ADHD Medication and Treatment Reviews

Aptensio XR

Generic Name: methylphenidate

What is Aptensio XR?

Aptensio XR (Generic Name: methylphenidate) is a once-daily, timed-release stimulant medication primarily used to treat attention deficit hyperactivity disorder (ADHD) for children over age 6, adolescents, and adults. According to the FDA, Aptensio XR is a federally controlled substance (CII) because it can be abused or lead to dependence.

It has the same active ingredient as do medications like Ritalin and Daytrana. Aptensio XR may improve focus for people with inattentive ADHD, and decrease impulsivity and hyperactive behavior, the hallmark symptoms in patients with the condition. It has not been studied in children under the age of 6.

The American Academy of Pediatrics recommends treatment with behavioral therapy before medication for children under the age of 6. For children ages 6 to 11, the AAP says “The primary care clinician should prescribe US Food and Drug Administration–approved medications for ADHD and/or evidence-based parent- and/or teacher-administered behavior therapy as treatment for ADHD, preferably both.” Likewise, the National Institute of Mental Health finds the most successful treatment plans use a combination of ADHD medication, like Aptensio XR, and behavior therapies.

Aptensio XR is also sometimes used to treat narcolepsy.

How to Use Aptensio XR

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage for Aptensio XR

As with all medications, follow your Aptensio XR prescription instructions exactly. Aptensio XR is taken orally, with or without food, once daily. The first dose is typically taken first thing in the morning; it should be taken at the same time each day for the best results.

For updated information about dosages, interactions, and precautions, see the Aptensio XR drug monograph on WebMD.

Do not drink alcohol while taking this medication.

Capsules should be swallowed whole with water or other liquids. If your child is unable to swallow the capsule, it can be opened and sprinkled over a spoonful of applesauce. Taken this way, the mixture should be swallowed whole without chewing, followed by a drink of water or other liquid. Capsules should never by crushed or chewed.

Aptensio XR is a long-lasting, extended release form of methylphenidate, designed to maintain a steady level of medication in your body throughout the day.  Aptensio XR has twice the amount of methylphenidate as a tablet of Ritalin, to achieve the same effect over twice the time.

The optimal dosage varies patient by patient; is not determined by age, weight, or height, but rather by how a person metabolizes the medication. Your doctor may adjust your daily dosage by 10mg increments until you or your child experiences the best response — that is, the lowest dosage at which you experience the greatest improvement in symptoms without side effects.

Some patients report developing a tolerance to Aptensio XR after long-term usage. If you notice that your dosage is no longer controlling your symptoms, talk to your doctor to plan a course of action.

Side Effects Associated with Aptensio XR

The most common side effects of Aptensio XR are as follows: stomach pain, decreased appetite, headache, and trouble sleeping.

Other uncommon side effects can include priapism and circulation problems in fingers and toes. There has been some concern that stimulants may cause a slowing of growth in children and adolescents, however research findings are mixed. Some studies show no impact on growth at all,2 while others find what is considered “negligible” slowing of growth.3 If you find evidence of suppressed growth in your child, talk to your doctor about what steps might help.

Taking Aptensio XR may impair your or your teenager’s ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor. Most people taking this medication do not experience any of these side effects.

Disclose to your physician all mental health issues including any family history of suicide, bipolar illness, or depression. Aptensio XR may create new or exacerbate existing behavior problems, bipolar illness, or psychotic symptoms. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including hallucinations or sudden suspicions.

Discuss circulation problems with your doctor before taking Aptensio XR, which has been known to cause numbness, coolness, or pain in fingers or toes, including Raynaud’s phenomenon. Report to your doctor any new blood-flow problems, pain, skin color changes, or sensitivities to temperature while taking Aptensio XR.

Aptensio XR and Cardiac Side Effects

While there has long been concern that stimulant medication, Aptensio XR included, could potentially cause cardiac side effects. no evidence of this has been found. In fact, a recent meta-analysis of 19 observational studies including 3.9 million participants, found that stimulants do not place patients of any age at greater risk for cardiovascular events such as heart failure and hypertension.1

Patients with any heart-related problems or a family history of heart and blood pressure issues should discuss these conditions with their doctor before starting Aptensio XR. Call your doctor immediately if you or your child experiences warning signs such as chest pain, shortness of breath, or fainting.

During treatment, your doctor may periodically ask you to stop taking your Aptensio XR so that he or she can monitor ADHD symptoms; check vital statistics including blood, heart, and blood pressure; or evaluate height and weight. If any problems are found, your doctor may recommend discontinuing treatment.

Aptensio  and Substance Abuse

Research has clearly shown that substance abuse is rarely caused by stimulant medication.4  In fact, studies show that adolescents who use stimulants on a regular basis are far less likely to abuse other substances than teens with ADHD who are not treated.5

Aptensio XR is a “Schedule II Stimulant,” a designation that the Drug Enforcement Agency uses for drugs with a high potential for abuse, especially among people who do not have ADHD. Other Schedule II drugs include Dexedrine, Adderall, and cocaine. People with a history of drug abuse should use caution when trying this medication. Taking the medication exactly as prescribed can reduce potential for abuse.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions Associated with Aptensio XR

Store Aptensio XR in a secure place out of the reach of children and at room temperature. Do not share your Aptensio XR prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal, and can cause harm.

You should not take Aptensio if you are allergic to methylphenidate or other ingredients.

If you’re thinking of becoming pregnant, discuss the use of Aptensio XR with your doctor. Animal studies indicate a potential risk of fetal harm. Aptensio XR is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

The effects of Aptensio XR on children under six and on the elderly have not been studied.

Interactions Associated with Aptensio XR

Before taking Aptensio XR, discuss all other active prescription medications with your doctor. Aptensio XR can have a dangerous, possibly fatal, interaction with antidepressants including MAOIs.

Do not drink alcohol while taking this medication.

Exercise caution with medicines including antacids and dexmethylphenidates. Even over-the-counter medications may contain ingredients that raise or lower the level of the medication in your blood to a dangerous level.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking Aptensio XR before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

Aptensio XR: Next Steps

View Article Sources

1Zhang L, Yao H, Li L, et al. (2022). Risk of Cardiovascular Diseases Associated with Medications Used in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. JAMA Netw Open.

2 Harstad E, Weaver A, Katusic S, Robert C. Colligan, Kumar S, Chan E, Voigt R, Barbaresi W. (2014.) ADHD, Stimulant Treatment, and Growth: A Longitudinal Study. Pediatrics.

3 Greenhill L, Swanson J, Hechtman L, Waxmonsky J, Arnold L, Molina B, Hinshaw S, Jensen P, Abikoff H, Wigal T, Stehli A, Howard A, Hermanussen M, Hanć T (2020),Trajectories of Growth Associated With Long-Term Stimulant Medication in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder,
Journal of the American Academy of Child & Adolescent Psychiatry, v 59, Issue 8. 978-989,

4McCabe, S.E., Schulenberg, J.E., Wilens, T.E., Schepis, T.S., McCabe, V.V., Veliz, P.T. (2023). Cocaine or Methamphetamine Use During Young Adulthood Following Stimulant Use for Attention-Deficit/Hyperactivity Disorder During Adolescence. JAMA Netw Open. 6(7):e2322650.

5Wilens, T. E., Biederman, J., Mick, E., Faraone, S. V., & Spencer, T. (1997). Attention deficit hyperactivity disorder (ADHD) is associated with early onset substance use disorders. The Journal of nervous and mental disease.185(8), 475–482.!aptensio-xr-capsules-cii