Methylphenidate can be habit-forming. Take methylpenidate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. If you take too much methylphenidate, the medication may no longer work as well and you may feel a need to take more of it, 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.
You will be given 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 https://www.fda.gov/Drugs/DrugSafety/ucm085729.htm or the manufacturer's website to obtain the Medication Guide.
Why is this medicine prescribed?
Methylphenidate is used to control symptoms of attention deficit hyperactivity disorder (ADHD; condition that makes it hard to pay attention, control your behavior, and remain still or quiet) and to treat narcolepsy (condition that causes people to be very sleepy during the day and to fall asleep suddenly). 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.
Are there other uses for this medicine?
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medicine be used?
Methylphenidate comes as a tablet, a chewable tablet, a solution (liquid), a suspension (liquid), an orally disintegrating tablet (tablet that dissolves quickly in the mouth), a long-acting (extended-release) tablet, and a long-acting capsule to take by mouth. Your doctor will tell you how often to take methylphenidate and how you should take it. This depends on the dosage form that you are taking. Ask your doctor or pharmacist if you have questions about taking methylphenidate.
Do not try to push the orally disintegrating tablet through the blister pack foil. Instead, use dry hands and peel back the foil. Immediately take out the tablet and place it in your mouth. The tablet will quickly dissolve and can be swallowed with saliva; no water is needed to swallow the tablet.
Swallow the long-acting tablets and capsules whole; do not split, chew, or crush them. Tell your doctor if you have problems swallowing. Your doctor will tell you how to take methylphenidate.
If you are taking the suspension, your doctor with give you the manufacturer's instructions for use. These instructions describe how to measure and take a dose of the suspension. Read these instructions and follow them carefully. Be sure to ask your pharmacist or doctor if you have any questions.
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.
Some methylphenidate products may not be able to be substituted for another. Ask your pharmacist if you have any questions about the type of methylphenidate product your doctor has prescribed.
What special precautions should I follow?
Before taking methylphenidate,
- tell your doctor and pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
- tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past two weeks: monoamine oxidase (MAO) inhibitors, including isocarboxazid, linezolid, methylene blue, phenelzine, rasagiline, selegiline, and tranylcypromine.
- some medications should not be taken with methylphenidate. Other medications may cause dosing changes or extra monitoring when taken with methylphenidate. Make sure you have discussed any medications you are currently taking or plan to take before taking methylphenidate with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking methylphenidate, please get the advice of your doctor or pharmacist.
- tell your doctor if anyone in you or anyone in your family has or has ever had an irregular heartbeat or has died suddenly, a heart defect, or any other heart problem; high blood pressure; Tourette's syndrome (a condition that causes sudden repeated motions, sounds or words), facial or motor tics (repeated uncontrollable movements), or verbal tics (repeated sounds or words that are hard to control); depression, bipolar disorder (mood that changes from depressed to abnormally excited), mania (abnormally excited mood), has thought about or attempted suicide, or other mental problems; glaucoma (increased pressure in the eye that may cause vision loss) or other vision problems; circulation problems in your fingers or toes; seizures; an abnormal electroencephalogram (EEG; a test that measures electrical activity in the brain); or narrowing or blockage of your digestive system.
- tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking methylphenidate, call your doctor.
- tell your doctor if you are breastfeeding or plan to breastfeed. If you are breastfeeding while taking methylphenidate your doctor may tell you to watch your baby closely for unusual agitation, difficulty sleeping, poor appetite, or weight loss.
- if you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent brain damage that can cause severe disability), you should know that the chewable tablets contain aspartame that forms phenylalanine.
- 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.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking methylphenidate.
- ask your doctor about the safe use of alcoholic beverages while you are taking methylphenidate. Alcohol can make the side effects from methylphenidate worse.
What should I do if I forget to take a dose?
Take the missed dose as soon as you remember it. Talk to your doctor or pharmacist about how late in the day you should take a missed dose of your medication so that it will not cause difficulty in falling asleep or staying asleep. 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.
What should I do in case of overdose?
In case of overdose, call the poison control helpline at 1-800-222-1222
. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Symptoms of overdose may include the following:
- vomiting
- nausea
- diarrhea
- fainting, blurred vision, or dizziness
- restlessness
- abnormally rapid breathing
- anxiety
- agitation
- uncontrollable shaking of a part of the body
- muscle twitching
- seizures
- loss of consciousness
- inappropriate happiness
- confusion
- hallucinating (seeing things or hearing voices that do not exist)
- sweating
- flushing
- headache
- fever
- fast, pounding, or irregular heartbeat
- widening of pupils (black circles in the middle of the eyes)
- dry mouth or nose
- muscle weakness, fatigue, or dark urine
What side effects can this medicine cause?
Methylphenidate may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- nervousness
- irritability
- difficulty falling asleep or staying asleep
- dizziness
- nausea
- vomiting
- loss of appetite
- weight loss
- stomach pain
- diarrhea
- heartburn
- dry mouth
- headache
- muscle tightness
- drowsiness
- uncontrollable movement of a part of the body
- restlessness
- decreased sexual desire
- heavy sweating
- back pain
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:
- fast, pounding, or irregular heartbeat; chest pain; shortness of breath; excessive tiredness; or fainting
- seizures
- changes in vision or blurred vision
- agitation, 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
- depression, abnormally excited mood, or mood changes
- frequent, painful erections or 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; or unexplained wounds on the fingers or toes
- hives; rash; itching; blistering or peeling skin, swelling of the eyes, face, lips, mouth, tongue, or throat; difficulty breathing or swallowing; or hoarseness
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.
What should I know about storage and disposal of this medication?
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 or how much liquid is left so you will know if any medication is missing.
Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach https://www.upandaway.org
Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.
What other information should I know?
If you are taking methylphenidate long-acting tablets, 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 check your blood pressure and heart rate and 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.
Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.