Methylphenidate, Oral Tablet

Other warnings

• Heart problems warning: Methylphenidate may cause stroke, heart attack, or sudden death in people with heart issues. People with serious heart problems shouldn’t take this drug. This medication may increase your blood pressure and heart rate. If you have high blood pressure, heart failure, a history of heart attack, or an abnormal heart rate, ask your doctor if this drug is safe for you.
• Psychiatric disorders warning: If you have mental health conditions, this drug may make your symptoms worse. It can also cause psychotic or manic symptoms in children and teenagers without a history of these problems. They may have symptoms such as hallucinations (seeing, hearing, or believing things that aren’t real) or paranoia (feeling suspicious).
• Digestive problems warning: This warning is only for the brand Concerta. Concerta may cause a blockage of the esophagus, stomach, or intestines in people who already have a narrowing in any of these organs. Concerta tablets should only be used if you can swallow the tablet whole. Cutting or breaking apart the tablet might increase the amount of medication in your body. This increases your risk of side effects.

Methylphenidate oral tablet is a prescription drug. It comes in these forms: oral tablet, extended-release tablet, extended-release capsule, chewable tablet, extended-release chewable tablet, and extended-release orally disintegrating tablet. Methylphenidate also comes as a transdermal patch, oral suspension, and oral solution.

Methylphenidate is a controlled substance. This means that its use will be closely monitored by your doctor.

Methylphenidate oral tablet is available as the brand-name drugs Ritalin, Ritalin SR, Concerta, Metadate ER, QuilliChew ER, and Cotempla XR-ODT. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

Methylphenidate oral tablet may be used as part of a combination therapy. That means you may need to take it with other drugs.

Why it’s used

Methylphenidate oral tablet is used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. It may help to increase attention and decrease impulsiveness and hyperactivity if you have ADHD.

How it works

Methylphenidate belongs to a class of drugs called central nervous system (CNS) stimulants. It works by increasing the amount of the chemicals norepinephrine and dopamine in your brain. These chemicals send signals to other parts of your body, which will help to improve your symptoms.

Methylphenidate oral tablet doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects that can occur with methylphenidate include:

• headache
• decreased appetite
• upset stomach
• nervousness
• trouble sleeping
• nausea

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Heart problems. Symptoms can include:
  • pain in your chest, left arm, jaw, or between your shoulders
  • increased blood pressure
  • increased heart rate
  • shortness of breath
• Stroke. Symptoms can include:
  • weakness in one part or side of your body
  • slurred speech
• Abnormal liver function that may be mild or lead to severe liver damage
• Mental health problems. Symptoms can include:
  • symptoms of mania, such as racing thoughts, feelings of power, and excessive energy
  • aggression or hostility
  • hallucinations (seeing or hearing things that aren’t real)
  • paranoia (feeling suspicious)
  • feeling overexcited
• Seizures
• Slowed growth (height and weight) in children
• Changes in eyesight or blurred vision
• Circulation problems. Symptoms in your fingers or toes can include:
  • numbness
  • feeling cool (sensitive to temperature)
  • pain
  • changes in skin color from pale to blue to red
  • new, unexplained wounds
• Priapism (painful and prolonged erections)

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Methylphenidate oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with methylphenidate are listed below.

Acid reflux drugs

Taking these drugs with methylphenidate may increase the level of methylphenidate in your body and lead to more side effects. These medications may also affect the way long-acting forms of methylphenidate work. Examples of these drugs include:

• antacids
• H2 blockers
• proton pump inhibitors

Serotonergic drugs

Taking these drugs with methylphenidate may increase your risk of serotonin syndrome, which can be fatal. If you take any of these drugs, your doctor will start you on a lowered dosage of methylphenidate and monitor you for signs of serotonin syndrome. Symptoms can include agitation, sweating, muscle twitches, and confusion.

Examples of these drugs include:

• selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine and sertraline
• serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine and venlafaxine
• tricyclic antidepressants (TCAs) such as amitriptyline and clomipramine
• monoamine oxidase inhibitors (MAOIs) such as selegiline and phenelzine
• the opioids fentanyl and tramadol
• the anxiolytic buspirone
• triptans
• lithium
• tryptophan
• St. John’s wort

Methylphenidate cannot be used during treatment with MAOIs. You can’t take it within 14 days of stopping treatment with an MAOI. Using these medications together can lead to a dangerous increase in your blood pressure.

