Methylphenidate

CAUTION:
Methylphenidate can be habit-forming. Do not take a larger dose, take it more often, or take it for longer than prescribed by your doctor. If you take too much methylphenidate, you may experience unusual changes in your behavior. Inform 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 discontinue taking methylphenidate without informing 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.

General Information and Indications:

Methylphenidate is used as part of a treatment program for attention deficit hyperactivity disorder (ADHD; more difficulty focusing, controlling actions, and remaining still or quiet than other people who are the same age). 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.

Information For Users:

Methylphenidate comes as an immediate-release tablet, chewable tablet, and solution (liquid); an intermediate-acting (extended-release) tablet; and a long-acting (extended-release) capsule and 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 long 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 2–3 times a day, preferably 35–40 minutes before meals.The last dose should be taken at least several hours before bedtime. The intermediate-acting extended release tablets (Ritalin SR, Metadate ER, Methylin ER) are usually taken once a day in the morning with or without food. The long-acting extended release capsule (Metadate CD) is usually taken once a day before breakfast; the long-acting extended-release tablet (Concerta) and capsule (Ritalin LA) are usually taken once a day in the morning with or without food.

Follow the directions on your prescription label, ask your doctor or pharmacist If you have any questions. Take methylphenidate exactly as directed.

You should thoroughly chew the chewable tablets and then drink a full glass (at least 8 ounces) 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.

Your doctor might start you on a low dose of methylphenidate and slowly 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 one 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.

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Other uses for this medicine

Methylphenidate should not be used to treat depression or extreme tiredness (fatigue) that is not caused by narcolepsy.

special precautions:

o Inform your doctor or pharmacist if you have allergy to methylphenidate or any other medications.
o do not take methylphenidate if you are taking monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl), and tranylcypromine (Parnate), or have stopped taking them within the past 2 weeks. If you stop taking methylphenidate, you should wait at least 2 weeks before you start to take an MAO inhibitor.
o Inform your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: antidepressants ('mood elevators'); anticoagulants ('blood thinners') such as warfarin (Coumadin); clonidine (Catapres); guanabenz; medications for seizures such as phenobarbital, phenytoin (Dilantin), and primidone(Mysoline); and methyldopa (Aldomet). If you are taking Ritalin LA, also Inform your doctor if you take antacids.
o Inform your doctor if you or anyone in your family has or has ever had Tourette's syndrome (difficult to control need to perform repeated motions or to repeat sounds or words). Also Inform your doctor if you have or ever have had severe anxiety, tension, or agitation; glaucoma (an eye disease); motor tics (repeated twitching of any part of your body that is difficulty to control) or spasms; seizures; high blood pressure; irregular heartbeat; a heart attack; mental illness; a narrowing or blockage of your digestive system; or heart or thyroid disease. If you are taking the chewable tablets, Inform your doctor if you have trouble swallowing or if you have phenylketonuria (PKU, a disease in which you must avoid certain foods).
o Inform your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking methylphenidate, call your doctor.
o if you are having surgery, including dental surgery, Inform your doctor or dentist that you are taking methylphenidate.
o you should know that methylphenidate should be used as part of a total treatment program for ADHD, which may include counseling and special education. Make sure to follow all of your doctor's and/or therapist's instructions.

Possible Adverse Effects:

Methylphenidate may cause adverse effects. Inform your doctor if any of the following symptoms are severe or do not go away:

o nervousness
o difficulty falling alseep or staying asleep
o dizziness
o upset stomach
o vomiting
o loss of appetite (anorexia)
o stomach pain
o diarrhea
o headache
o cough, runny nose, and other cold symptoms
o painful menstruation

Some adverse effects could be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor without delay:

o seizures
o blurred vision (Impaired vision)
o agitation
o abnormal thoughts
o hallucinating (seeing things or hearing voices that do not exist)
o motor tics or verbal tics (repeating of words or sounds that is difficult to control)
o depression
o irregular heartbeat or heart palpitations
o fever
o sore throat
o unusual bruising or bleeding
o muscle or joint pain
o hives (Urticaria)
o rash
o itching
o difficulty swallowing or breathing

Methylphenidate may cause slower growth (height and weight) in children, especially those who take the medication for a long time.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.

Possible Symptoms of Overdose:

o vomiting
o agitation
o shaking of hands that you cannot control
o muscle twitching
o seizures
o loss of consciousness
o exaggerated or inappropriate happiness
o confusion
o hallucinating (seeing things or hearing voices that do not exist)
o sweating
o flushing
o headache
o fever
o fast, pounding, or irregular heartbeat
o widening of pupils (black circles in the middle of the eyes)
o dry mouth

Brand Name(s):

o Concerta®
o Metadate CD®
o Metadate ER®
o Methylin®
o Methylin ER®
o Ritalin®
o Ritalin-LA®
o Ritalin-SR®

Other Name(s):

o Methylphenidylacetate hydrochloride