I'm thinking about trying Concerta, and am currently taking 100 mg of Ritalin IR a day. How much Concerta should I take to get the same effect?

I can't ask my doctor-my doctor doesn't have a clue about ADD medication, and I can't replace him as you're only allowed to switch doctors twice a year here in Norway, and I've already switched twice. I'm waiting to get treatment from a psychiatrist, but there's a long waiting list.

I know that 100mg is definitely over the max dose for ritalin in one day (although It seems like alot of people get more than the max dose)

concerta comes in 18,27,36,54mg (I think thats it). therefore if your taking 100mg of IR a day, taking 2 54mg pills would be about 100mg, or 3 36mg pills....but again thats above recommended dosage for a day.

hi ethereal,

i don't think that it's a 1:1 ratio for dosing. i found this table on an add resources website (i don't think we're allowed to post websites without the sites permission, but if you message me i can direct you):

Refer to the following table for the dosage of Concerta for people who have previously taken methylphenidate:

Concerta Dose for People Who Have Been on Methylphenidate

Previous Methylphenidate Dose Concerta Starting Dose
5 mg two or three times a day 18 mg once daily
10 mg two or three times a day 36 mg once daily
15 mg two or three times a day 54 mg once daily
20 mg two or three times a day 72 mg once daily

then it says you may need to move up from that starting dose.

i recall the brief period i spent trying to go to extended release ritalin and i had to take significantly more mg per day to come close to the reduction in hyperactivity and increased attentiveness as the instant release. plus, if you already metabolize the ir quickly, then it makes sense that the long-acting/sustained-release stuff gets metabolized more quickly than they advertise too. for me, it was just a mess.

i have not tried concerta, though, because it's fairly new and i'm just not interested in trying out things until i'm forced to because of waning efficacy.

willinabox is correct that this amount is higher than the suggested maximum. he's also correct in saying that many people here are prescribed more than the 'maximum', which i believe is 60 (although some places say 90). ah, if only 60 would allow all of us to be functional... you're not alone, ethereal; for years i've been prescribed up to 120 ir.

best of luck with the switch,

72mg of Concerta is approximately equivalent to a 16mgx3 of IR.
54=12

I think 72mg is = about 65mg ritalin ir, in terms of what gets put into your body.


72 = 16 x 3 in EFFICACY, true (see post below), but in terms of actual stimulant absorbed, that's not the case as I understand it!

This is confusing (as also detailed below). if your goal is to match the 100mg ir in terms of effect, that is a complicated question. if you want to ensure you don't put more than 100 mg of mph (methylphenidate hydrochloride, I think: the stimulant) in your body, I think your max dose of Concerta is 108mg.

as i understand it, with concerta, about 10% is not absorbed.
CADDRA, a Canadian organization, puts out a treatment guidelines manual. in it, they recommend a max dose of ritalin ir of 100mg,
and a max dose of concerta of 108 mg.

this seems like further reason to believe that the total amount of methylphenidate absorbed in the day is 10% than the stated dosage--108 mg Concerta equals just underr 98mg absorbed.

THAT IS WHAT IS ABSORBED BY THE BODY. Based on my understanding, I would not recommend going above 108 mg of Concerta, as that would (per my understanding) put you at 98mg mph absorbed for the day.

I'm not a doctor; I just started concerta recently myself.

efficacy equivalency is another question, which I am confused about. as I understand it, the actual effect of Concerta is lower than the total dose.

for example, the Concerta website for doctors (it's like add360.com or something like that) gives these equivalencies

18mg C = 4 mg Ritalin TID (which I think means three in a day)
...
54mg = 12mg Ritalin TID = 36 mg total Ritalin
72 = 16mg TID, = 52mg
and so forth.

This is explained on Dr. Kenny Handelman's blog (google 'concerta dose: getting it right). If the same amount of mph is released steadily throughout the day, the body actually develops tolerance as the day goes on, and the efficacy of the mph decreases.
Thus, different amounts of mph are released at different times of the day.
The immediate release portion of the tablet is 22% of the total dose, and the remaining part of the tablet 'supports' this throughout the day.

Per my understanding, then, Concerta is really inefficient--you're taking, e.g., 72mg for the equivalent of 52mg ritalin ir...this seems like a ripoff.

However, I wonder if, with IR, the same thing--tolerance-buildup during the day--happens, so that 72 mg of Ritalin IR across the day is no more effective than 72 mg of Concerta.

if not, that seems dumb to me.

that's a lot of info. hope it's useful. check out that blog post, it's easier to understand :)