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What is the most important information I should know about methylphenidate?

Do not use methylphenidate if you have used an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam) within the past 14 days. Serious, life-threatening side effects can occur if you use methylphenidate before the MAO inhibitor has cleared from your body.

Do not use this medication if you are allergic to methylphenidate or if you have glaucoma, tics (muscle twitches) or Tourette’s syndrome, depression, or severe anxiety, tension, or agitation (methylphenidate can make these symptoms worse).

Methylphenidate may be habit-forming and should be used only by the person it was prescribed for. Methylphenidate should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

Warning

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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What is methylphenidate?

Methylphenidate is a central nervous system stimulant. It affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control.

Methylphenidate is used to treat attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and narcolepsy.

Methylphenidate may also be used for other purposes not listed in this medication guide.


Precautions

Do not take methylphenidate if you have used an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam) within the past 14 days. Serious, life-threatening side effects can occur if you use methylphenidate before the MAO inhibitor has cleared from your body.

Do not use this medication if you are allergic to methylphenidate or if you have:

  • glaucoma;
  • a personal or family history of tics (muscle twitches) or Tourette's syndrome; or
  • severe anxiety, tension, or agitation (methylphenidate can make these symptoms worse).

Some stimulants have caused sudden death in children and adolescents with serious heart problems or congenital heart defects.

Before using methylphenidate, tell your doctor if you are allergic to any drugs, or if you have:

  • a congenital heart defect;
  • high blood pressure;
  • heart failure, heart rhythm disorder, or recent heart attack;
  • a personal or family history of mental illness, psychotic disorder, bipolar illness, depression, or suicide attempt;
  • epilepsy or other seizure disorder; or
  • a history of drug or alcohol addiction.

If you have any of these conditions, you may not be able to use methylphenidate, or you may need a dose adjustment or special tests during treatment.

FDA pregnancy category C. Methylphenidate may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether methylphenidate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Long-term use of methylphenidate can slow a child’s growth. Tell your doctor if the child using this medication is not growing or gaining weight properly.

Do not give methylphenidate to a child younger than 6 years old without the advice of a doctor.

Methylphenidate can cause side effects that may impair your vision or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of methylphenidate can be fatal.

Overdose symptoms may include vomiting, agitation, tremors, muscle twitching, seizure (convulsions), confusion, hallucinations, sweating, fast or pounding heartbeat, blurred vision, dry mouth and nose, and fainting.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.

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Side-effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking methylphenidate and call your doctor at once if you have any of these serious side effects:

  • fast, pounding, or uneven heartbeats;
  • feeling like you might pass out;
  • fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
  • aggression, restlessness, hallucinations, unusual behavior, or motor tics (muscle twitches);
  • easy bruising, purple spots on your skin; or
  • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Less serious side effects may include:

  • vision problems;
  • mild skin rash;
  • dizziness;
  • nervous feeling, sleep problems (insomnia);
  • nausea, vomiting, loss of appetite; or
  • weight loss.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

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Interactions

Before taking methylphenidate, tell your doctor if you are using any of the following drugs:

  • blood pressure medications;
  • a blood thinner such as warfarin (Coumadin);
  • clonidine (Catapres);
  • seizure medicine such as phenytoin (Dilantin), phenobarbital (Luminal), primidone (Mysoline); or
  • an antidepressant such as amitriptyline (Elavil, Etrafon), citalopram (Celexa), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Janimine, Tofranil), paroxetine (Paxil), sertraline (Zoloft), and others.

This list is not complete and there may be other drugs that can interact with methylphenidate. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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