Quillivant XR

What Is Quillivant XR?

Quillivant XR (generic name: methylphenidate) is the only liquid, extended release methylphenidate product available to treat attention deficit hyperactivity disorder (ADHD or ADD) in children ages 6+ and adults. Quillivant XR may improve focus, and decrease impulsivity and hyperactive behavior.

It contains the same active ingredient as Ritalin. Quillivant XR is a federally controlled substance (CII) because it can be abused or lead to dependence, according to the FDA. 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 Quillivant XR, and behavior therapies.

Quillivant XR can also be used to treat narcolepsy.

How Do You Use Quillivant XR?

Before starting or refilling a Quillivant XR prescription, read the medication guide included with your pills, as it may be updated with new information.

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.

What Is the Dosage for Quillivant XR?

As with all medications, follow your Quillivant XR prescription instructions exactly. Quillivant XR is a banana-flavored liquid formulation that is especially useful for the one-third of children who can’t swallow pills and for people of any age who need very low doses of methylphenidate medication.

Quillivant XR releases the first dose of methylphenidate in 45 minutes and slowly keeps working for up to 12 hours. It is taken once daily in the morning with or without food. Shake the bottle well for at least 10 seconds, and then measure the medicine with the included syringe. The time-release formulation is designed to maintain a steady level of medication in your body throughout the day.

The optimal dosage of Quillivant XR varies by patient. It is not determined by age, weight, or height, but rather by how a person metabolizes the medication, and the condition treated. Your doctor may adjust your daily dosage 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. For updated information about dosages, interactions, and precautions, see the Quillivant XR drug monograph on WebMD.

During treatment, your doctor may periodically ask you to stop taking your Quillivant XR so that they 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.

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

What Side Effects Are Associated with Quillivant XR?

The most common side effects of Quillivant XR are as follows: decreased appetite, weight loss, nausea, stomach pain, dry mouth, vomiting, trouble sleeping, anxiety, nervousness, restlessness, mood swings, agitation, irritability, dizziness, shaking, blurred vision, increased blood pressure, fast heartbeat, increased sweating, and fever.

Other serious side effects include seizures, priapism, and eyesight changes or blurred vision.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,¹ while others find what is considered “negligible” slowing of growth.² If you find evidence of suppressed growth in your child, talk to your doctor about what steps might help.

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.

Report to your doctor any heart-related problems or a family history of heart and blood pressure problems. Patients with structural cardiac abnormalities and other serious heart problems have experienced sudden death, stroke, heart attack, and increased blood pressure while taking Quillivant XR. Stimulants can increase blood pressure and heart rate. Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you or your child experiences warning signs such as chest pain, shortness of breath, or fainting while taking Quillivant XR.

Also disclose to your physician all mental health issues, including any family history of suicide, bipolar illness, tics, or depression. Quillivant XR may create new or exacerbate existing behavior problems, bipolar illness, or Tourette’s syndrome. The FDA recommends evaluating patients for bipolar disorder, tics, and Tourette’s syndrome prior to stimulant administration, which can cause psychotic or manic symptoms in children and teenagers. 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 Quillivant 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 Quillivant XR.

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

What Precautions Are Associated with Quillivant XR?

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

You should not take Quillivant XR if you have any of the following conditions: allergy or hypersensitivity to methylphenidate or any of the ingredients in Quillivant XR medications or if you are taking monoamine oxidase inhibitors (MAOIs).

You should use caution taking Quillivant XR if you have a history of heart or mental problems or circulation problems.

If you’re thinking of becoming pregnant, discuss the use of Quillivant XR with your doctor. It is not known if it will cause fetal harm. Quillivant XR is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

The safety of Quillivant XR for children under 6 has not been established.

What Interactions Are Associated with Quillivant XR?

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

Tell your doctor if you are taking seizure medications, blood thinners, blood pressure medication, or any medication containing a decongestant.

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 Quillivant XR before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

Quillivant XR and Other ADHD Medications: More Information

• A Parent’s Guide to ADHD Medications
• Free Resource: How Do We Know the Medication is Working?
• Dear ADDitude: What Should We Expect from Quillivant?
• Making the Switch: Trying a New ADHD Medication
• ADDitude Directory: Find ADHD Specialists or Clinics Near You

Sources:

¹Pediatrics (2014.) “ADHD, Stimulant Treatment, and Growth: A Longitudinal Study.” https://publications.aap.org/pediatrics/article-abstract/134/4/e935/77034/ADHD-Stimulant-Treatment-and-Growth-A-Longitudinal

²Journal of the American Academy of Child & Adolescent Psychiatry. (2019.) “Trajectories of Growth Associated With Long-Term Stimulant Medication in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder.” https://www.jaacap.org/article/S0890-8567(19)31443-1/fulltext

http://www.accessdata.fda.gov/drugsatfda_docs/label/2017/202100s012lbl.pdf
https://www.quillivantxr-quillichewer.com/