1.2. Pediatrics
Many ADHD medications are FDA-approved for use in pediatric patients. In addition to the maximum FDA recommended doses, there is a column with maximum recommended doses from other medical and pharmacological literature sources. This information is obtained through the Psychotropic Medication Utilization Parameters for Children and Youth in Texas Public Behavioral Health (7th Version). 28 The Texas Vendor Drug Program’s Prior Authorization Criteria is set to approve maximum daily doses based off the recommendations outlined within this manual. Tables 3-5 summarize pediatric ADD/ADHD recommended daily doses based upon patient-specific characteristics including age and weight.
Drug Name | Dosage Form/Strength | Maximum Recommended Dosage | Maximum Recommended Dosage (PMUP#) |
---|---|---|---|
amphetamine salts (mixed)* (Adderall, generic) | 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, 30 mg tablets | 3 -17 years of age: 40 mg/day |
|
amphetamine salts, mixed* (Adderall XR, generic) | 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg ER capsules |
|
|
amphetamine salts, mixed* (Mydayis, generic) | 12.5 mg, 25 mg, 37.5 mg, 50 mg ER capsules | 13-17 years of age: 25 mg/day |
|
amphetamine (Adzenys XR-ODT) | 3.1 mg, 6.3 mg, 9.4 mg, 12.5 mg, 15.7 mg, 18.8 mg extended-release oral disintegrating tablets |
|
|
amphetamine (Dyanavel XR) | 5 mg, 10 mg, 15 mg, 20 mg ER tablets; 2.5 mg/mL ER oral suspension | 6-17 years of age: 20 mg/day | 6-17 years of age: 20 mg/ day |
amphetamine sulfate (Evekeo) | 5 mg, 10 mg tablets | 3 -17 years of age: 40 mg/day | 3 -17 years of age: 40 mg/day |
dexmethylphenidate (Focalin, generic) | 2.5 mg, 5 mg, 10 mg tablets | 6-17 years of age: 20 mg/day | greater than or equal to 6 years of age: 50 mg/day |
dexmethylphenidate (Focalin XR, generic) | 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 35 mg, 40 mg ER tablets | 6-17 years of age: 30 mg/day | greater than or equal to 6 years of age: 50 mg/day |
dextroamphetamine (generic) | 5 mg, 10 mg tablets | 3-16 years of age: 40 mg/day |
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dextroamphetamine (Dexedrine Spansules, generic) | 5 mg, 10 mg, 15 mg ER capsules | 6-17 years of age: 40 mg/day |
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dextroamphetamine (ProCentra, generic) | 5 mg/5 ml oral solution | 3-16 years of age: 40 mg/day |
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dextroamphetamine (Xelstrym) | 4.5 mg/9 hours, 9 mg/9 hours, 13.5 mg/ 9 hours, 18 mg/9 hours transdermal system | 6-17 years of age: 18 mg/ 9 hours patch daily | Greater than 6 years of age: 18 mg/9 hours patch daily |
dextroamphetamine (Zenzedi) | 2.5 mg, 5 mg, 7,.5 mg, 10 mg, 15 mg, 20 mg, 30 mg tablets | 3-16 years of age: 40 mg/day |
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lisdexamfetamine (Vyvanse) | 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, 70 mg capsules; 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg chewable tablets | 6-17 years of age: 70 mg/day |
|
methamphetamine (generic) | 5 mg tablets | 6-17 years of age: 25 mg/day | N/A |
methylphenidate (Aptensio XR) | 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg ER capsules | 6-17 years of age: 60 mg/day | † |
methylphenidate (Concerta, generic) | 18 mg, 27 mg, 36 mg, 54 mg ER tablets | 6-12 years of age: 54 mg/day |
|
