Daytrana (patch)? | ADHD Information

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Thanks SO MUCH!!!!! I have found that if you take them out of the pharmacy package, that has the dryer pack in it, they don't peel as easily and don't adhere as well.  I have also found that if it is hard to peel (if as you are peeling it some of it sticks to the plastic and you can't get it apart) I set it in the freezer for about 3-5 seconds to cool it and it peels more easily.  However, then I have to warm it in my hand, without getting it stuck, to get it to stick easier to his hip.  I too have put a waterproof bandaid over the patch to ensure that it will stay attached for  the school day...The patch works well so the efforts pay off.My son has been on the patch since March.  I've had some bad boxes and some impossible boxes.  Right now I have a bad one and it is a box of 30 - 10 mgs.  My son now takes a 5 mg ritalin pill first thing in the morning which is really good for him.  I have managed to get the backing off the bad boxes though.  Here is what I find helps, bend it many times before you try to peel it off.  If you start to peel it and it won't come off don't keep pulling at that spot.  Pull from a different spot.  And for the most part I pull right from the middle and not the sides if I have a bad box.  That seems to work but you really have to stop pulling like I said at the area that is not coming off and try another spot to be able to save the patch.  I find with the bad boxes that my son does not seem as good when he is on them.  Hope this helps, otherwise phone Shire and they will probably send you the credit card to replace the bad ones.  I did have a CVS take them back and replace them one time but then they would not do it a second time I asked.   Thank you to Timzmom for posting the article with the date of the patches.  Unfortunately the bad ones I have are out of the box and in a zip bag in my freezer so I think the expiration date is on the box but I'll check. 

[QUOTE=Joejoesmom]Thank you to Timzmom for posting the article with the date of the patches.  Unfortunately the bad ones I have are out of the box and in a zip bag in my freezer so I think the expiration date is on the box but I'll check.  [/QUOTE]

Even if you don't have the original box, I would call Shire anyway and tell them. You can always tell them that you will return the unused patches for a refund and then they can actually see for themselves that they are no good. They shouldn't give you any hassle then. Good Luck.

Tracy

[QUOTE=Joejoesmom]Thank you to Timzmom for posting the article with the date of the patches.  Unfortunately the bad ones I have are out of the box and in a zip bag in my freezer so I think the expiration date is on the box but I'll check.  [/QUOTE]

You can also get the date and lot number on each individual wrapper. It is located at the bottom. Hard to see but its there. Hope that helps.

FourPaula,

You should scroll up from this page and read the thread that I had posted on the voluntary recall that Shire has started due to the exact same problem that you are describing. Call the number provided and they will help you get the patches replaced with better ones for free.

Good luck

Tracy

TimzMom39331.4734722222My son has been using Daytrana 30Mg for over a year now. I found this
site researching the recall. We put his patch on WHILE he is sleeping at
6:30a.m. on school days. It works by 8. As for the recall, I had to use
pharmacy mail order for several months (insurance incentive). I just went
back to my regular pharmacy and found they gave us a box they received
9 months ago! It's not the exact recall Lot #, but I know the issue. I had
contacted Shire several times about adhesive problems. They were more
open on the phone. They did replace the patches with bad adhesive via a
card. However, they also sent an insulting letter on how to apply the
patches. Glad to see they are finally admitting there was a manufacturing
problem. The last few months via mail order were very easy to apply. My
son did his own at camp. I read refrigerating helps the adhesive in an
ADHD magazine. Now, we are going to try the new Shire drug, Vayvanese,
since we have been on the max Daytrana level and it's not as effective
anymore. I'm going to ask the doctor for Daytrana tomorrow. My 8 y/o son is on
Ritalin LA 30 mg in the morning. He also takes Clonidine 0.1 mg morning
and night and 1/2 tab at 4 p.m.

Our biggest problem is the he picks at his face, arms, fingers, ears, nose for
about 4 hours after taking the Ritalin LA.

Does anyone else take Clonidine along with Daytrana?
Does anyone else have kids that pick at themselves after taking the meds?
He also did that on Focalin and Concerta.

yes jeaniejo my daughter was picking. This is one of the reasons I stopped stimulants.  Our doctor is hoping if what we are trying does not work out, this wont happen with the Daytrana and the different method of absorption. She doesnt do nay of that on the TCA we are currently using. No tics, no picking, no excessive nervousness. The only reason we would think about switching is it's not perfect symtpom relief. I'm at a crossroads on balancing symtpoms and side effects (again).

Please keep me posted if you go this route.

[QUOTE]

Does anyone else take Clonidine along with Daytrana?

[QUOTE]

Jeaniejo,

Yes, I give my DS Clonidine with the Daytrana. He is on the .2mg Catepres Clonidine patch which we remove and replace only once a week. He also can take an extra .1mg tab of Clonidine for evenings for sleep or for bouts of severe agitation. However, that hasn't been needed as of late.

Tracy

I'm wondering what is conodine for in addition to daytrana?  Is it just a sleep aide?  Is Vayvanese a patch also?  I have never heard of that.  I have gone back to just trying the patch in the morning and not using the ritalin pill for my son.  It seems that if I give him a dollar towards his savings for a GI Joe doll he will get out of bed.  LOL  I know bribing may not work long term but for now it seems to be some incentive.  I wonder what will happen when he finally gets his GI Joe doll.  Last night though he set the table and did most of the clean up to get another 2 dollars.  Sometimes I think my husband and I are just lousy at knowing how to handle him. 

HAs anyone used the patch for longer than 9 hours?  My son's school day with travel is over 9 hours.  How long does the medicine keep dispensing? He is on 10mg. patch. Why do they limit it to 9 hours?  Thanks.

[QUOTE=Enbmom]HAs anyone used the patch for longer than 9 hours?  My son's school day with travel is over 9 hours.  How long does the medicine keep dispensing? He is on 10mg. patch. Why do they limit it to 9 hours?  Thanks. [/QUOTE]

 I place the patch on my son at 5:30 am (he gets on the bus at 6:30) and it stays on all day when he returns home at 5pm. He has even forgotten to take it off and I have had to remove it the next morning.

So therefor, the patch can stay on longer as long as it does not effect sleep to bad. If it does, Meletonin, Clonidine or Benadryl can be given to help with sleep. I prefer using the Meletonin simply because it is a natural and safer over-the-counter alternative and it's cheap.

Remember though, that the Daytrana may last either longer or shorter for each person. Although my son keeps the patch on for more than 12 hours, it's effectiveness only lasts for about 9 hours. HTH

Tracy

TimzMom39344.2048958333RE: Question about Clonidine. We use at night as a sleep aid. Also use in
the morning to 1)decrease side effects of the stimulant and 2)increase the
effect of the stimulant and we give at 4 p.m. to ease the transition of the
meds wearing off. It is pretty darn good at keeping our evenings "fairly"
calm.

I asked the doctor to prescribe Daytrana yesterday because of TLM's side
effect of the stimulant (pick, pick, picking at himself for hours).

Our doctor has never prescribed it and does not wish to.

He is concerned about the skin irritation and the possibility of the
Daytrana causing him to develop an allergy to stimulant. I don't know if
he meant a true "allergy" or if he just meant that the oral stimulants
would not work once the patch has been used.

