What Is Focalin XR?

Focalin XR (Dexmethylphenidate Hydrochloride extended-release) is a prescription CNS stimulant medication approved by the FDA for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in patients aged 6 years and older. It is manufactured by Novartis Pharmaceuticals and is available in both brand-name and generic forms.

Focalin XR is the extended-release version of Focalin, designed to be taken once daily in the morning. The capsules use a dual-bead technology that releases half the dose immediately and the other half approximately 4 hours later, providing up to 12 hours of symptom control.

Dexmethylphenidate is the more pharmacologically active d-threo enantiomer of Methylphenidate (the active ingredient in Ritalin and Concerta), which means it may provide equivalent efficacy at roughly half the dose of racemic Methylphenidate.

How does Focalin XR work?

Focalin XR works by blocking the reuptake of two key neurotransmitters — dopamine and norepinephrine — into presynaptic neurons in the brain. By preventing these neurotransmitters from being reabsorbed, Focalin XR increases their availability in the extraneuronal space, particularly in the prefrontal cortex.

This enhanced dopamine and norepinephrine signaling improves attention, focus, and impulse control — the core symptoms of ADHD. The extended-release capsule uses a bimodal release mechanism: approximately 50% of the dose is released immediately, with the remaining 50% released about 4 hours later, mimicking twice-daily dosing in a single capsule.

What doses are available for Focalin XR?

• Focalin XR (extended-release capsules): 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg, 35 mg, 40 mg
• Focalin (immediate-release tablets): 2.5 mg, 5 mg, 10 mg

Most adults are prescribed between 10 mg and 40 mg daily. Children aged 6 and older typically start at 5 mg/day and may be increased in 5 mg increments weekly up to 30 mg/day.

How hard is it to find Focalin XR in stock?

Focalin XR has a findability score of 35 out of 100, meaning it is currently very difficult to find in stock at most pharmacies. The broader ADHD stimulant shortage that began in October 2022 continues to affect Dexmethylphenidate ER products in 2026. Multiple manufacturers have limited supply across various strengths, and many pharmacies experience intermittent stock-outs.

Patients may need to call multiple pharmacies, check independent pharmacies, or use tools like Medfinder to locate Focalin XR in stock near them. Some strengths may be more available than others, so ask your prescriber about dose flexibility.

Who Can Prescribe Focalin XR?

As a Schedule II controlled substance, Focalin XR must be prescribed by a licensed healthcare provider with prescribing authority. Common prescribers include:

• Psychiatrists — specialists in ADHD and mental health conditions
• Pediatricians — for children and adolescents with ADHD
• Family Medicine physicians — primary care doctors who manage ADHD
• Internal Medicine physicians — for adult ADHD management
• Neurologists — particularly for complex or treatment-resistant cases
• Nurse Practitioners and Physician Assistants — with appropriate prescribing authority (varies by state)

Telehealth providers can also prescribe Focalin XR in many states, though some states have restrictions on prescribing Schedule II stimulants via telemedicine. Use Medfinder to find prescribers near you.

Is Focalin XR a controlled substance?

Yes. Focalin XR is classified as a Schedule II (CII) controlled substance by the DEA. This is the most restrictive category for medications with accepted medical use, indicating a high potential for abuse and dependence.

Because of its Schedule II status:

• Prescriptions cannot be called in to pharmacies — a written or electronic prescription is required
• No refills are allowed; a new prescription is needed each time
• Pharmacies may have quantity limits or additional verification requirements
• Some pharmacies limit their stock of Schedule II stimulants, making shortages worse

The boxed warning on Focalin XR states that CNS stimulants have a high potential for abuse and dependence, and prescribers should assess abuse risk before prescribing and monitor patients during therapy.

Common Side Effects of Focalin XR

Like all stimulant medications, Focalin XR can cause side effects. Most are mild and may improve over time. Common side effects include:

• Decreased appetite and weight loss
• Headache
• Dry mouth
• Nausea and stomach pain
• Anxiety and feeling jittery
• Insomnia (trouble sleeping)
• Dizziness

Serious side effects that require immediate medical attention include:

• Cardiovascular events (chest pain, shortness of breath, fainting)
• Increased blood pressure and heart rate
• New or worsening psychiatric symptoms (psychosis, mania, aggression)
• Circulation problems in fingers and toes (Raynaud's phenomenon)
• Serotonin syndrome (when combined with serotonergic drugs)
• Seizures
• Priapism (prolonged erection)

Contact your doctor if side effects are persistent or concerning. Regular monitoring of blood pressure, heart rate, and growth (in children) is recommended.

Alternative Medications to Focalin XR

If you cannot find Focalin XR in stock or need to switch medications, these are common alternatives your doctor may consider:

• Concerta (Methylphenidate ER) — Extended-release methylphenidate using OROS technology, lasts up to 12 hours
• Vyvanse (Lisdexamfetamine) — Prodrug amphetamine stimulant, lasts up to 14 hours, lower abuse potential
• Adderall XR (Mixed Amphetamine Salts ER) — Extended-release mixed amphetamine salts, lasts up to 12 hours
• Ritalin LA (Methylphenidate ER) — Extended-release methylphenidate with bimodal release, lasts up to 8 hours
• Focalin IR (Dexmethylphenidate immediate-release) — Same active ingredient, taken 2–3 times daily
• Strattera (Atomoxetine) — Non-stimulant ADHD medication, not a controlled substance
• Qelbree (Viloxazine ER) — Non-stimulant option approved for ADHD

Always consult your prescriber before switching medications. Do not stop taking Focalin XR abruptly without medical guidance.

Drug Interactions with Focalin XR

Focalin XR can interact with several classes of medications. Always inform your doctor about all medications, supplements, and herbal products you take.

Major interactions (avoid combining):

• MAO inhibitors (e.g., Selegiline, Phenelzine) — risk of hypertensive crisis; do not use within 14 days of an MAOI
• Serotonergic drugs (SSRIs, SNRIs, Triptans, Tricyclic Antidepressants) — risk of serotonin syndrome

Moderate interactions (use with caution):

• Coumarin anticoagulants (e.g., Warfarin) — Focalin XR may increase anticoagulant levels
• Anticonvulsants (Phenobarbital, Phenytoin, Primidone) — may increase anticonvulsant levels
• Blood pressure medications — Focalin XR may reduce antihypertensive effects
• Antacids and proton pump inhibitors — may alter the release profile of Dexmethylphenidate ER
• Alpha-2 agonists (Clonidine, Guanfacine) — additive effects on heart rate and blood pressure
• Halogenated anesthetics — risk of sudden blood pressure increase during surgery

Final Thoughts on Focalin XR

Focalin XR remains an effective and widely prescribed treatment for ADHD, but the ongoing stimulant shortage makes finding it in stock a real challenge for patients in 2026. With a findability score of just 35 out of 100, many patients are forced to call multiple pharmacies or go without their medication.

If you're struggling to find Focalin XR, try using Medfinder to check real-time pharmacy availability near you. You can also save money with coupons from GoodRx or SingleCare, which can bring the generic price down to as low as $30 for a 30-day supply. If cost is a barrier, explore Novartis's patient assistance program through NeedyMeds or RxAssist.

Talk to your prescriber about alternatives if you consistently cannot fill your Focalin XR prescription — there are several effective ADHD medications that may be easier to find in stock.