. This reaction can occur up to 14 days after the last dose of an irreversible MAO-inhibitor and 24 hours after the last dose of a reversible MAO-inhibitor.

Alcohol can exacerbate the central side effects and is not recommended. At particularly high alcohol concentration, the kinetic profile of modified release tablets may change towards more immediate release.

Serotonin syndrome may develop during concomitant use with serotonergic agents. Discontinue methylphenidate as soon as possible if serotonin syndrome is suspected (tachycardia, blood pressure fluctuations, hyperthermia, agitation, hallucinations, coma, hyperreflexia, incoordination, rigidity, nausea, vomiting, diarrhea.)

Certain drugs (such as acetazolamide, thiazide diuretics, and sodium hydrogen carbonate), as well as a vegetarian diet, can make urine alkaline and thus slow its excretion. Buy Adderall XR 10mg

Use caution with the concomitant use of halothane and related anesthetics because of sudden increases in blood pressure and the potential for arrhythmias.

The effect of antihypertensive drugs, guanidine derivatives, and methyldopa may be reduced.

Sympathomimetics and presumably also tricyclic antidepressants can potentiate the blood pressure-raising effect of amphetamines.

Antipsychotics can counteract most centrally stimulant effects.

The metabolism of vitamin K antagonists, anticonvulsants (phenobarbital, phenytoin, primidone), phenylbutazone and tricyclic antidepressants may be inhibited; dose reduction may be necessary.

Do not co-administer Medikinet CR with antacids, H2- receptor blocking agents or proton pump inhibitors as this accelerates the release of methylphenidate.

Pregnancy

Teratogenesis: In humans, limited data for the 2nd and 3rd trimesters. In animals indications of harmfulness at high doses.

Pharmacological effect: One study shows a slightly increased risk of heart defects in the 1st trimester, of which it is unclear whether these defects are really caused by methylphenidate. Neonatal cardiorespiratory toxicity, especially fetal tachycardia and respiratory distress, has been reported. Buy Adderall XR 10mg

Advice: Probably safe to use in the 1st trimester . Use not recommended in the 2nd and 3rd trimester .

  • Information from Lareb about this medicine during pregnancy

Lactation

Transition into breast milk: Yes.

Advice: Not to use this medicine or to breastfeed.

  • Information from Lareb about this drug during lactation

Contraindications

Cardiovascular disorders (severe hypertension, heart failure, arterial occlusive disease, potentially life-threatening arrhythmias, angina pectoris, hemodynamic significant congenital heart disease, cardiomyopathy, myocardial infarction and channelopathy).

Cerebrovascular disease, cerebral aneurysm, vascular abnormalities such as vasculitis and stroke.

(History of) anorexia, psychotic symptoms, major depression, suicidal tendencies, mania, severe mood disorder, schizophrenia or psychopathic/borderline personality disorder. (History of) severe type 1 bipolar disorder that is not well controlled.

Also: hyperthyroidism or thyrotoxicosis, glaucoma, pheochromocytoma.

For Medikinet CR: gastric acidity with pH > 5.5.

For more contraindications see the Interactions section.

Warnings and Precautions

Treatment should be under the supervision of a physician specialized in behavioral disorders in children, adolescents or adults. Buy Adderall XR 10mg

Controls

Before initiation of treatment is indicated: registration of height (in children) and weight on the growth chart and an assessment of cardiovascular status (including measurement of blood pressure and heart rate and a family history of sudden cardiac/unexplained death, ventricular arrhythmia and mental disorders).

During treatment growth in children (height and weight) or weight in adults, psychological status (e.g. control of tics, aggressive behaviour, suicidal behaviour, anxiety, agitation, depression, psychosis, mania, delusions, withdrawal symptoms, obsessive-compulsive disorder) blood pressure and heart rate at least every 6 months and after each dose adjustment.

Furthermore, control is indicated because of the risk of abuse and use for entertainment.

Suspend or interrupt

Discontinue treatment or reduce dose if symptoms paradoxically worsen

Discontinue treatment if symptoms of heart disease develop, such as palpitations, chest pain after exercise, unexplained syncope, or dyspnoea; direct cardiac evaluation is indicated. Do not use in cardiovascular disease unless cardiac advice has been obtained from the pediatrician.

Discontinue treatment at any sign of cerebral vasculitides, such as severe headache, numbness, weakness, paralysis, incoordination, memory impairment, visual, speech, or language impairment.

Interrupt treatment if growth retardation is suspected.

Discontinue treatment if seizures develop or worsen.

Methylphenidate may exacerbate behavioral and thinking disorders in psychotic patients. In case of undesirable behavioral change, consider adjustment of treatment: dose change or interruption of treatment.

Discontinuation may be indicated if a mental disorder and suicidal tendencies develop or worsen.

Discontinuation may be indicated for leukopenia, anemia and other hematological changes (e.g. indicative of severe renal or hepatic disease)

Careful monitoring is necessary after discontinuation as depression or chronic hyperactivity may be masked during treatment.

Other warnings

Bipolar Disorder: Take special care in patients with an increased risk of bipolar disorder; see also the section Contraindications.

Surgery: Methylphenidate should not be used on the day of a (planned) operation.

Abuse: Chronic abuse can lead to habituation and dependence with varying degrees of abnormal behavior.

Ocular Effects: This drug can cause acute glaucoma by increasing the intraocular pressure by mydriasis.

Comorbidities: Use caution with EEG abnormalities or epilepsy, drug or alcohol dependence or risk factors for these, and underlying medical conditions where a rise in blood pressure or heart rate may be dangerous.

Laboratory Testing: Methylphenidate can give false positive laboratory tests for amphetamines, especially on an immunoassay screening test.

Concerta and Kinecten: the non-absorbable shell of these tablets can be found in the feces, therefore do not use in severe gastrointestinal stricture, dysphagia, or severe swallowing difficulties. Buy Adderall XR 10mg

Study data: Use in children < 6 years and in the elderly (> 65 years) is not recommended, as safety and efficacy have not been established in this age group. There is no experience with methylphenidate in renal insufficiency and in hepatic insufficiency. The implications for long-term safety and efficacy are incompletely known. After use for more than 1 year, interrupt the treatment annually (in children preferably during school holidays) to determine whether continuation of the treatment is still necessary. Treatment is usually discontinued during or after puberty.

Driving ability: This medicine may affect the ability to drive and use machines. Consult ‘Drive Safely with Medicines’ of the IVM.

  • Drive Safely with Medicines

Overdose

See poisonings.info for symptoms and treatment.

Characteristics

Methylphenidate has a stimulating effect on the central nervous system. It is an indirectly acting sympathomimetic and resembles amphetamines in pharmacological properties. The mechanism of action is not fully known. It is believed that methylphenidate blocks the reuptake of norepinephrine and dopamine into the presynaptic neuron and thereby increases the release of neurotransmitters into the extraneuronal space. The mechanism of mental and behavioral effects has not yet been fully elucidated; there is also no convincing evidence linking these neuronal effects to the state of the central nervous system. The preparation falls under the full scope of the provisions of the Opium Act. Duration of action: regular tablet 3–5 hours; Concerta 12 hours; Medikinet CR and Equasym XL 8 hours. Buy Adderall XR 10mg

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