I've read on this site about the skin irritations and it seems to me that
they would be manageable. Has anyone developed an allergy to the
stimulants?

[QUOTE=Enbmom]HAs anyone used the patch for longer than 9 hours?  My son's school day with travel is over 9 hours.  How long does the medicine keep dispensing? He is on 10mg. patch. Why do they limit it to 9 hours?  Thanks. [/QUOTE]

 

It still works for 3 hours after removal, it is a 12 hour med( for some). We have used it for the entire 12 hours, and it does stop working after a while.

Thank you for your responses concerning the 9 hours.  Other than sleep interruption (which is not a problem since we put it on him around 7:00 am) are there any dangers to wearing the patch longer than 9 hours?  

We are considering trying the patch for my 11 yo ds with ADHD.  He currently does ok with 45 mg Concerta but he needs a booster for evening sports or other late activities.  He is going through the stage of not wanting to take a booster at all and he really benefits from it.  We are hearing and reading of other good effects from teh patch but we would mainly be changing to get longer coverage at school ( and home).  Our concern is that he may need 2 patches becasue he is already on such a high does of Concerta.  Has anyone gone to patches from 45 mg or higher of Concerta?  If so, what mg patch ended up working for your child?  I'm not sure we'd want to have to use two patches and I know the insurance doesn't cover the patch as well as pills.  Any thoughts?

 

[QUOTE=TLCsmom]

We are considering trying the patch for my 11 yo ds with ADHD.  He currently does ok with 45 mg Concerta but he needs a booster for evening sports or other late activities.  He is going through the stage of not wanting to take a booster at all and he really benefits from it.  We are hearing and reading of other good effects from teh patch but we would mainly be changing to get longer coverage at school ( and home).  Our concern is that he may need 2 patches becasue he is already on such a high does of Concerta.  Has anyone gone to patches from 45 mg or higher of Concerta?  If so, what mg patch ended up working for your child?  I'm not sure we'd want to have to use two patches and I know the insurance doesn't cover the patch as well as pills.  Any thoughts?

 

[/QUOTE]

Daytrana and Concerta are completely two different medications. And because of this, you cannot determine the needed dosing of Daytrana to your current dose of Concerta.

Also the way the medication is distributed through the skin, the use of the Daytrana (Ritalin) patch results in a smaller needed dose for optimum results compared to the Ritalin oral pill form.

For many, an average of 15-30 mg of Daytrana is given per day. I am not aware of  anyone be given a dose of anything over 30 mg a day.

If you decide to switch to Daytrana, your doctor will most likely prescribe a 10 mg patch to start and then it would be titrated (gradually increased) to the dose to 15, 20 and 30 if or when needed.  HTH

Tracy

I am so sick of the fight in the morning to chew the pills....i started crushing them but he still fights with me to take it, i was lookign into the patch to see if that would be easier but he cant wait 2 hours for the meds to kick in....he is the worst in the morning at school. hmmm what to docan you put the patch on him while he is sleeping so it's already working or close to working when he wakes up? We may give Daytrana a try if our plan A and plan B dont work. This is my plan if that is the route I take. I LOVE having 24 hour coverage and can't imagine going back to unmedicated mornings.

TimzMom,

Thanks for your reply.  Our doctor already wrote me a prescription for 30 mg Daytrana patches to START out with.  He told me to keep it , think on it and if I want to try it, fill it.  From what you say, the 30 may be way too high.  I know the doctor is trying not to disturb school too much by writing the script way too low to start with but, I don't want 30 zombie patches, either.  I really think his other patients that use it were new patients that had to be started low and worked up slowly.  I'm wondering if he has had anyone else switch from longtime stims to the patch.  Hmmm.  Not sure what to do.  I hate arguing with him when I know he's trying to help but maybe we should try something lower.

Anyone else have any thoughts to add?

 

 

 

One more question:  Is there a way to minimize the cost of Daytrana while titrating?  It looks like our insurance co-pay is the same whether we get 1 patch or 30 and we could conceivabley need all 4 strengths in  a months time.  Just wondering how others have worked it or if you just pay and hope.

 

 

[QUOTE=dcarsen]I am so sick of the fight in the morning to chew the pills....i started crushing them but he still fights with me to take it, i was lookign into the patch to see if that would be easier but he cant wait 2 hours for the meds to kick in....he is the worst in the morning at school. hmmm what to do[/QUOTE]

See if his doc would be willing to prescribe Focalin that comes in capsules for early morning until the patch kicks in. The capsule can be broken open and sprinkled in apple sauce, yogurt or whatever he likes to eat. This way, he'll be getting the meds without all the fuss.

TimzMom39342.5138888889

[QUOTE=Diane V]can you put the patch on him while he is sleeping so it's already working or close to working when he wakes up? We may give Daytrana a try if our plan A and plan B dont work. This is my plan if that is the route I take. I LOVE having 24 hour coverage and can't imagine going back to unmedicated mornings.[/QUOTE]

Daytrana doesn't cover for 24 hours...only about 12 maximum

[QUOTE=TLCsmom]

One more question:  Is there a way to minimize the cost of Daytrana while titrating?  It looks like our insurance co-pay is the same whether we get 1 patch or 30 and we could conceivabley need all 4 strengths in  a months time.  Just wondering how others have worked it or if you just pay and hope.

 

 

 

[/QUOTE]

You could try cutting the patch in half. This would give you 15mg. I know they say you shouldn't, but my doc gave me permission to do it and it works fine.

This would allow you to know if 15mg is enough and you won't have to buy a different dose of patches.

Cut the patch diagonally so that you have two pieces of backing to peel away. Do not cut along the separated line that is already there or it will be difficult to grab hold of to remove backing. Good luck!

Thanks, yes I knew this. What we are using currently is 24 hours, but it is not really effective for focus in school, so we're looking at other options. I will try Strattera first. Then if that fails too we will try Daytrana and pray it has less side effects. Our mornings before we used 24 hour meds were rough, so my plan is to go and put the patch on her while sleeping (5:00am), this way by the time school starts it's working and then we can take it off after school.

Diane V.

Yes you can place the patch on the child while he is sleeping. Many do that a couple hours before normal waking hours so that the patch is working by the time they wake for the day.

Tracy

thanks, that was my thought.

I used to actually wake her up give her a pill to swallow then she'd go back to sleep so I figured it would work. Of course you lose the end of the day, but.................

[QUOTE=Diane V]

Thanks, yes I knew this. What we are using currently is 24 hours, but it is not really effective for focus in school, so we're looking at other options. I will try Strattera first. Then if that fails too we will try Daytrana and pray it has less side effects. Our mornings before we used 24 hour meds were rough, so my plan is to go and put the patch on her while sleeping (5:00am), this way by the time school starts it's working and then we can take it off after school.

[/QUOTE]

What are you using that lsat 24 hours? I have never heard of such a thing.

Personally I think Strattera stinks and I have too many negative things I know about it and I don't recommend it, but good luck anyway. Maybe your child will have better results.

Thanks for the idea of cutting them.  I also went online to the Shire website and printed the voucher for 30 patches free.  We don't have to pay as much as some people but they do cost us more than the Concerta so who wants to waste 'em.  Right?It is not recommended to cut the patches, it affects the absorption of the meds.

