Cotempla for ADHD
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Cotempla is a long acting methylphenidate based stimulant that is FDA approved to treat pediatric ADHD.
Cotempla XR-ODT (methylphenidate) is a prescription medication that is FDA approved for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in pediatric patients aged 6 to 17 years. Cotempla XR-ODT is a central nervous system (CNS) stimulant that contains methylphenidate, which works by increasing the activity of certain chemicals in the brain to help improve attention and decrease impulsiveness and hyperactivity.
Cotempla XR-ODT is an extended-release orally disintegrating tablet that is designed to release the medication gradually over time, providing a steady level of medication throughout the day. The medication is intended to be taken once daily in the morning with or without food.
Given the current national shortage of Adderall, Cotempla is an excellent alternative. It is also a great alternative to Concerta or Ritalin LA - and it is a long-acting (XR) tablet that orally disintegrates. It is brand and avoids the issues we prescribers see with many of the generic forms of Concerta, ritalin, adderall, and adderall xr. It is very rare for an insurance company to refuse covering Cotempla entirely, but in the event that this does happen, the absolute most that anyone will pay out of pocket is $35. The pharmacist will help determine this very quickly.
Here is more information on what to watch for when taking stimulants:
Note: If there is a history of cardiac problems such as sudden cardiac death or arrhythmias in the immediate family (parents, siblings), please get an EKG prior to starting stimulants. Stimulants are thought to be safe on the heart but, like drinking high amounts of caffeine, stimulants can be problematic for people who have a family history of severe cardiac issues.
Stimulants are the most commonly prescribed treatment for ADHD & impulse control disorders. The reason for this is that they are SO effective and they tend to be reasonably well tolerated. That said, they have side effects to watch for. Here are the big 5 that we really want to watch for, followed by other issues to consider in general:
- Appetite suppression (with weight loss eventually)
- Irritability (either when on the med or, more likely, when it wears off)
- Anxiety while on the medication (just as caffeine makes some people more anxious)
- Insomnia
- Tics -- motor and/or verbal tics, which tend to be more of an issue in boys under the age of 10
The other fairly common (1/20 range) side effects to watch for include:
- GI (stomach) upset
- Headache
- Dry mouth
- Increased heart rate
- Increased blood pressure.
Extremely rare side effects include:
- Seizures
- Hallucinations
- Cardiac arrhythmias
