9 Focalin Side Effects To Know About

Focalin (dexmethylphenidate) and its extended-release version, Focalin XR, are first-choice options for treating attention-deficit hyperactivity disorder (ADHD). It’s FDA approved for adults and children ages 6 and older.

Focalin is a stimulant. This plays a role in side effects you may experience while taking it. Here, we’ll review possible Focalin side effects to help you know what to expect.

Focalin side effects at a glance

Below is a list of common as well as rare but serious Focalin side effects reported in clinical studies.

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Common Focalin side effects include: 

• Upset stomach

• Nausea

• Stomach pain

• Decreased appetite

• Headache

• Fever

• Anxiety or irritability

• Dry mouth

• Sore throat

• Weight loss

• Trouble sleeping

• Dizziness

• Fast heart rate

• Increased blood pressure

Rare, but serious Focalin side effects include:

• Increased risk of heart attack, stroke, or sudden death from heart-related effects

• Mood changes

• Hallucinations

• Slowed growth in children taking Focalin

• New or worsening tics

• Priapism (erection that doesn’t go away)

• Decreased blood flow to extremities

• Increased risk of glaucoma

Focalin also carries a boxed warning for the risk of misuse and dependence. This is the FDA’s strictest warning for medications.

Let’s review nine Focalin side effects in greater detail, including what to do if they occur.

1. Upset stomach

Upset stomach, nausea, and stomach pain are the most common side effects reported by people taking Focalin.

EXPERT PICKS: WHAT TO READ NEXT

• Understanding stimulant medications: Focalin is a stimulant medication. Learn more about how stimulants affect your body and brain and what conditions they’re prescribed to treat.

• Which type of ADHD do I have? There are three types of ADHD. Understanding which type you or your child have may help you manage symptoms.

• How long does Focalin last? Learn more about how long Focalin’s effects last in the body.

Stomach-related side effects may go away on their own as you continue taking Focalin. Other tips that may help include taking Focalin with food and eating smaller, more frequent meals.

If stomach issues don’t go away or become worse, let your prescriber know. Switching from Focalin to Focalin XR may help reduce stomach issues for some people. A lower dose may also help.

2. Decreased appetite and weight loss

Focalin and other stimulants can reduce your appetite. This may also lead to unintended weight loss. Reduced appetite and weight loss can lead to nutritional problems and other health issues over time — especially for children taking Focalin.

Ways to manage decreased appetite while taking Focalin include:

• Eat a meal before you take your first Focalin dose of the day.

• Eat smaller, more frequent meals.

• Stick to simple foods, such as smoothies, soups, and oatmeal.

• Eat a larger meal in the evening or an additional snack at bedtime after Focalin wears off.

• If you’re taking Focalin XR, consider switching to the shorter-acting Focalin. This may help increase your midday appetite between doses.

Let your prescriber know if you or your child are having trouble getting enough calories or lose significant weight while taking Focalin. They may decide to lower your dose or try a different medication.

3. Headache

Headache is another common Focalin side effect. Keep in mind that headaches are also associated with ADHD itself. So it may be unclear if it’s the medication or the health condition causing them. Regardless, staying hydrated and being sure to eat a balanced diet can help prevent headaches.

Most headaches will resolve on their own. But if needed, an over-the-counter (OTC) pain medication may help. Reach out to your prescriber if headaches don’t go away or worsen. They can help determine if there’s something else causing them. Or they may decide to adjust your Focalin dosage or try a different ADHD medication altogether.

Good to know: It isn’t common, but Focalin can increase your risk of a stroke while you’re taking it. If you develop a sudden, severe headache along with symptoms such as vision changes or trouble walking or speaking, seek emergency care right away. These are possible stroke symptoms and require immediate care.

4. Dry mouth

Focalin and other stimulants are known to cause dry mouth. Dry mouth may be more likely in adults taking Focalin XR, but it’s possible with all forms of Focalin.