[QUOTE=edbson]It is not recommended to cut the patches, it affects the absorption of the meds. [/QUOTE]

Yeah, that is what they say, but I have done it and it doesn't seem to change anything at all. I even discussed this with my Doctor about the absorption thing and she said it wouldn't hurt to give it a try. Before I was able to get the 15 mg patches, I had to use one and half of the 10's and it worked the same as the 15's that I received later that month.

When one is trying to save money, sometimes you need to try any option available.

TimzMom39342.5794328704We are using Desipramine currently. It is a TCA but can be prescribed for ADHD. I't helping wonderfully with anxiety, tics, calming, most impulsive behavior. Not perfect for focus. Good enough for home, but not sure it'll cut it for school. Still ironing it out. If it doesnt work out over the next week or so we will then try Strattera. That is my next choice. I have heard many people have great success. We hated Concerta and Focalin, but others love it, so everyone is different. My LAST choice is any kind of stimulant, but we have not tried Daytrana and the doc thinks with the different absorption she may do ok..............I'm very, very hesitant. I had such a bad morning with my son today it was very distressing.  He refused to get out of bed and everything I asked him to do was answered with no I won't.  He loves his new teacher this year but getting up early has never been easy for him.  I got him to take the 5 mg fast acting ritalin and then put his patch on.  I was so shaken that he refused every request I finally ended up losing it and yelling at him.  Then my hubby came running in and he did back me up but it was a little late.  I told my hubby from now on he needs to just be up and help me with him before he gets me so upset.  My hubby says I should take him to school in his pjs and just drop him at the office to embarass him and let him take the consequences at school.  I just think that would not work becuase I would have to drag him out to the car and in to the school kicking and screaming.  Not exactly the impression you want to make when you are trying to help foster friends for a kid that has some but not alot.  I was supposed to attend the PTA meeting, first one of the year and I was just too upset to go, had a major headache by the time I finally dropped him at school.  Anyone have any suggestions how to deal with an oppositional kid in the morning before the meds kick in.  Any suggestions would be helpful.  I took away his t.v. tonight and also no playdate with a friend he wanted over tonight either.  Then he asked if we would take him to Shakeys.  We told him if he can get up and ready for school Mon., Tues. & Wed. next week we will take him Wednesday night, he's almost 8 years old now.what happened once the 5mg Ritalin kicked in?

 I called Shire about the box of bad patches I have. Mine are part of the recall. They were very helpfull. They are sending me an over night pouch to return 4 or 5 strips in with a trial card to take to the pharmacy with a new Rx. The weird thing is, they told me to have my Dr write an Rx for 10 strips then another for 30. I take the first & have it filled then take the 2nd along with the same card, both of which will be at no cherge obviously. The thing I don't get & looking back I should have asked, is the reason for the 2 Rx. I did ask if either had to be filled first & the guy said doesn't matter. They were helpfull but I called on a friday meaning I can't get the whole deal taken care of until next week. This means I have to attempt to use the ones I have until then.

I also talked to the pharmacy I use about the recall. They didn't have anything about it because it wasn't a manditory recall. Funny thing is my sister was put on the same med 4 days after me & she uses the same pharmacy. I told her I would print out the recall sheet to take with her to get it filled.

I think anyone who gets this Rx should make sure BEFORE you pick up the Rx that they are NOT the ones effected. The effected ones to not expire untill 2009 & with it not being manditory, I bet some have no clue about the whole thing. Makes me really wonder how many other things have a "voluntary" recall that get overlooked because they are not required to make the extra effort to let people know.

My son is 11 and took Methylin from kindergarten through fifth grade. We switched to Daytrana this summer, in anticipation of moving to middle school (less disruption to his day, better delivery of meds). I waited a year before I made the switch, thinking the kinks would get worked out.

The drug is not on my insurance company's formulary list, so I have to pay quite a bit more for it.

We started with 10MG patches (he had been taking 20MG ER in the morning and 10MG at noon). The patches were terrible; the backing would not come off. Because of those issues, the patches wouldn't stay on. I finally discovered that BandAid Water Block Plus bandaids would keep the patches on.

However, we discovered that 10 MG wasn't enough medication. I experimented with two 10MG patches, and that seemed to work. We've switched to 20MG patches, and those work beautifully. Backing comes right off. They stay on, unless he is swimming for hours and hours.

Shire understands this is an issue, and will give you the standard line of they are working on it. It's my understanding that if you contact them, there is some kind of a debit card they will send you that you can use to pay for the patches for the first month or so.

I found this link helpful when I was researching ways to make the patch stick. The thread got so large that you will have to click on the link at the bottom to follow the conversation forward.

http://counsellingresource.com/features/2007/03/22/adhd-patc h-problems/

Anyone else have trouble applying the patch?  

Our 9-year-old son just started on Daytrana and my wife and I have had to throw away three or four patches...we can't get 'em apart, the sticky stuff with the medicine in it sticks to the throwaway backing

Thanks,

Tazio

[QUOTE=tazio]

Anyone else have trouble applying the patch?  

Our 9-year-old son just started on Daytrana and my wife and I have had to throw away three or four patches...we can't get 'em apart, the sticky stuff with the medicine in it sticks to the throwaway backing

Thanks,

Tazio

[/QUOTE]

 

I have had this problem many many times. Lately however I have been getting good packs where it comes right off with no hesitation. I used to get so upset when the medication would stick and end up ruining the patch. I think Daytrana has been working on fixing the problem. May be why I havent had any problems lately..but almost time for a new pack..never know what each packs brings. Its not good because those patches cost money and are being wasted. What I can tell you is what I have done when I had the "bad" packs. I would hold each end of the patch and kinda roll it like if you had a slinky in your hand and went back and forth..lol Best way I can describe it. I would do it a little forecefully for a while till I saw it start to peel off by itself. It didnt always work and took some time and patience, but eventually I got it off some of the time. Wish I had more advice, but I have gone through it myself.

My son has been on the patch 10 mg since March.  We tried 15 and he becomes like a zombie.  If you contact Shire and tell them about your bad boxes of patches they are very good at sending out the card that you can use at your pharmacy for 30 patches.  I do find that if you keep them in the freezer it makes a huge difference in getting the backing off.  I have also cut them in half and at one time I thought they did not work the same but lately I ran out of the 10s.  I had some 20 mgs that we never used so I have been cutting them in half.  But I need to pull the backing off one side before cutting or I can't get it off.  We had a follow up appointment today and my doctor prescribed 5 mg of fast acting ritalin pills for the mornings because it takes the patch about 3 hours to work on my son.  I do get up early but I am hoping these pills will help.  However, my son has never been able to swallow pills before.  I sure hope he will do it tomorrow the pills are very very tiny.  I have also bought some mini m&ms as a reward and to practice swallowing per the doctors suggestion.  The patches really do work well and for anyone who has a child that gets a rash I have to say it decreases over time.  My son had terrible rashes and he just doesn't get them anymore.  I used many topical creams like benedryl and hydrocortisone creams to decrease the rash in the past.  But now he never gets a rash anymore.  Good luck to all.

