Methylphenidate can be habit-forming. Do not take a larger dose, take it more often, take it for a longer time, or take it in a different way than prescribed by your doctor. If you take too much methylphenidate, you may find that the medication no longer controls your symptoms, you may feel a need to take large amounts of the medication, and you may experience unusual changes in your behavior. Tell your doctor if you drink or have ever drunk large amounts of alcohol, use or have ever used street drugs, or have overused prescription medications.
Do not stop taking methylphenidate without talking to your doctor, especially if you have overused the medication. Your doctor will probably decrease your dose gradually and monitor you carefully during this time. You may develop severe depression if you suddenly stop taking methylphenidate after overusing it. Your doctor may need to monitor you carefully after you stop taking methylphenidate, even if you have not overused the medication, because your symptoms may worsen when treatment is stopped.
Do not sell, give away, or let anyone else take your medication. Selling or giving away methylphenidate may harm others and is against the law. Store methylphenidate in a safe place so no one else can take it accidentally or on purpose. Keep track of how much medication is left so you will know if any is missing.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with methylphenidate and each time you get more medication. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.
Methylphenidate is used as part of a treatment program to control symptoms of attention deficit hyperactivity disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age) in adults and children. Methylphenidate (Ritalin, Ritalin SR, Methylin, Methylin ER) is also used to treat narcolepsy (a sleep disorder that causes excessive daytime sleepiness and sudden attacks of sleep). Methylphenidate is in a class of medications called central nervous system (CNS) stimulants. It works by changing the amounts of certain natural substances in the brain.
Methylphenidate comes as an immediate-release tablet, a chewable tablet, a solution (liquid), a long-acting (extended-release) suspension (liquid), an intermediate-acting (extended-release) tablet, a long-acting (extended-release) capsule, and a long-acting (extended-release) tablet. The long-acting tablet and capsules supply some medication right away and release the remaining amount as a steady dose of medication over a longer time. All of these forms of methylphenidate are taken by mouth. The regular tablets (Ritalin, Methylin), chewable tablets (Methylin), and solution (Methylin) are usually taken two to three times a day by adults and twice a day by children, preferably 35 to 40 minutes before meals. Adults who are taking three doses should take the last dose before 6:00 pm, so that the medication will not cause difficulty in falling asleep or staying asleep. The intermediate-acting extended release tablets (Ritalin SR, Metadate ER, Methylin ER) are usually taken once or twice a day, in the morning and sometimes in the early afternoon 30 to 45 minutes before a meal. The long-acting extended release capsule (Metadate CD) is usually taken once a day before breakfast; the long-acting extended-release tablet (Concerta), long-acting suspension (Quillivant XR), and capsule (Ritalin LA) are usually taken once a day in the morning with or without food. The long-acting suspension (Quillivant XR) will begin to work sooner if it is taken with food.
Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take methylphenidate exactly as directed.
You should thoroughly chew the chewable tablets and then drink a full glass (at least 8 ounces [240 milliliters]) of water or other liquid. If you take the chewable tablet without enough liquid, the tablet may swell and block your throat and may cause you to choke. If you have chest pain, vomiting, or trouble swallowing or breathing after taking the chewable tablet, you should call your doctor or get emergency medical treatment immediately.
Swallow the intermediate acting and long-acting extended-release tablets and capsules whole; do not split, chew, or crush them. However, if you cannot swallow the long-acting capsules (Metadate CD, Ritalin LA), you may carefully open the capsules and sprinkle the entire contents on a tablespoon of cool or room temperature applesauce. Swallow (without chewing) this mixture immediately after preparation and then drink a glass of water to make sure you have swallowed all of the medicine. Do not store the mixture for future use.
Remove the bottle of medication and dosing dispenser from the box. Check to be sure that the bottle contains liquid medication. Call your pharmacist and do not use the medication if the bottle contains powder or if there is no dosing dispenser in the box.
Shake the bottle up and down for at least 10 seconds to mix the medication evenly.
Remove the bottle cap. Check that the bottle adapter has been inserted into top of the bottle.
If the bottle adapter has not been inserted into the top of the bottle, insert it by placing the bottom of the adaptor into the opening of the bottle and pressing down firmly on it with your thumb. Call your pharmacist if the box does not contain a bottle adapter. Do not remove the bottle adapter from the bottle once it is inserted.
Insert the tip of the dosing dispenser into the bottle adapter and push the plunger all the way down.
Turn the bottle upside down.
Pull the plunger back to withdraw the amount of oral suspension prescribed by your doctor. If you are not sure how to correctly measure the dose your doctor has prescribed, ask your doctor or pharmacist.
Remove the dosing dispenser and slowly squirt the oral suspension directly into your mouth or your child's mouth.
Replace the cap on the bottle and close tightly.
Clean the dosing dispenser after each use by placing it in the dishwasher or by rinsing with tap water.
Your doctor may start you on a low dose of methylphenidate and gradually increase your dose, not more often than once every week.
Your condition should improve during your treatment. Call your doctor if your symptoms worsen at any time during your treatment or do not improve after 1 month.
Your doctor may tell you to stop taking methylphenidate from time to time to see if the medication is still needed. Follow these directions carefully.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
talk to your doctor about the risks and benefits of taking methylphenidate if you are 65 years of age or older. Older adults should not usually take methylphenidate because it is not as safe as other medications that can be used to treat the same condition.
Take the missed dose as soon as you remember it. However, if it is almost time for your next scheduled dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
difficulty falling asleep or staying asleep
loss of appetite
uncontrollable movement of a part of the body
numbness, burning, or tingling in the hands or feet
decreased sexual desire
fast, pounding, or irregular heartbeat
shortness of breath
slow or difficult speech
weakness or numbness of an arm or leg
changes in vision or blurred vision
believing things that are not true
feeling unusually suspicious of others
hallucinating (seeing things or hearing voices that do not exist)
motor tics or verbal tics
abnormally excited mood
frequent, painful erections
erection that lasts longer than 4 hours
numbness, pain, or sensitivity to temperature in the fingers or toes
skin color change from pale to blue to red in the fingers or toes
unexplained wounds on the fingers or toes
blistering or peeling skin
swelling of the eyes, face, lips, mouth, tongue, or throat
difficulty breathing or swallowing
Methylphenidate may cause sudden death in children and teenagers, especially children or teenagers with heart defects or serious heart problems. This medication also may cause sudden death, heart attack or stroke in adults, especially adults with heart defects or serious heart problems. Talk to your doctor about the risks of taking this medication.
Methylphenidate may slow children's growth or weight gain. Your child's doctor will watch his or her growth carefully. Talk to your child's doctor if you have concerns about your child's growth or weight gain while he or she is taking this medication. Talk to your child's doctor about the risks of giving methylphenidate to your child.
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature, away from light and excess heat and moisture (not in the bathroom). Store methylphenidate in a safe place so that no one else can take it accidentally or on purpose. Keep track of how many tablets or capsules are left so you will know if any are missing. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
uncontrollable shaking of a part of the body
loss of consciousness
hallucinating (seeing things or hearing voices that do not exist)
fast, pounding, or irregular heartbeat
widening of pupils (black circles in the middle of the eyes)
dry mouth or nose
If you are taking methylphenidate long-acting tablets (Concerta), you may notice something that looks like a tablet in your stool. This is just the empty tablet shell, and this does not mean that you did not get your complete dose of medication.
Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your response to methylphenidate.
This prescription is not refillable. Be sure to schedule appointments with your doctor on a regular basis so that you do not run out of medication.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Last Revised - 03/15/2014
AHFS® Consumer Medication Information. © Copyright, 2015. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.