Medication Information

Classification: Central nervous system

Common Usage: Methylphenidate is indicated for treatment of attention-deficit/hyperactivity disorder (ADHD) and narcolepsy.

Important Side Effects: The most common side effects in patients using methylphenidate are nervousness and insomnia, which can usually be controlled by reducing the dosage and not taking methylphenidate in the afternoon or evening. Other possible side effects include loss of appetite, nausea, dizziness, heart palpitations, headache, changes in blood pressure or pulse and rash. Methylphenidate should be taken with caution in people who have a history of drug dependence or alcoholism. Abuse of methylphenidate may lead to tolerance and dependence on the drug. If the drug is withdrawn suddenly, depression or overactivity may occur.

If you are planning to become pregnant, are pregnant, or are a nursing mother, the potential benefits of this medication must be weighed against the possible hazards. Discuss these issues in advance with all of your health care providers.

This is not a complete list of all known or potential adverse effects. Notify your prescriber or pharmacist of any symptoms that have started since you began taking this medication, changing its dose, or adding or changing other medication or diet. Take care when performing any task (for example, driving or operating machinery) that requires your attention until you have experience with this drug and are confident you can perform the task safely.

Interactions with Other Medications: Methylphenidate may decrease the effectiveness of guanethidine (Ismelin). It should be used with caution with monoamine oxidase inhibitor (MAOI) antidepressants such as phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), orphenadrine (Norflex) or cyclophosphamide (Cytoxan). Methylphenidate also may inhibit the metabolism of warfarin (Coumadin); anticonvulsants, such as phenobarbital (Donnatal and others); and tricyclic antidepressants such as imipramine (Tofranil). Those drugs may need to be given at lower doses than normal when taken with methylphenidate.

This is not a complete list of all known or potential drug interactions. To help prevent problems, always make sure that your pharmacist and all prescribers know about all medications you are taking, including over-the-counter drugs; dietary herbal supplements; folk or home remedies; or unusual foods, drinks, or dietary habits.

Common Dosages: Adults: Methylphenidate should be taken in divided doses two or three times daily, usually 30 to 45 minutes before breakfast and lunch. The average dose is 20 to 30 mg/day, but a dose as low as 10 mg/day may be effective and some patients may need up to 60 mg/day. Doses above 60 mg/day are not recommended.

Children: Methylphenidate should not be used in children under six years old because safety and efficacy in this group has not been determined. The usual starting dose of methylphenidate for children is 5 mg twice daily (before breakfast and lunch) with increases of 5 to 10 mg on a weekly basis until the desired effect is achieved.

Extended-release formulations of methylphenidate (Ritalin SR, Metadate ER, Methylin ER) have a duration of eight hours and should be taken in equivalent dose as the immediate-release formulation for adults and children.

Once-daily formulations of methylphenidate are also available. The recommended starting dose of Concerta is 18 mg/day, taken before breakfast. The dose can be increased at weekly intervals by 18 mg up to a maximum daily dose of 54 mg.

Metadate CD combines 30 percent immediate-release methylphenidate and 70 percent extended-release methylphenidate. The recommended starting dose of Metadate CD is 20 mg/day, taken before breakfast. The dosage may be increased up to 60 mg/day, depending on tolerability and efficacy.

Ritalin: The 5-mg tablets are round, yellow and imprinted "CIBA 7." The 10-mg tablets are round, pale green, scored and imprinted "CIBA 3." The 20-mg tablets are round, pale yellow, scored and imprinted "CIBA 34." Ritalin SR is available as a 20-mg tablet that is round, white, coated and imprinted "CIBA 16."

Methylin ER: The 10-mg tablets are round, white or off-white and debossed with "1423" on one side and a boxed "M" on the other. The 20-mg tablets are round, white or off-white and debossed with "1451" on one side and a boxed "M" on the other.

Metadate ER: The 10-mg tablets are oval, white, uncoated, unscored and debossed "561 MD." The 20-mg tablets are round, white, uncoated, unscored and debossed "562 MD."

Metadate CD: The 20-mg capsule is blue and white. "MEDEVA 575" is printed on the blue side of the capsule in white letters and "20 mg" is printed on the white side in black letters.

Concerta: The 18-mg tablets are yellow and imprinted "alza 18." The 36-mg tablets are white and imprinted "alza 36." The 54-mg tablets are brownish-red and imprinted "alza 54."

Storage: Store tablets between 59° and 86° F in a light- and moisture-tight container. Store liquids below 77° F in a tight, amber glass bottle. Do not freeze. Avoid skin contact with liquid dosage forms as they can rarely cause skin irritation.

To prevent accidental poisoning, keep all medications out of the reach of children or impaired adults. If you have difficulty opening child-resistant containers, your pharmacist can provide you with a container that is easier to open, but then you must take special care to keep children and impaired adults from having access to this medication. Keep out of direct sunlight and avoid storing in a warm and humid area, such as the bathroom or kitchen, to prevent deterioration. Do not take an expired medication. Do not transfer medication from one container to another. Carefully discard discontinued medication where children or impaired adults cannot find it or return it to your pharmacy for destruction.

Last Update: 02/16/2003