This is for everyone with the red, itchy and burning spots with Daytrana.  My doctor prescribed nasonex to spray on the skin before applying the patch and it works great.  You spray the area well and let it dry COMPLETELY (I use a hair dryer on low setting) the apply the patch over it.  I have not had any problems with the patch coming off and it GREATLY reduces the reactions to the patch.  There are other allergy nasal sprays that work well also.  I find the nasonex works best for us.  

hope this helps

Just FYI ... got our second box of 20 MG patches from a different pharmacy. I didn't save the first box to compare lot numbers, but I suspect they are a different lot. These aren't staying on like the first lot. We're back to putting BandAid Water Block Plus band aids over the top to keep them on. I'm going to call the second pharmacy to see if they can get a different lot.

The reason they give you an RX for 30 and another one for 10 is that the patches do not come in boxes of 40.  I had a few times when my doc. only wrote 2 RX's for 30 but the pharmacy made me forefit the extra 20.  So the next time I had my doc. write it for 30 and another one for 10[QUOTE=fourpaula]

 I called Shire about the box of bad patches I have. Mine are part of the recall. They were very helpfull. They are sending me an over night pouch to return 4 or 5 strips in with a trial card to take to the pharmacy with a new Rx. The weird thing is, they told me to have my Dr write an Rx for 10 strips then another for 30. I take the first & have it filled then take the 2nd along with the same card, both of which will be at no cherge obviously. The thing I don't get & looking back I should have asked, is the reason for the 2 Rx. I did ask if either had to be filled first & the guy said doesn't matter. They were helpfull but I called on a friday meaning I can't get the whole deal taken care of until next week. This means I have to attempt to use the ones I have until then.

I also talked to the pharmacy I use about the recall. They didn't have anything about it because it wasn't a manditory recall. Funny thing is my sister was put on the same med 4 days after me & she uses the same pharmacy. I told her I would print out the recall sheet to take with her to get it filled.

I think anyone who gets this Rx should make sure BEFORE you pick up the Rx that they are NOT the ones effected. The effected ones to not expire untill 2009 & with it not being manditory, I bet some have no clue about the whole thing. Makes me really wonder how many other things have a "voluntary" recall that get overlooked because they are not required to make the extra effort to let people know.

[/QUOTE]

 

The reason is because the card is good for 40 patches.

I thought it would be of help to share this information for those who have opted to receive replies for this thread and may not know yet about Shire's voluntary recall on the Daytrana patches due to the adhesive backing problems it has had. HTH

Tracy

Dear Daytrana(TM) Patients and Caregivers:

Shire wants to advise you of the company’s decision to implement
a voluntary market withdrawal of limited portions of the
Daytrana(TM) patches. Shire is taking this proactive step not due
to safety and efficacy issues, but due to feedback from patients
and caregivers who have experienced difficulty removing the
release liner from some Daytrana(TM) patches.

Shire expects the remaining supply of Daytrana(TM) will offer
patients and caregivers improved ease of use when peeling the
release liner off the patch.  All Daytrana(TM) patches, including
those that are part of the voluntary market withdrawal, can
continue to be used unless the release liner cannot be removed or
the patches are damaged while being opened.  The current supply
levels of Daytrana(TM) are sufficient, ensuring that those
patients who currently use Daytrana(TM) and those patients
looking for an alternative ADHD treatment option will be able
to have their prescriptions filled with Daytrana(TM) patches
with an improved ease of use. 

Here is important information you should know about this
voluntary market withdrawal:

--Are the affected lots safe and effective?

Shire is taking this proactive step not due to safety and
efficacy issues, but due to feedback from patients and caregivers
who have experienced difficulty removing the release liner from
some Daytrana(TM) patches.   All Daytrana(TM) patches, including
those affected by the voluntary market withdrawal, can be used
unless the release liner cannot be removed or the patches
are damaged. 

--How do I know if my current supply of Daytrana(TM) is affected
  by this voluntary market withdrawal?

Only those Daytrana(TM) packages that have an expiration date of
March 31, 2009 or earlier or lots 2563511, 2563611, or 2570411
are impacted by this voluntary market withdrawal. 
All Daytrana(TM) patches including those affected by the
voluntary market withdrawal can continue to be used unless the
patches are damaged when opening or the release liner
cannot be removed. 

--What should parents and caregivers of patients prescribed
  Daytrana(TM) do with their packages of Daytrana(TM) if they
  meet the criteria for the voluntary market withdrawal?

They have two options:

a. If the release liners can be easily removed and the patches
   are not damaged, use the patches as directed.

b. Or, if the patches cannot be used, call the
   Shire Customer Service/DaytranaCare line at
   1-800-828-2088, option 1. 

Please see Important Safety Information below
and accompanying Full Prescribing Information.

--Please describe what you mean by “damaged.”

If it appears to you that anything about a patch looks unusual,
please do not use.  Damaged patches should be discarded according
to the directions in the Daytrana(TM) package insert.

--What changes have been made to Daytrana(TM)?  

We have increased the release coating on the release liner.
No changes to the medication, itself, have been made.    

At Shire our patients always come first and Shire is dedicated to
providing you with the information you need to make informed
decisions related to your child’s care.  If you have further
questions after reviewing this information, please call us at
1-800-828-2088, option 1. 


Sincerely,

Joel Cohen, MD
Medical Director, Global Medical Affairs
Shire Pharmaceuticals

Hopefully this problem wasn't already addressed but I could't find a solution. I'm 31 year old female with ADHD. I have used countless combinations of meds that either last way to long causeing sleep issues or not lasting long enough & causing aggression when coming off the med. I started the patch yesturday which at first I was VERY excited. Problem is I had a HELL of a time getting it appart! When I did manage to get the tab pealed back half the med & sticky stuff staid on the removal tab.

Problem #1 not getting all the med from the patch onto my skin, #2 the dang thing doesn't stick to my skin like it should. I had to use a bandage to hold the thing down on one side. Not a nice "feature" for a medication tab.

I went over the seemingly simple instructions 3 times, thinking I'm a moron but still can't seem to make it work. I tried putting it in the frig for 10 minutes but no help. I waisted 2 patches in the past 2 days. I am on the 30 mg & I saw someone had a little trouble with the 15. Has anyone found a trick to this?  I don't want to waist another patch if I can get the thing to work, I'm sure everyone knows what 1 day without meds can be like.

PLEASE anyone have a solution???

 

[QUOTE=Jeaniejo]
 Has anyone developed an allergy to the
stimulants?[/QUOTE]

I have never heard of it happening to anyone. Stimulants are stimulants, regardless of how they are administered, so I don't see how one can suddenly become allergic to them after they have been on them for months or years.

I personally think your doctor is being unreasonable not wanting to try the Daytrana. If it works well for your child, it can be a Godsend! For us, it has been the best stimulant that we have used so far. It helped us decrease the amount of stimulants that he was on. (He was taking over 120mg of Ritalin a day! And it still wasn't effective enough) This required him to take the meds 4 times a day, which is a real hassle in or out of school. Many times it was forgotten to be given or a double dose was given because the last time it was administered couldn't be remembered.

