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:
- overactive thyroid;
- severe high blood pressure;
- angina (chest pain), heart failure, heart rhythm disorder, or recent heart attack;
- a personal or family history of tics (muscle twitches) or Tourette's syndrome;
- severe anxiety, tension, or agitation (methylphenidate can make these symptoms worse); or
- a hereditary condition such as fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltase insufficiency.
Some stimulants have caused sudden death in children and adolescents with serious heart problems or congenital heart defects. Tell your doctor if you have a congenital heart defect.
If you have certain other conditions, you may need a dose adjustment or special tests to safely take this medication. Before using methylphenidate, tell your doctor if you are allergic to any drugs, or if you have:
- a congenital heart defect;
- 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.
FDA pregnancy category C. It is not known whether methylphenidate is 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.
Seek emergency medical attention if you think you have used too much of this medicine. An overdose of methylphenidate can be fatal.
Overdose can cause 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.
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:
- stomach pain, nausea, vomiting, loss of appetite;
- vision problems, dizziness, mild headache;
- sweating, mild skin rash;
- numbness, tingling, or cold feeling in your hands or feet;
- nervous feeling, sleep problems (insomnia); 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. You may report side effects to FDA at 1-800-FDA-1088.
Before taking methylphenidate, tell your doctor if you are using any of the following drugs:
- a blood thinner such as warfarin (Coumadin);
- clonidine (Catapres);
- dobutamine (Dobutrex), epinephrine (EpiPen), or isoproterenol (Isuprel);
- phenylbutazonie (Azolid, Butazolidin);
- cold/allergy medicine that contains phenylephrine (a decongestant);
- potassium citrate (Urocit-K, Twin-K), sodium acetate, sodium bicarbonate (Alka-Seltzer), citric acid and potassium citrate (Cytra-K, Poly-Citra), or sodium citrate and citric acid (Bicitra, Oracit);
- medications to treat high or low blood pressure;
- stimulant medications or diet pills;
- seizure medicine such as phenytoin (Dilantin), phenobarbital (Luminal), primidone (Mysoline); or
- an antidepressant such as amitriptyline (Elavil, Etrafon), citalopram (Celexa), doxepin (Sinequan), fluoxetine (Prozac, Sarafem), imipramine (Janimine, Tofranil), nortriptyline (Pamelor) 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.
Concerta, Daytrana, Metadate CD, Metadate ER, Methylin, Methylin ER, Ritalin, Ritalin LA, Ritalin-SR, and methylphenidate
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