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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 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). So, buy Adderall overnight delivery
The following ADHD medications are 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.
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- You don’t need a referral from a doctor.
- The costs for ADHD medication and pharmacy services are out from your deductible.
Please note: for medicines that are not insuring, you pay all costs yourself .
Check your compensation
You can see exactly:
- Which ADHD medicines (and dosages) are fully back.
- Which ADHD Medication is partially back (and you have to pay extra)
- Which medication is not return 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 back according to the Medicines Reimbursement System (GVS).
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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 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 parenting support. Behavioral therapy is also indict if there are clear impairments in functioning. If non-drug treatment does not provide sufficient improvement, medication can be as support. Methylphenidate is then the first choice. In case of insufficient effect or bothersome side effects, atomoxetine or dexamphetamine may be to consider .
Modafinil is in narcolepsy in which daytime sleepiness is a priority. When cataplexy is paramount, sodium oxalate 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.
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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.
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 .
ADHD
In the case of long-term treatment (> 12 months), evaluate the use regularly (≥ 1×/year) by means of trial periods without medication.
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.
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 : registration of height (in children) and weight on the chart and an assessment of cardiovascular status (including measurement of blood pressure and heart rate and a family history of sudden cardiac/unreap 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 behavior, suicidal behavior, 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 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, unexplain syncope, or dyspnoea; direct cardiac evaluation is indicated. Do not use in cardiovascular disease unless cardiac advice has been obtain 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 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 if a mental disorder and suicidal tendencies develop or worsen.
Discontinuation may 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 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.
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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.
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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 view. 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