The best advantage to Daytrana is that it works all day without the ups and downs between doses like the Ritalin. This meant no waiting for meds to kick in and having to wait for the next dose to take effect and that awful 'down' time in between. Much more consistent!

If your child has this problem as well, I would find another doctor. But that is only my personal feelings on this. Good luck!

Tracy

[QUOTE=Enbmom]Thank you for your responses concerning the 9 hours.  Other than sleep interruption (which is not a problem since we put it on him around 7:00 am) are there any dangers to wearing the patch longer than 9 hours?   [/QUOTE]

Like I had said previously, my son wears his patch everyday (in a different place) for over 12 hours and sometimes even overnight.He has been using Daytrana for about 6 months now. We have never experienced any problems or dangers of doing this except for irritation on the site area. But Benadryl works well for this. Some kids do have more serious issues with irritations, so you won't really know until you try it on your own child. HTH

Tracy

We have never experienced any problems or dangers of doing this except for irritation on the site area. But Benadryl works well for this. Some kids do have more serious issues with irritations, so you won't really know until you try it on your own child. [/QUOTE]

 

A little help here folks...I love the patch and how it is working for us as a family  (5 mg tablet crushed in a drink in the morning plus the 15 mg patch) and getting my son through the school day.  We have been using just tablets on the weekends so that his hips can take a break from all the irritation.  We've been trying everything to heal the site areas but nothing seems to work overnight.  We switch from side to side.  We have tried Neosporin and baby rash ointments. Are there any other suggestions? I would hate to have to take him off of this method as he likes it and he is not required to go to the nurse while at school to get meds. 

From what I understand is that any swelling, bumps or blisters would be an allergic reaction and that is when the Daytrana should be stopped immediately.

But for those who are just seeing a little redness or itchiness, it can still be used.

[QUOTE=TimzMom]

I would suppose if you noticed your child getting a bad irritation to it, to stop using it right away and maybe that would prevent it from being a permanent problem with future stims?

[/QUOTE]

Not sure it's that easy.  It might be the type of thing that "flips a switch" in the body and sends it into a tailspin when it encounters the same chemical again. You'd need to talk to a doctor about the specifics.  I know that my son's psychiatrist was concerned when I told her that I had given him a short-acting Ritalin in the morning before the patch kicked in.  I think that she had wanted to monitor his reaction to the patch over time first (although she did not communicate this with me ).  I do think that it is a very serious allergic reaction but rare.  Your doctor isn't crazy, just cautious

Joy2
LOL -- we are posting over each other.

My son's skin gets VERY red from the patch and it used to itch like crazy.  He doesn't complain about it any more.  Redness is definitely normal.

Like I said, though, if you are one of the unlucky ones who reacts to it, there goes your methylphenidate for life.

[QUOTE=Joy2]LOL -- we are posting over each other.

My son's skin gets VERY red from the patch and it used to itch like crazy.  He doesn't complain about it any more.  Redness is definitely normal.

Like I said, though, if you are one of the unlucky ones who reacts to it, there goes your methylphenidate for life.
[/QUOTE]

That's a scary thought when deciding to use the patch. If we personally had not already  been through the entire gamut of stims and I had this information, I would probably opt to try something else instead.

Although it's rare, I would hate to be the child or the parent who would have this happen to them!

Yeah, I'm glad I didn't know beforehand, or I would have worried about it.  Sometimes ignorance IS bliss!

Ok, me again! LOL

I just went back and read some more research and if one DOES develop an allergy to the Daytrana, they may never be able to use methylphenidate again, HOWEVER, this DOSE NOT rule out the use of OTHER stims. Other stims should still work. I thought I would clear this up or someone please correct me if I am wrong?

TimzMom39345.4803240741

You all must be sick of me by now! LOL

Sorry! But I just came across an interesting tidbit for those of you wanting to know more about how long to leave the Daytrana patches on. Here is some interesting info that I found:

 

Daytrana is an adhesive patch formulation of methylphenidate The approved wear time is for up to 9 hours, providing 12 hours of effective control of symptoms. Wearing time for the patch can be individualized so that it is removed 3 hours before you want it to wear off. This allows for up to 15 hours of effectiveness, i.e., 12 hours wearing time. Many patients leave the patch on for 24 hours. The effect wears off in 15 hours and sometimes sleep is better when leaving it on.

 

We did not try Daytrana when it first came out for this reason. We now have it on our radar because like Timzmom we've used just about everything without success. I'd hate to keep that whole family of meds out of my options though. That only leaves Adderall, Vyvanse and Dexedrine. Diane V39345.4907523148For anyone who is using the patch or thinking of using the patch, this is excellent information to refer to. I just printed it out for myself for future reference. Please read it thoroughly. I  just learned alot of positive things about the patch that I did not know. PART TWO( from my last post): DOSING

The patch is 10, 15, 20, & 30mg in strength. This refers to the amount of medication released during a 9 hour wearing time. If left on longer than 9 hours additional medication is released.  After 4-5 weeks of regular wear, absorption improves and up to twice as much medication is released.

This may result in better efficacy or may cause side-effects. In the event of side-effects the dose just needs to be reduced. Total dose should not exceed the maximum published dosing limits of 2mg per kg of body weight.

This translates to:

100kg = 220 pounds

50kg = 110 pounds

1 kg = 2.2 pounds

The medication is equally distributed throughout the patch. Although it's not part of the formal FDA approval some patients report that cutting the patch in half and wearing on separate days works well.

Patients may wear 2 patches at one time when requiring a higher dose. It is recommended they both be put on the same side. The patch should be alternated between the left side and the right side. If any redness remains don’t put the patch on the red area but move it down or further back on the hip.

Each patch has 2 ¾ the total medication on the label.  This means that:

10mg has 27.5mg

15mg has 41.3mg

20mg has 55mg

30mg has 82.5mg

A unique feature of Daytrana is that after 4-5 weeks of regular use the absorption of medication improves and close to twice as much medication is released into the system.

If switching from Concerta 36mg, Daytrana 30mg was found to be equivalent.  After 4-5 weeks the dose of Daytrana may need to be reduced. 72mg of Concerta (2 x 36mg) may require 2 patches of 20-30mg initially but after 4-5 weeks one patch will be sufficient.

The patch sizes are:

1 ½ x 3 ½ inches(30mg)

1 ½ x 2 ½ inches(20mg)

1 3/8 x 1 7/8 inches(15mg)

1 3/8 x 1 3/8 inches(10mg)

SIDE-EFFECTS

Side-effects are the same as for all methylphenidate products except for possible skin irritation. In a large clinical trial only 7% discontinued due to side-effects and about ½ of those were due to skin irritation.

Other side-effects include:

Decreased appetite Sleeplessness Sadness/crying Muscle twitches Weight loss Nausea

Most of the significant side-effects like muscle twitches, insomnia, irritability, and possibly even decreased appetite and stomach ache can be improved by reducing the dose. But if side-effects persist at the effective dose then Tenex (Guanfacine) ½ to 2mg once or twice daily can be very effective plus it also improves distractibility.

Most patients do not have any skin reaction or have mild redness that goes away quickly once the patch is removed. A small percent of people will have more marked redness that may persist for a few hours and a very few may develop a more significant localized skin allergic rash.

