Ritalin (methylphenidate)

Methylphenidate is used to treat attention deficit hyperactivity disorder (ADHD). Methylphenidate (Ritalin, Ritalin-SR) is also used to treat narcolepsy (uncontrolled desire for, or 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.

How should this medicine be used?
Methylphenidate comes as a tablet, an extended- or sustained-release (long-acting) tablet, and an extended-release capsule to take by mouth. The regular tablet and the extended-release tablet (Metadate ER, Methylin ER, Ritalin-SR) are usually taken two or three times a day, preferably 30-45 minutes before meals. The last dose of the day should be taken at least several hours before bedtime because the drug can cause sleeplessness. The extended-release tablet (Concerta) usually is taken once a day, in the morning, with or without food. The extended-release capsule usually is taken once a day, in the morning, before breakfast.
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. Do not take more or less of it or take it more often than prescribed by your doctor.
Swallow the extended-release tablets and capsules whole; do not split, chew, or crush them.
Your doctor may start you on a low dose of methylphenidate and gradually increase your dose.
Continue to take methylphenidate even if you feel well. Do not stop taking methylphenidate without talking to your doctor, especially if you have taken large doses for a long time. Your doctor probably will decrease your dose gradually. This drug must be taken regularly for a few weeks before its full effect is felt.

What special precautions should I follow?
Before taking methylphenidate,
• tell your doctor and pharmacist if you are allergic to methylphenidate or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially MAO inhibitors such as phenelzine (Nardil) or tranylcypromine (Parnate), even if you stopped taking them in the last 2 weeks; anticoagulants (blood thinners) such as warfarin (Coumadin); medications for depression such as amitriptyline (Elavil), impramine (Tofranil), and desipramine (Norpramin); guanethidine (Ismelin); medications for epilepsy such as phenobarbital, phenytoin (Dilantin), and primidone(Mysoline); and vitamins.
• tell your doctor if you have or have ever had severe anxiety, tension, or agitation; glaucoma; motor tics or spasms; a history or family history of Tourette's syndrome; seizures; high blood pressure; or mental illness.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking methylphenidate, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking methylphenidate.
• you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
• remember that alcohol can add to the drowsiness caused by this drug.

What should I do if I forget a dose?
Take the missed dose as soon as you remember it and take any remaining doses for that day at evenly spaced intervals, but do not take a dose at or near bedtime. However, if you remember a missed dose when it is almost time for your next scheduled dose, skip the missed dose. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?
Although side effects from methylphenidate are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:
• nervousness
• difficulty falling alseep or staying asleep
• dizziness
• drowsiness
• upset stomach
• vomiting
• headache
• loss of appetite
If you experience any of the following symptoms, call your doctor immediately:
• seizures or convulsions
• blurred vision
• agitation
• skin rash
• heart palpitations or irregular heartbeat
• fever
• sore throat
• unusual bleeding or bruising.

What storage conditions are needed for 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). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.