methylphenidate (Cotempla XR-ODT) | 8.6 mg, 17.3 mg, 25.9 mg orally disintegrating tablets | 6-17 years of age: 51.8 mg/day | 6-17 years of age: 51.8 mg/day |
methylphenidate (Daytrana) | 10 mg/9h, 15 mg/9h, 20 mg/9h, 30 mg/ 9h transdermal patches | 6-17 years of age: 30 mg/9 h/day |
|
methylphenidate (Jornay PM) | 20 mg, 40 mg, 60 mg, 80 mg, 100 mg ER capsules | 6-17 years of age: 100 mg/day | greater than or equal to6 years of age: 100 mg once daily given in the evening |
methylphenidate (Metadate CD, generic) | 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg ER capsules | 6-17 years of age: 60 mg/day | † |
methylphenidate (generic) | 10 mg, 20 mg ER tablets | 6-17 years of age: 60 mg/day | † |
methylphenidate (Methylin, generic) | 5 mg/5 mL (500 mL); 10 mg/5 mL (500 mL) IR oral solution | 6-17 years of age: 60 mg/day | † |
methylphenidate (generic) | 2.5 mg, 5 mg, 10 mg immediate-release (IR) chewable tablets | 6-17 years of age: 60 mg/day | † |
methylphenidate (Relexxii) | 18 mg, 27 mg, 36 mg, 45 mg, 54 mg, 63 mg, 72 mg ER tablets |
| N/A |
methylphenidate (Ritalin, generic) | 5 mg, 10 mg, 20 mg IR tablets | 6-17 years of age: 60 mg/day | † |
methylphenidate (Ritalin LA, generic) | 10 mg, 20 mg, 30 mg, 40 mg, 60 mg (generic only) ER capsules | 6-17 years of age: 60 mg/day | † |
methylphenidate (QuilliChew ER) | 20 mg, 30 mg, 40 mg ER chewable tablets | 6-17 years of age: 60 mg/day | † |
methylphenidate (Quillivant XR) | 300 mg/60 ml, 600 mg/120 ml, 750 mg/150 ml, 900 mg/180 ml ER suspension | 6-17 years of age: 60 mg/day | † |
serdexmethylphenidate & dexmethylphenidate (Azstarys) | 26.1 mg/5.2 mg, 39.2 mg/7.8 mg, 52.3 mg/10.4 mg capsules | 6-17 years of age: 52.3 mg/10.4 mg daily | N/A |
serdexmethylphenidate & dexmethylphenidate (Azstarys) | 26.1 mg/5.2 mg, 39.2 mg/7.8 mg, 52.3 mg/10.4 mg capsules | 6-17 years of age: 52.3 mg/10.4 mg daily | Greater than 6 years of age: 52.3 mg/10.4 mg daily |
Legend:
- # Psychotropic Medication Utilization Parameters
- * Mixed amphetamine salts are a 1:1:1:1 combination of dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine aspartate monohydrate and amphetamine sulfate
- † PMUP recommends the following literature based maximum methylphenidate dosing:
- 3-5 years of age: 22.5 mg/day
- Greater than or equal to 6 years of age & less than or equal to50 kg: 60 mg/day
- Greater than or equal to 6 years of age & greater than 50 kg: 100 mg/day
- Any dose of methylphenidate exceeding 60 mg/day should be used with caution, and with attentive monitoring
Drug Name | Dosage Form/Strength | Maximum Recommended Dosage | Maximum Recommended Dosage (PMUP#) |
---|---|---|---|
atomoxetine (Strattera, generics) | 10 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg 100 mg capsules |
| greater than or equal to 6 years of age: 1.8 mg/kg/day or 100 mg/day, whichever is less |
viloxazine (Qelbree) | 100 mg, 150 mg, 200 mg | 6-17 years of age: 400 mg/day | Greater than or equal to 6 years of age: 400 mg/day |
Legend:
- # Psychotropic Medication Utilization Parameters
Drug Name | Dosage Form/Strength | Maximum Recommended Dosage | Maximum Recommended Dosage (PMUP#) |
---|---|---|---|
clonidine (generic) | 0.1 mg ER tablets | 6-17 years of age: 0.4 mg/ day |
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guanfacine (Intuniv, generic) | 1 mg, 2 mg, 3 mg, 4 mg ER tablets |
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Legend:
- # Psychotropic Medication Utilization Parameters