GENERAL INFORMATION

Remember that after 5 weeks the amount of medication released is almost double the dose on the label if worn for 9 hours and even higher if worn longer.

Because the patch provides up to 15 hours of effective symptom control and can be flexibly dosed to wear off within 3 hours when removed, it should be considered the first line form of methylphenidate in clinical practice. No other stimulant on the market provides more than 12 hours with single dosing and in ADHD it is hard to remember to take second and third doses of medication.

Note: If there are concerns about the possibility of growth delay – especially in children in the bottom quartile, Tenex can be given at bedtime. Clonidine is even stronger but is frequently too sedating. Tenex is also effective for the occasional person that has increased blood pressure from stimulants.

TimzMom39345.4957986111[QUOTE=TimzMom]

A unique feature of Daytrana is that after 4-5 weeks of regular use the absorption of medication improves and close to twice as much medication is released into the system.

[/QUOTE]

 

TimzMom.

 

Can you tell me where your source of information comes from.  I'd like to read more on this. We've just recently noticed that in the last two days my son has been much more quiet when we pick him up from school.  We are just hitting that 5 week time period and I'm wondering if we might need to reduce his patch mg quantity.  I was not aware that this is a factor, but it may be for my son.  I may cut the patch in half this weekend and see how he does.

Thanks.

Zin.

[QUOTE=zinfandel][QUOTE=TimzMom]

A unique feature of Daytrana is that after 4-5 weeks of regular use the absorption of medication improves and close to twice as much medication is released into the system.

[/QUOTE]

 

Can you tell me where your source of information comes from. 

 

 

[/QUOTE]

I got the information from this website:

http://www.askdrjones.com/2006/11/06/how-to-use-the-daytrana -patch/

Wow - I had never heard about the effective dose becoming stronger!  Do you need to use the patch every day for that to happen? I wonder if taking off on the weekends slows down this process or stops it from happening.  We are only 1 week in (with today off because I destroyed three patches trying to open them when I was half awake myself).

I keep reading about kids  taking tenex with stimulants.  Does it help with appetite?  My son is pretty tiny. He grew some on his summer off of stims. but is still way smaller than his brother.  His psychiatrist has never mentioned it as a possibility.  He does take zoloft which I've never been crazy about. Is this something to ask about instead?

[QUOTE=Enbmom]

Wow - I had never heard about the effective dose becoming stronger!  Do you need to use the patch every day for that to happen? I wonder if taking off on the weekends slows down this process or stops it from happening.  We are only 1 week in (with today off because I destroyed three patches trying to open them when I was half awake myself).

I keep reading about kids  taking tenex with stimulants.  Does it help with appetite?  My son is pretty tiny. He grew some on his summer off of stims. but is still way smaller than his brother.  His psychiatrist has never mentioned it as a possibility.  He does take zoloft which I've never been crazy about. Is this something to ask about instead?

[/QUOTE]

I think it needs to be given everyday. But i am just guessing. Tenex is supposed to help some with appetite. Is your son being given Zoloft for that or for mood? I'd rather have my son on either Clonidine or Tenex before I would even consider Zoloft!

We started with the zoloft because of OCD type behaviors (that started after the ritalin).  I want to take him off but I also know that the zoloft is supposed to help other meds work better and we've been messing around with the ritalin and straterra and seem to finally be at an ok place with the 2.  Straterra seems to have no side effects other than tiredness in the morning.  Too bad it doesn't work well enough to get through school.   Does tenex also help with the afternoon crabbies? 

TimzMom
Thanks for the info on the Daytrana patch. I thought it was interesting that it
noted "slight redness that goes away after a few hours" as one of the side
effects. From what I'm reading on this message board, EVERYONE here is
experiencing much more than just a mild redness that goes away. It sounds
to me like creams are required and even then it doesn't completely go away.

Is this correct? Is there ANYONE out there who only has a "mild irritation" as
suggested by the literature.??[QUOTE=Enbmom]

We started with the zoloft because of OCD type behaviors (that started after the ritalin).  I want to take him off but I also know that the zoloft is supposed to help other meds work better and we've been messing around with the ritalin and straterra and seem to finally be at an ok place with the 2.  Straterra seems to have no side effects other than tiredness in the morning.  Too bad it doesn't work well enough to get through school.   Does tenex also help with the afternoon crabbies? 

[/QUOTE]

Yes, Tenex is given specifically for the afternoon crabbies..lol

But if he has OCD and the Zoloft is working for him, leave it alone. Ever hear the old adage, "don't fix what isn't broken"?

The tenex could be given along with it for afternoon or evenings.

Enbmom:
What type of OCD behaviors did you notice?

Jeaniejo,

My son's redness is mild to moderate, but you must remember that even though each side is alternated, those areas are going to be still healing when you apply a patch there. Even if you don't see any sign of irratation, it still may be more prone to getting red and staying red longer. This doesn't mean however that the patch is going to cause worsening problems and should be stopped.

To avoid this, I try to apply the patch as far away from the first area of redness and give it at least 4 days to heal before using that area again. Since I have been doing this, the redness only seems to last overnight and by morning, sometimes it is only slighly pink.

TimzMom39345.5700115741Oh and I forgot to menttion that I haven't had to use any creams for over 3 months now. The cream is more for those who complain that it is itchy. So yeah, I consider my son's redness to be slight as "suggested by literature".

He became obsessed with all things blue. He still has a color preference (now it's red) but he HAD to have the blue one always and threw fits if he didn't.  He also started walking one way to the kitchen and one way out.   It's been so long that I don't remember the other behaviors, but they were there. I think he has tendencies in that direction anyway, but the ritalin definitely exacerbated them.  I suppose I should have tried taking him off the zoloft this summer when he was also off the ritalin but things were going well and I didn't want to jinx anything. 

I can't imagine adding the tenex just because he would be on 4 meds (on school days at least)!  On another posting I got the advice to look into reducing or dropping the zoloft because of the effect that the straterra has on it.  He takes 25 mg. every other day.  

I like the psychiatrist that we see but I wonder why he's never mentioned tenex when I've been complaining about the eating thing (it was really bad when he took 30mg. of ritalin before we started straterra) and the afternoon rebound for years.  On the other hand, we went to a different psychiatrist for a (short) while and he was so medication and diagnoses happy that he freaked me out!  I've been trying to find a good psyhiatric nurse who specializes in ADHD meds but so far no luck. 

Tenex is not going to help with his OCD tendancies, I wouldnt think. Zoloft seems the right choice. I also would not mess with that if it's working. Zoloft will increase the blood levels of the methyphedinate, so if the dose is becoming stronger, maybe you can drop the Zoloft a bit and hope no anxiety increase. We used to cut the Zoloft in half and gave 12.5.

Or like you suggested maybe a lower dose of Daytrana (which IMO is the way to go).

A person can develop a very serious skin reaction to Daytrana that precludes him/her from ever taking a stimulant again.  From what I've heard, it's rare, but it can happen and some doctors are reluctant to prescribe it for that reason. 

There are a number of websites that state this, although I could not find one that describes it in detail. 