Blood pressure drugs

Taking these drugs with methylphenidate may reduce the intended effects of these medications. This means that they will be less effective. Examples of these drugs include:

• angiotensin II receptor blockers such as losartan, valsartan, and irbesartan
• angiotensin-converting enzyme (ACE) inhibitors such as enalapril and lisinopril
• diuretics (water pills) such as hydrochlorothiazide and furosemide

Antipsychotics

Using these drugs with methylphenidate may increase your risk of side effects from both the antipsychotics and from methylphenidate. Examples of these antipsychotics include:

• chlorpromazine
• haloperidol

Seizure medications

Using these drugs with methylphenidate may increase the amount of the seizure drug in your body. This can lead to more side effects from the seizure drug. Examples of these drugs include:

• phenytoin
• phenobarbital

Warfarin

Using warfarin, a blood thinner, with methylphenidate may increase the effect of warfarin in your body. This can raise your risk of bleeding.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

Methylphenidate can cause a severe allergic reaction. Symptoms can include:

• trouble breathing
• swelling of your throat or tongue
• rash
• hives (itchy welts)

If you develop these symptoms, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction warning

Alcohol may increase the effects of methylphenidate. You should not use alcohol while taking this drug.

Alcohol may cause Metadate CD and Ritalin LA to be released in your body more quickly. This can cause more side effects and lower the effect of the medication.

Warnings for people with certain health conditions

For people with heart problems: Methylphenidate may increase the risk of sudden death, stroke, and heart attack. If you have a heart condition, a history of heart attack, high blood pressure, or an abnormal heart rate, ask your doctor if this drug is safe for you.

For people with psychiatric disorders: Methylphenidate may make the symptoms of your condition worse. It can also cause new psychotic symptoms, especially in children and adolescents. You may need to stop taking this drug if this happens.

For people with circulation problems: This drug can worsen circulation problems in your fingers and toes.

For people with seizures: If you or your child has a history of seizures, don’t take methylphenidate. It may increase your risk of having a seizure.

For people with glaucoma: Methylphenidate may worsen your vision.

For people with growth issues: Methylphenidate has been shown to slow growth in children. Your child’s doctor will monitor your child’s height and weight while they take this drug. If your child is not gaining height or weight, methylphenidate may need to be stopped.

For people with digestive tract problems: Don’t use the brand-name drug Concerta if you have a blockage in your esophagus, stomach, or small or large intestine. Concerta can make this problem worse.

Warnings for other groups

For pregnant women: Methylphenidate is a category C pregnancy drug. That means two things:

1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
2. There haven’t been enough studies done in humans to be certain how the drug might affect a fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Methylphenidate should be used during pregnancy only if the potential benefit justifies the potential risk.

If you become pregnant while taking this drug, call your doctor right away.

For women who are breastfeeding: It’s not known if methylphenidate passes through breast milk. You and your doctor may need to decide if you’ll take methylphenidate or breastfeed.

For seniors: This drug hasn’t been established as safe and effective for use in people over 65 years of age.

For children: This drug hasn’t been established as safe and effective for use in children under 6 years old.

Children should have their growth monitored by their doctor while they’re taking methylphenidate.

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how you react to the first dose

Dosage for attention deficit hyperactivity disorder (ADHD)

Generic: Methylphenidate

• Form: oral immediate-release tablet
• · Strengths: 5 mg, 10 mg, 20 mg
• Form: chewable tablet
• Strengths: 2.5 mg, 5 mg, 10 mg

• Form: oral extended-release tablet
• Strengths: 10 mg, 18 mg, 20 mg, 27 mg, 36 mg, 54 mg, 72 mg

Brand: Ritalin

• Form: oral immediate-release tablet
• Strengths: 5 mg, 10 mg, 20 mg

Brand: Ritalin SR

• Form: extended-release oral tablet
• Strength: 20 mg

Brand: Concerta

• Form: extended-release oral tablet
• Strengths: 18 mg, 27 mg, 36 mg, 54 mg

Brand: Cotempla XR-ODT

• Form: extended-release orally disintegrating tablet
• Strengths: 8.6 mg, 17.3 mg. 25.9 mg

Brand: Metadate ER

• Form: oral extended-release tablet
• Strengths: 20 mg

Brand: QuilliChew ER

• Form: extended-release chewable tablet
• Strengths: 20 mg, 30 mg, 40 mg

CONCERTA:

Adult dosage (ages 18 years and older)

• Typical dosage: 18 mg or 36 mg taken once per day.
• Dosage increases: Your doctor may increase your dosage by 18 mg each week.
• Maximum dosage: 72 mg per day.

