Relexxii Is an Extended-Release Methylphenidate Tablet for ADHD

Relexxii (methylphenidate hydrochloride extended-release) is a once-daily, oral ADHD medication approved for adults up to age 65 and children ages 6 and older. It belongs to the CNS stimulant drug class and is classified as a Schedule II controlled substance. Relexxii is manufactured by Vertical Pharmaceuticals, a subsidiary of Osmotica Pharmaceuticals.

If you've heard of Concerta, Relexxii uses the same osmotic-controlled release oral delivery system (OROS) technology — meaning the medication is released gradually through a laser-drilled hole in the tablet over the course of 6-7 hours, providing steady symptom control throughout the day.

What Is Relexxii Used For?

Relexxii is FDA-approved for one primary indication:

• Attention Deficit Hyperactivity Disorder (ADHD) in adults (up to age 65) and pediatric patients aged 6 years and older

ADHD is a neurodevelopmental disorder characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning. Relexxii helps manage these symptoms by increasing the availability of two key neurotransmitters — dopamine and norepinephrine — in the brain.

While methylphenidate as a class is sometimes used off-label for narcolepsy and treatment-resistant depression (as augmentation therapy), Relexxii is specifically approved and marketed for ADHD.

How Does Relexxii Work?

Relexxii contains methylphenidate, which works by blocking the reuptake of dopamine and norepinephrine into presynaptic neurons. In simple terms, it prevents your brain from reabsorbing these neurotransmitters too quickly, keeping more of them available in the spaces between neurons where they do their work — helping you focus, control impulses, and regulate attention.

What makes Relexxii unique is its osmotic delivery system. The tablet has three layers:

1. An immediate-release drug overcoat that provides a quick initial dose
2. An osmotically active bilayer core that slowly pushes medication through the tablet over hours
3. A semipermeable membrane shell that controls the rate of release

This design means you take one pill in the morning and get consistent medication delivery throughout the day — no peaks and valleys like you might get with immediate-release methylphenidate. For a deeper dive, read: How Does Relexxii Work? Mechanism of Action Explained in Plain English.

Relexxii Dosage: Strengths and How to Take It

Available Strengths

Relexxii comes in seven tablet strengths:

• 18 mg
• 27 mg
• 36 mg
• 45 mg
• 54 mg
• 63 mg
• 72 mg

The typical dose range is 18 mg to 72 mg once daily. Your doctor will usually start at a lower dose and increase gradually based on your response and tolerability.

How to Take Relexxii

• Take once daily in the morning — taking it later in the day can cause insomnia
• Swallow whole with a full glass of water or other liquid
• Do NOT cut, crush, or chew the tablet — this destroys the time-release mechanism and can cause the entire dose to be released at once
• Can be taken with or without food — though taking it with breakfast may reduce nausea

A note about the tablet shell: Because Relexxii uses a non-digestible osmotic shell, you may see what looks like the whole tablet in your stool. This is normal — the medication has already been absorbed, and you're just passing the empty shell.

Who Should Not Take Relexxii

Relexxii is not appropriate for everyone. You should not take it if you have:

• A known allergy to methylphenidate or any component of the tablet
• Current MAO inhibitor use (or use within the past 14 days) — this combination can trigger a dangerous hypertensive crisis
• Severe gastrointestinal narrowing — including conditions like esophageal motility disorders, small bowel inflammatory disease, short gut syndrome, a history of peritonitis, or cystic fibrosis. The rigid, non-deformable tablet could cause a GI obstruction.

Side Effects Overview

Like all stimulant medications, Relexxii has potential side effects. The most common include:

• Decreased appetite
• Headache
• Dry mouth
• Nausea
• Insomnia
• Anxiety
• Weight loss

Serious but rare side effects include cardiovascular events (increased blood pressure, heart rate, and in rare cases sudden death or stroke in patients with heart conditions), psychiatric symptoms (psychosis, mania, aggression), priapism, and peripheral vasculopathy (Raynaud's phenomenon).

Relexxii also carries a boxed warning about the high potential for abuse and dependence, as is standard for all Schedule II stimulants.

For a complete breakdown of side effects and when to seek emergency care, read: Relexxii Side Effects: What to Expect and When to Call Your Doctor.

How Much Does Relexxii Cost?

Cost varies significantly depending on whether you're getting brand-name Relexxii or its generic equivalent:

• Brand-name Relexxii: $350 to $505 per month (30 tablets) at retail without insurance
• Generic methylphenidate ER: $32 to $45 per month with discount coupons from GoodRx or SingleCare; retail generic around $39-$50

Most insurance plans cover generic methylphenidate ER on Tier 2 or Tier 3. Brand-name Relexxii may require prior authorization or step therapy (trying the generic first).

The manufacturer offers a Relexxii Savings Card for commercially insured patients — eligible patients may pay as little as $0 per month. Visit relexxii.com/savings for details.

For patients without insurance, GoodRx offers exclusive discounted pricing on the generic, and organizations like NeedyMeds and RxAssist can help connect patients with additional financial assistance.

For more cost-saving strategies, read: How to Save Money on Relexxii.

Relexxii vs. Other ADHD Medications

Relexxii isn't the only methylphenidate ER option on the market. Here's how it compares to some common alternatives:

• Concerta — Uses the same OROS technology as Relexxii. They're therapeutically similar, but pricing and availability may differ.
• Aptensio XR — An extended-release methylphenidate capsule that can be opened and sprinkled on applesauce, making it easier for patients who can't swallow tablets.
• Jornay PM — A unique methylphenidate formulation taken at night that's designed to be active by morning. Useful for patients who struggle with morning routine.
• Vyvanse (Lisdexamfetamine) — An amphetamine-based stimulant, representing a different drug class entirely. Often tried when methylphenidate doesn't provide adequate relief.

Is Relexxii Available During the Stimulant Shortage?

The methylphenidate ER shortage that began in late 2022 has affected multiple manufacturers and formulations. As of early 2026, the shortage has improved — the DEA increased production quotas by up to 25% in October 2025 — but intermittent supply disruptions continue at the pharmacy level.

Brand-name Relexxii has generally had more stable supply than some generic alternatives. If your pharmacy is out of stock, use Medfinder to quickly check which pharmacies near you have Relexxii available. For a detailed breakdown, read: How to Check If a Pharmacy Has Relexxii in Stock (Without Calling).

Thanks to a partnership between Relexxii's manufacturer and Medfinder, you can use Medfinder's medication locating services completely free of charge.

Finding a Doctor Who Prescribes Relexxii

Relexxii can be prescribed by psychiatrists, primary care physicians, pediatricians, neurologists, and qualified nurse practitioners or physician assistants. If you're looking for a provider, start with your current PCP — many are comfortable prescribing ADHD medications without a specialist referral.

For a complete guide to finding a prescriber, read: How to Find a Doctor Who Can Prescribe Relexxii Near You.

Final Thoughts

Relexxii is a well-established, once-daily ADHD treatment that uses proven osmotic delivery technology to provide consistent symptom control throughout the day. It's available in a wide range of strengths, has an affordable generic option, and — despite the ongoing stimulant shortage — has maintained relatively stable supply.

The manufacturer of Relexxii has partnered with Medfinder to provide medication locating services free of charge. Visit medfinder.com to find Relexxii in stock near you at no cost.

Whether you're newly diagnosed or considering switching from another ADHD medication, talk to your doctor about whether Relexxii is the right fit. And if cost or availability is a concern, tools like Medfinder and the Relexxii Savings Card can help.