View Full Version : Determining alternatives to Focalin

05-08-11, 11:56 AM
Well, the health insurance changed, and as a result, our previous $25 Focalin XR for my son has jumped to $60, which is eating our wallets. Also, the 20mg is no longer having a long enough effect, wearing off before school ends. The doctor tried him on 20mg Adderall XR, with the result being that he gained a wealth of emotional issues becoming very snippy, unable to handle interactions with other people without a kind of paranoia setting in, thinking that his friends are trying to make fun of him in some manner, so that's out. I got the list of "Suggested Alternative" medications from the insurance company, and they're amphetamine-heavy. The closest I've found to the Focalin XR is 20mg Methylphenidate SR. Alternatively, we could use an instant-release, which I'm in favor of anyways, but not of the Focalin because, again, "non-tier medication" as they call it.

So, trying to come up with options. This is the "Recommended list" from the company, capitalized names being brand names and lowercase being, of course, generic:

Dextroamp-Amphet Er
amphetamine salts
d-amphetamine er
methylin er
methylphenidate sr

05-08-11, 06:15 PM
Methylphenidate ER/SR is the generic version of Ritalin SR. Cheap but highly unreliable.

You can get a free prescription assistance card for focalin XR on their website ( ( that should cover most if not all of your co-pay for up to 12 months.
Also, Focalin XR is now available in 30mg and 40mg doses.

You could also look into Concerta. It may give a little longer coverage for your son and it became available in generic just last week. It will take some trial and error to get the dosing correct compared with Focalin (since Focalin is 2x stronger than regular methylphenidate).

Yet another option could be the Daytrana patch. Their website has a prescription co-pay card too ( ( It is the longest acting stimulant on the market (will work up to 24 hours if left on) but takes a couple hours to really kick-in.

05-08-11, 07:37 PM
I was looking at Concerta, but the insurance does not list the Generic form of it at this time as an option. He was on Daytrana for a month way back when and had skin issues from it. Although Daytrana is listed as an "approved brand-name" so is within the affordable range. I will check into the Focalin Savings Card first, thank you.

05-08-11, 11:32 PM
Addendum, almost forgot the other reason why wanting him off of Focalin XR, namely the digestive issues. Ever since he started taking it, he's not been able to keep regular, regular constipation, impaction, never fun.

05-09-11, 03:55 PM
Update: The pedi and I decided on using the IR Focalin for the immediate point, and this summer try more in-depth exploration to find the ideal setup.

05-18-11, 01:33 PM
Most methylphenidate preparations (except for Concerta and Daytrana) have problems with rapid tolerance development. The tolerance builds up in a matter of 2-3 hours, which causes problems for the double-release products like Methylin ER and Focalin XR. They are basically two instant-release doses given 4 hours apart.

Unless you're using Concerta or Daytrana (or, for amphetamines: Vyvanse, Adderall XR, or Dexedrine Spansules) the best results come from frequent small doses.

For focalin, what seems to work well is 2.5mg to 5 mg given every 2 hours. Some people start with low doses in the morning and take higher doses in the afternoon and evening, to cope with rising tolerance. Other people take a break from frequent dosing in the afternoon to nap, eat, relax, etc. Then resume the frequent microdosing when it's time to get back to work or studying. (Or socializing, if Focalin helps you do that.)

If you go with the standard 3-4x a day Focalin IR (or any other instant release methylphenidate), it's asking for frustration as you ride the peaks and valleys of overmedication and undermedication all day. Microdosing isn't the most convenient way to deal with that problem, but it's cheaper than Concerta and Daytrana, and it avoids the use of amphetamines.

02-10-12, 09:23 PM
I know, it's my old post, but have had updates. After working on the IR since May, our insurance coverage changed, and now none of the Focalin or generics are covered. Pediatrician put my son on plain Methylphenidate, the exact same dosage as Focalin (20mg day in total). This has been a nightmare of peaks, valleys, a rollercoaster, and yet, the doctor insists that it's the same so no changes.

Seeing a specialist tuesday to get a second opinion.