Child dosage (ages 13–17 years)

• Typical dosage: 18 mg per day.
• Dosage increases: Your doctor may increase your child’s dosage by 18 mg each week.
• Maximum dosage: 72 mg per day.

Child dosage (ages 6–12 years)

• Typical dosage: 18 mg per day.
• Dosage increases: Your doctor may increase your dosage by 18 mg each week.
• Maximum dosage: 54 mg per day.

Child dosage (ages 0–5 years)

Dosages for people younger than 6 years haven’t been established.

RITALIN, GENERIC IMMEDIATE-RELEASE TABLETS AND CHEWABLE TABLETS:

Adult dosage (ages 18–64 years)

• Typical dosage: 20–30 mg per day taken in 2–3 divided doses.

Child dosage (ages 6–17 years)

• Typical dosage: 5 mg taken twice per day before breakfast and lunch.
• Dosage increases: Your doctor may increase your dosage by 5–10 mg each week.

Child dosage (ages 0–5 years)

Dosages for people younger than 6 years haven’t been established.

RITALIN SR, METADATE ER, GENERIC EXTENDED-RELEASE TABLETS:

Adult dosage (ages 18 years and older)

• Typical dosage: These extended-release tablets work for about 8 hours. These tablets may be used in place of immediate-release tablets when the 8-hour dose of the extended-release tablet corresponds to the titrated 8-hour dose of the immediate-release tablet. Your doctor can tell you more.

Child dosage (ages 6–17 years)

• Typical dosage: These extended-release tablets work for about 8 hours. These tablets may be used in place of immediate-release tablets when the 8-hour dose of the extended-release tablet corresponds to the titrated 8-hour dose of the immediate-release tablet. Your child’s doctor can tell you more.

Child dosage (ages 0–5 years)

Dosages for people younger than 6 years haven’t been established.

COTEMPLA XR-ODT

Adult dosage (ages 18 years and older)

This drug is not prescribed for this age range.

Child dosage (ages 6–17 years)

• Typical dosage: 17.3 mg taken once per day in the morning.
• Dosage increases: Your doctor may increase your child’s dosage by 8.6 mg to 17.3 mg each week until a suitable dosage is determined. If prescribed for long-term use, your doctor may adjust your child’s dosage from time to time.
• Maximum dosage: 51.8 mg per day.

Child dosage (ages 0–5 years)

This drug has not been established as safe or effective in children younger than 6 years.

QUILLICHEW ER

Adult dosage (ages 18 years and older)

• Typical dosage: 20 mg once daily in the morning.
• Dosage increases: Your doctor may increase or decrease your dosage by 10, 15, or 20 mg each week until they determine a suitable dosage.
• Maximum dosage: 60 mg daily.

Child dosage (ages 6–17 years)

• Typical dosage: 20 mg once daily in the morning.
• Dosage increases: Your doctor may increase or decrease your dosage by 10, 15, or 20 mg each week until they determine a suitable dosage.
• Maximum dosage: 60 mg daily.

Child dosage (ages 0–5 years)

This drug has not been established as safe or effective in children younger than 6 years.

Dosage for narcolepsy

Generic: Methylphenidate

• Form: oral immediate-release tablet
• Strengths: 5 mg, 10 mg, 20 mg
• Form: oral extended-release tablet
• Strengths: 10 mg, 20 mg
• Form: chewable tablet
• Strengths: 2.5 mg, 5 mg, 10 mg

Brand: Ritalin

• Form: oral immediate-release tablet
• Strengths: 5 mg, 10 mg, 20 mg

Brand: Ritalin SR

• Form: extended-release oral tablet

• · Strength: 20 mg

Brand: Metadate ER

• Form: oral extended-release tablet
• Strengths: 20 mg

RITALIN, GENERIC IMMEDIATE-RELEASE TABLETS AND CHEWABLE TABLETS:

Adult dosage (ages 18–64 years)

• Typical dosage: 20–30 mg per day taken in 2–3 divided doses.