Dry mouth may get better as your body adjusts to taking Focalin. OTC remedies such as chewing sugar free gum or saliva substitutes may also help. And be sure to stay on top of your regular dental care, since dry mouth can make cavities more likely. Let your prescriber know if dry mouth doesn’t improve or worsens while taking Focalin.

5. Trouble sleeping

Since it’s a stimulant, Focalin can also cause trouble sleeping (insomnia). To help reduce the risk of insomnia, take Focalin XR first thing in the morning and avoid taking short-acting Focalin less than 4 hours before bedtime. This helps ensure the medication’s effects wear off by the time you want to go to sleep.

Insomnia may improve as your body adjusts to Focalin. But if it doesn’t, talk to your prescriber about whether a dose or medication change is an option for you.

6. Mood changes

Focalin’s stimulant effects can cause side effects such as anxiety, irritability, and agitation. These side effects often improve as your body adjusts to Focalin or with a lower dose.

Focalin can also cause more serious mood changes. It raises the levels of chemicals in your brain called dopamine and norepinephrine. This helps manage ADHD symptoms. But it may also cause or worsen depression-related symptoms for some people. In rare cases, more serious symptoms, such as hallucinations or delusions, can occur.

Let your prescriber know about any mood changes that appear while taking Focalin. They can decide on next steps based on your symptoms and personal history.

7. Heart problems

Heart-related side effects, such as a small increase in blood pressure and heart rate, are possible with Focalin. In most cases, these side effects are mild and improve over time.

More serious heart-related side effects of Focalin include an increased risk of heart attack, stroke, or an irregular heart beat (arrhythmia). Sudden death is less likely, but also possible. These more serious heart-related side effects aren’t common. But the risk may be higher if you’re living with a heart-related condition, such as high blood pressure or cholesterol levels.

Be sure your prescriber is aware you’re living with a heart-related condition before starting Focalin. They can help determine if it’s a safe option for you. If you develop a fast heart rate along with chest pain or trouble breathing, seek emergency care.

8. Slowed growth

Focalin may cause slowed growth in children, but this side effect doesn’t seem to be as concerning as previously thought. In most cases, growth delays are short-lived and aren’t a long-term issue. Still, there are steps you can take to help minimize this side effect.

Since Focalin can reduce your child’s appetite, focusing on proper nutrition can help support healthy growth. Taking regular breaks from Focalin, such as on weekends or over the summer, can also help reduce the possibility of growth delays.

Your child’s prescriber will also measure their height and weight regularly while they’re taking Focalin. This can help them identify any growth issues and take action to address it.

9. Dependence and misuse

Focalin and Focalin XR are controlled substances. This means they have a risk for misuse and dependence. Misusing Focalin can lead to a stimulant use disorder, or even a life-threatening overdose. So it may not be the best choice for those with a history of substance misuse.

These tips can help reduce the risk of this side effect while taking Focalin:

• Take Focalin exactly as prescribed. If you feel Focalin isn’t working for your symptoms, let your prescriber know. Don’t adjust your dose on your own.

• Take the lowest Focalin dose needed to treat your symptoms. Keeping a symptoms journal may help.

• Don’t stop taking Focalin without talking to your prescriber. Suddenly stopping Focalin may cause withdrawal symptoms. If you need to stop taking Focalin, your prescriber can give you instructions to stop taking it safely.

• Store Focalin in a secure place away from children or pets. This can help prevent an accidental overdose.

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Written by:

Alex Brewer, PharmD, MBA

Alex Brewer, PharmD, MBA, is a licensed pharmacist specializing in chronic disease and health and wellness. Upon completing his residency, he worked in the managed care field, conducting medication therapy management and adherence counseling sessions with Medicaid, Medicare, and private insurance patients, before transitioning to a career in medical writing.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Ferras Bashqoy, PharmD, BCCCP, BCPPS

Ferras Bashqoy, PharmD, BCCCP, BCPPS, is a clinical pharmacotherapy specialist in the Neonatal Intensive Care Unit (NICU) at Hassenfeld Children’s Hospital in New York City. His favorite part of the job is working with preterm newborns because they are strong and mighty despite their size.

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