Joy2

[QUOTE=Joy2]A person can develop a very serious skin reaction to Daytrana that precludes him/her from ever taking a stimulant again.  From what I've heard, it's rare, but it can happen and some doctors are reluctant to prescribe it for that reason. 

There are a number of websites that state this, although I could not find one that describes it in detail. 

Joy2
[/QUOTE]

Ok, I was quickly able to google some information on this subject, and you are right. I have copied the information that I found below:

Skin reactions including skin irritation and allergic skin rash can happen with Daytrana. Skin redness or itching at the application site is common.

You can keep using Daytrana if this happens. Stop using Daytrana and see your doctor right away if swelling, bumps, or blisters happen at or
around the application site. You may have a skin allergy to Daytrana.

People that have skin allergies with Daytrana may develop an allergy to all medicines that contain methylphenidate, even those taken by mouth.

 

TimzMom39345.4704282407[QUOTE=zinfandel]

We have never experienced any problems or dangers of doing this except for irritation on the site area. But Benadryl works well for this. Some kids do have more serious issues with irritations, so you won't really know until you try it on your own child. [/QUOTE]

 

A little help here folks...I love the patch and how it is working for us as a family  (5 mg tablet crushed in a drink in the morning plus the 15 mg patch) and getting my son through the school day.  We have been using just tablets on the weekends so that his hips can take a break from all the irritation.  We've been trying everything to heal the site areas but nothing seems to work overnight.  We switch from side to side.  We have tried Neosporin and baby rash ointments. Are there any other suggestions? I would hate to have to take him off of this method as he likes it and he is not required to go to the nurse while at school to get meds. 

[/QUOTE]

Benadryl Cream works well for my son. You might want to try that. Also Vaseline Intensive Care  Cream might work too. I always apply the patch higher or lower, forward or back more on the hip, to avoid an area that might still be irritated. You might want to try that to give it more time to heal before using the red area again.

Tracy

For the person asking about mild redness.  My son has been on Daytrana since March and he had redness and itched quite a bit and soreness for the first two months I'd say.  But for several months now the redness has subsided and I rarely need to put any creams on it.  We were close to quitting Daytrana due to the rash.  But I have to say he got past that and it works pretty good for him.  We have added in a 5 mg ritalin in the mornings but some days I don't even give it to him and other days I give him only half.  I find with the 5 mg of ritalin and the 10 mg of Daytrana patch he brings his entire lunch home and drink as well.  So I'm trying to skip the ritalin.  My son's doctor arranged for me to join a parenting group and she already had some advice.  She said he should be asleep by 8 each night and she said the crabbiness after the patch wears off and in the morning especially probably has more to do with not getting enough sleep.  Plus she said after the patch comes off they find that alot of kids get crabby due to the fact that they need more protien.  She said especailly if they are not eating lunch their blood sugar level can be low.  So she suggested an early dinner or at least a protein snack when he first starts to get hurngry a few hours after the patch is removed.  He usually is not asleep until 9 or 9:30 due to the fact that the patch keeps him up.  I have not wanted to add another med for sleeping but I may consider the melotonin someone suggested if I can get him to swallow it.  As for creams I did find that benedryl cream was good and also giving a bath in Aveno body bath wash and then applying a coat of aveno cream after that before bedtime.  But remember to wash it off and dry the area in the morning before applying the patch.  I also found that a homeopathic burn cream that I picked up at a regular pharmacy was really good.  In fact the rash seemed to go away after I tried that.  When the rash was bad I found that taking the adhesive off with baby oil seemed to cause more irritation.  I switched to olive oil to remove the adhesive and that was better.  I think the baby oil may have caused more irritation and be sure not to rub the adhesive too hard.  I actually found it better to just let it come off as much as it did in the bath and then leave the area alone.  Somtimes I think putting too much stuff on can be worse.  Hope this helps with the rash questions.

re: I may consider the melotonin someone suggested if I can get him to swallow it. 

Melatonin can be bought in chewable tablets. The ones that I have are tiny cherry flavored ones from GNC, but I'm sure other manufacturers have it as well.

it also comes in liquidKal brand also makes a seey flavored lozenge that melts in your mouth and works pretty quick. I have heard good things about the liquid as well.Good Luck!

The 5 mg didn't kick in fast enough to help my son before he got to school.  When we were finally on our way to school he appologized to me for his behavior so I guess by then it was kicking in.  I hate doing two forms of the meds because he really has no appetite all day but I really need that for him in the morning  Unfortunately it usually doesn't start working until we are on our way to school or till after we get there.  But the patch was taking 3 hours before we saw any affect.  Another thing that bothers me is that one the meds he has no interest now in sports.  He used to do every kind of sports.  Today I took him to the soccer try outs and he was just standing there.  Usually he's in the thick of the game getting the ball and he's just such a great player.  Today he was just stading tthere watching and afterwards he said he dididn't enjoy it and he doesn't want to join the team.  I'm thinking of not giving him meds before the game but then he will probalby be all oppositional and not want to go. 

I'm sick of all this bad patch stuff even the box we have not is difficult.  I've returned one is the past to the pharmacy and phoned Shire and got the card one time too.  By the time you get it all sorted out your kid has been without their meds for days so annoying.

has he tried other meds? It doesnt seem like you are that happy with the patch.

Unfortunately the patch as been our only hope until recently because he has never been able to or willing to swallow pills.   The 5 mg ritalin in the morning is very small and we started with half and I gave him an m&m for a reward and then the other half and another m&m.  After a few days he stopped asking for the m&M's and just swallowed the pill.  Ths has been a major breakthrough for him.  My doctor is trying to work his way up to a bigger pill after we have done this for a while, hopefully within the next 30 days.  The patch has been O.K. except the delayed release and the problems with some bad boxes.  But since we have had no other choice as I told the doctor some help is better than none.  The patch also seems to keep him pretty balanced all day once it kicks in and until we take it off.  Today since it was the weekend I tried only putting the patch on him and skpped the morning ritalin and he had a better appetite today pretty good actually.  I may just go back to getting up at 6:00 a.m. and putting the patch on.  We've made a deal that tomorrow he will get up on time and behave or no t.v. again so we will see if he keeps his end of the agreement.  If he does he gets t.v. and a slurpy after school.

 

My son Reno (7 yrs) just started medication for the first time, 10 mg of Daytrana, we are on week 2.  It has helped him tremendously. Side effects for him as of now would be nausea, decreased appetite, a bit sensative - will have his feelings hurt easily which leads to tears easily . The worse side effect is the redness and irritation at the site. Sometimes there are scabs and irritation/redness/swelling doesn't go away for about 3 days. Has anyone tried any topical creams that seem to shorten the duration.  I have been using triple antibiotic and hydrocortisone to ease itching (he says it still itches despite). Thank you for the hint about using Nasonex, luckily I have some samples and will try this tomorrow morning.  Any other suggestions to relieve site irritation would be MOST helpful and appreciated. My son was very sensitive for about 2 months and then it stopped bothering him.  It still gets red but he does not complain about it being itchy.  His never got so bad to cause scabs though.  If you are removing the sticky adhesive residue with baby oil after you take it off try switching to olive oil instead.  Also I use benedryl cream on the site of the patch at night sometimes.  I also found a homeopathic burn cream that works for burns.  I will try to find the name I'm not sure where it is at the moment.  I also tried the nasonex but it did not help him.  I think though my son just got kind of immune to the itching and it stopped bothering him.  Hopefully you will find that happens too.  We almost dropped the patch due to the itching for a while.  Thank you Joe Joe's Mom, I will try your suggestions and wait to see if you can find the name of the burn cream.  I hope this will dicipate over time as well.  I think he is scabing from scratching so I have suggested to him that he just rub the area over this cloths rather than directly on the skin. Benedryl sounds like a great idea.  [QUOTE=Joejoesmom]

Unfortunately the patch as been our only hope until recently because he has never been able to or willing to swallow pills.   The 5 mg ritalin in the morning is very small and we started with half and I gave him an m&m for a reward and then the other half and another m&m. 