Child dosage (ages 6–17 years)

• Typical dosage: 5 mg taken twice per day before breakfast and lunch.
• Dosage increases: Your doctor may increase your dosage by 5–10 mg each week.

Child dosage (ages 0–5 years)

Dosages for people younger than 6 years haven’t been established.

RITALIN SR, METADATE ER, GENERIC EXTENDED-RELEASE TABLETS:

Adult dosage (ages 18–64 years)

• Typical dosage: These extended-release tablets work for about 8 hours. These tablets may be used in place of immediate-release tablets when the 8-hour dose of the extended-release tablet corresponds to the titrated 8-hour dose of the immediate-release tablet. Your doctor can tell you more.

Child dosage (ages 6–17 years)

• Typical dosage: These extended-release tablets work for about 8 hours. These tablets may be used in place of immediate-release tablets when the 8-hour dose of the extended-release tablet corresponds to the titrated 8-hour dose of the immediate-release tablet. Your child’s doctor can tell you more.

Child dosage (ages 0–5 years)

Dosages for people younger than 6 years haven’t been established.

Dosage warning

Don’t take methylphenidate late at night. Doing so can cause trouble sleeping.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Methylphenidate oral tablet is used for short-term or long-term treatment. This drug is usually stopped after puberty. Your doctor may try to stop your treatment with methylphenidate on occasion to see if you still need to take it. If your symptoms return, you may need to keep taking it.

Methylphenidate comes with serious risks if you don’t take it as prescribed.

If you stop taking it: Your symptoms won’t be controlled. If you’ve been taking high doses of this drug for a long time and stop it suddenly, you may have extreme tiredness, fatigue, or severe depression.

If you don’t take it on schedule: If you take methylphenidate later in the day, you may have trouble falling asleep.

If you take too much: If you take too much methylphenidate, you may experience:

• restlessness
• muscle pain and weakness
• faster breathing
• confusion
• high or low blood pressure
• nausea
• vomiting
• diarrhea
• seizures
• coma

If you think you’ve taken too much of this drug, call your doctor or local poison control center. If your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you miss a dose, take it as soon as possible. If it’s almost time for your next dose, wait until then and take a single dose.

Don’t double the dose to try to catch up. This could result in dangerous side effects.

How to tell if the drug is working: For ADHD: You should be able to focus and pay attention better and be less impulsive and hyperactive.

For narcolepsy: You should feel less sleepy and more alert.

Keep these considerations in mind if your doctor prescribes methylphenidate for you.

General

• Certain forms shouldn’t be taken with food. If you take the immediate-release tablets or chewable tablets, take methylphenidate 30–45 minutes before meals.
• You can take the extended-release orally disintegrating tablets with or without food. However, you should take them the same way each time.
• Take the extended-release tablets when you wake up in the morning. This form releases the drug into your body throughout the day. Don’t take it in the late afternoon or at night because it can cause trouble sleeping.

Self-administration

For the immediate-release and chewable tablets:

• You can cut these tablets.

For the extended-release (non-orally disintegrating) tablets:

• Do not cut, chew, crush, or divide these tablets.
• Swallow them whole with water or other liquids.

For the extended-release orally disintegrating tablets:

• Use each tablet right after removing it from the blister pack.
• With dry hands, peel back the foil on the blister pack. Don’t push the tablet through the foil.
• Place the tablet on your tongue right away. Allow it to dissolve without chewing it. No liquid is needed.

Storage

• Each form should be stored at the appropriate temperature:

• o All generic tablets:Store at a temperature between 68°F and 77°F (20°C and 25°C).
• Concerta, Ritalin: Store these tablets at room temperature of 77°F (25°C). You can store them for a short time at temperatures between 59°F and 86°F (15°C and 30°C).
• Metadate ER: Store at a temperature between 68°F and 77°F (20°C and 25°C). You can store it for a short time at temperatures between 59°F and 86°F (15°C and 30°C).
• Cotempla XR-ODT: Store at a temperature between 59°F and 86°F (15°C and 30°C). After removing the blister packs from the carton, store them in the reusable travel case.

• Don’t freeze methylphenidate. Keep it away from high temperatures.
• Keep this drug away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is not refillable. You or your pharmacy will have to contact your doctor for a new prescription if you need this medication refilled.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t harm your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor will check you for the following while you take this drug:

• blood pressure and heart rate
• signs of aggressive behavior or changes in mental health conditions
• growth and weight in children

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.