[/QUOTE]

My son started with the pill only program. He is not a pill taker either.  With the tablets, we crush them (there are pill crushers near the pharmacy or you can use two spoons) and then put the pulverized powder in a small cup and have him drink it with soda using a straw.  You could add it to applesauce or pudding.  If you are working with the capsules then the medicine cannot be crush, but the capsules can be opened and sprinkled. 

I didn't mean to upset anyone regarding the melotonin I just read so many negative things about it so I wondered if others knew about them.  I guess if you feel comfortable giving it and it works for your child it's the right decision for you.  I'm going to try to let my son fall asleep naturally unless it gets to some unreasonably late hour.  As it is now he usually falls asleep by no later than 9:30 We keep trying for 8:00 though as he used to be able to do before he started Daytrana.  I agree too that stimulants are a worry as well, it's just that they are at least approved by the FDA and the melotonin is not.

I have recently started my 7 year old AHDH son on a 15 mg patch.   Our previous experience was with Ritalin 10 mg tablet in the a.m. which stopped working about lunch time. We would eat lunch and then follow with 10 mg RitalinLA in the afternoon.  I split the meds because we were homeschooling and he could eat lunch. The good thing about the Ritalin is that it works within about 15 minutes.  The part that I didn't like was the crash when it wore off long acting or not. We did not have any problems with sleeping. 

I saw our peditrician and asked about the patch.  We decided to give it a try so that he could avoid going to the school nurse when he entered 2nd grade in the public school system.   We started with a 3 day trial and a follow up with the doctor.  The first thing I noticed was that it took at least 2-3 hours for the patch to become effective.  That would not work with school.  Together, the physician and I decided that we would add a 5 or 10 mg tablet and patch at the same time.

What is working for us is right before breakfast taking a 5 mg crushed tablet (I put it in soda) and putting on the patch.  If we eat breakfast right away, the medication has not yet worked.  The 5 mg kicks in and gets him started in class.  The patch kicks in and takes him through the rest of the day. There is not the big crash at the end of the evening.  He is wearing the patch for about 11 hours.  Sleep is not a problem for us.

Things that I have noticed about the patch...  It falls off in the pool.  We've tried waterproof bandages and they have been at least keeping it on though the edges may be loose.  He is developing a bit of a rash, perhaps because the patch is on for 11 hours.  I believe that the suggested time is 9 hours.  I'm trying some aloe to the irritated area to see if that helps.  I may have to move the patch to other areas rather than only the hips to see if that will alleviate the rash. It is expensive for us as insurance does not cover this at all. A one month supply runs about 5. Other than this, he is happy with the patch and so am I.

 

Zin

DS 7, went off of Daytrana 15mg in June and began 27 mg Concerta...... 

Well, we just took him off the Concerta and returned to the Daytrana 15mg yesterday...we had taken him off due to the awful side effects with the skin and "prep" time.  However, DS has stated several times in the past 2 days that he is happier on the Daytrana as he can "get his thoughts through".  So, we will deal with the skin irritations.  I thought that I would share things I have learned with the patch:

1.)  No, it works best when adhered to the hip areas.  If placed on the "fatty" area, it does not absorb effectively and reduces the amount of drug absorption.    

2.)  We give him a 5 mg regular release Focalin when he wakes (6:30 to 6:45 am).  We then spray Nasonex onto the hip areas and let dry (we do both hips so that the day before patch area heals and so that it preps the other hip for the day's patch).  Our Pediatrician gives us some Nasonex samples as well to help as insurance will only cover one every 30 days and we use it in about 10 days to 2 weeks.

3.)  When we take the patch off, we use baby oil(gel type) and a disposable cotton make up remover.  We then wash with soap and water, and then spray on the Nasonex.  We had used Desonex (cream) before but we are trying a new lotion this time and not sure if it will help yet.  We left the Desonex on over night and put a very generous amount on.  We then wash his hips in the morning before he gets his patch on so that the area dries and is not greasy or have any lotion residue.

4.)  In the mornings, especially in the winter, we have him sit on our bed with a heating pad on low to medium and watch cartoons for about 10 minutes or so while his hip warms up.  We have found that the patch adheres much better and stays on better as well.

5.)  The patch falls off in water, not in the shower, but while swimming...I think that is because the water is colder and it affects the adhesive in some way.

6.)  The most important thing we have learned is to make sure to save the SILICA pack that comes in the tray with the patches.  We then store the patches with the silica packet in a FREEZER zip loc bag at room temperature.  This has GREATLY helped in getting the backing off of the patch.  I had noticed that each time we got a new tray, the backing was easier to remove.  I feel that it is because of the silica to absorb any moisture. 

I know that this was a long post but  I hope this will help.  DS is much happier on Daytrana and we hope that Shire will resolve these issues soon.  We want our boy to be as normal as possible and this med has helped us give him some help in his ADHD symptoms.  Good Luck everyone!

 

punkin' s mom39319.822037037 [QUOTE=TillyT] Anyone tried the new Daytrana methylphenidate patch?  Doc is recommending for DS, who does well on methylphenidate products, but none have lasted long enough. This is supposed to last 10+ hours. We'll be trying it next week, but wondered if anyone else has experience with their kids using it?
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My hyperactive 9 yr. old girl tried it. She kept peeling it off and complaining about it. She would peel it and drop it on the floor. We have little dogs who pick up everything in their mouths. I was actually afraid for them, and it did nothing but aggrivate her.My child has been on the daytrana patch since may of this year, I like it because you can control somewhat of how long the med stays in the system. My child is actually eating better on it, the concerta and adderall took his appetite away. The down side is it does at times make him itch and he can get focused on that and he takes it off. The patch can be worn for more than 9 hours, according to my doc, the med just starts to lose it strength.
Has any one heard of the book 3 steps to conquering ADHD and if so did it help; the web site was emailed to me by a friend.ADHD Mom239324.8040856481Thanks for the soda tip I might try that.  But in the past I've tried that when he needed antibiotics and he tasted the meds and refused it all or choked it up.  Also with the sprinkles he is a poor eater so he would not eat apple sauce or pudding every day.  Some days he will only eat a few slices or orange or some strawberries or other fruit.  He is quite the fruit eater wish I ate like him and I would be thinner too.  LOLKal makes a disolvable lozenge that is sweet tasting and works fast. you can break them in half as well. It takes my son about 15 min to go to sleep with the Melatonin.

Hello All: