Methylphenidate

Drug Class:	Commonly Known As:	Category:
	Ritalin, Ritalin LA, Ritalin SR, Medikinet MR, Concerta ER

Methylphenidate - What is it for

Methylphenidate is used for the treatment of attention deficit hyperactivity disorder (ADHD). It works by stimulating the brain to increase attention, concentration, reduce impulsive and hyperactiv behaviour and manage certain sleep disorders.

Methylphenidate is available as an immediate-release preparation or modified-release preparations.

The immediate-release preparation releases the medication relatively quickly in the body and the effects wear-off over a few hours.

Modified-release preparations mean that the medication is released slowly during the day, for a longer duration of effect. These preparations have the letters 'LA' (long-acting), 'SR' (sustained-release), 'MR' (modified-release) or 'ER' (extended-release) after the brand name, and may differ in their duration of effects.

Methylphenidate Tablet (Ritalin®, Rubifen®)
Methylphenidate LA Capsule (Ritalin® LA)
Methylphenidate SR Capsule (Ritalin® SR)
Methylphenidate MR Capsule (Medikinet® MR)
Methylphenidate ER Tablet (Concerta® ER)

Methylphenidate - Side Effects, Precautions, and Contraindications

What side effects can Methylphenidate cause?

Common side effects include:

Stomach discomfort e.g. stomach pain, nausea, vomiting

Take it after food to minimise these side effects

Dry mouth
Mild headache, body ache
Nervousness, not being able to sleep

Avoid taking the medication too late in the day as it may keep you awake

Dizzy or lightheadedness

Stand up slowly from a lying position

Loss of appetite - weight loss may occur during the first few months of treatment

Most of these side effects will get better or go away as your body gets used to the medication.

Inform your doctor if the side effects above become severe and bothersome.

Very rarely, this medication may cause

Fast or irrgular heartbeat (palpitations)
Uncontrolled speech and/or tics (uncontrolled and repeated body movements)
Seizures, confusion
Changes in eyesight e.g. blurred vision
Prolonged and/or painful erections (for males) lasting up to 4 hours and beyond
Increase in blood pressure
New or worsening signs of delusions (false beliefs), hallucinations (seeing or hearing things that are not real) or mania (abnormally high or excited mood)

The symptoms of a drug allergy include one or more of the following:

Swollen face/eyes/lips/tongue
Difficulty in breathing
Itchy skin rashes over your whole body

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

Before taking Methylphenidate , what precautions must I follow?

Inform your healthcare professional if:

You are allergic to this medication or any of the other ingredients of this medication
You are pregnant, planning to become pregnant, or breastfeeding
You are taking any other medications, including supplements, traditional medications and herbal remedies currently or in the last two weeks.
You have a history of or current medical conditions such as blood vessel disease, high blood pressure, stroke, heart disease, mental health disorders, glaucoma, overactive thyroid, seizures (fits), hard-to-control or repeated twitching of any parts of the body or you repeat sounds and words (Tourette's syndrome or tics disorder)

IMPORTANT:

In rare cases, this medication may cause the following changes to a person's mental condition, especially in the first few weeks of treatment or during dose changes:

Worsening agitation, restlessness, violent behaviour, or
New or worsening thoughts of harming yourself or ending your life
Other changes in mood or behaviour

Please inform your doctor as soon as possible, or for your family or caregiver to inform your doctor if you are unable to seek treatment on your own.

Do not stop taking this medication on your own without discussing with your doctor.

It is important to note that your doctor has prescribed this medication as he/she feels you will benefit more from taking this medication over the possible risks that it may cause, which have a low chance of occurring, and most people take this medication without any of such problems.

What food or medicine must I avoid when I take Methylphenidate ?

Avoid taking alcohol when you are taking this medication as alcohol may interact with your medication and increase the risk of side effects.

Methylphenidate - Dosage and How to Use

How should Methylphenidate be used?

Do not stop taking your medication without checking with your healthcare professional.
Most methylphenidate preparations can be taken with or without food, except for Medikinet® MR. Medikinet® MR should be taken with or after food as it may affect the absorption of the medication into the body.
For immediate-release preparations, do not take it too late in the evening as it may cause trouble sleeping.
If you are taking the modified-release preparations, the capsules/tablets must not be crushed or chewed. For Ritalin® LA and Medikinet® MR, the capsules may be opened and the contents sprinkled onto a small amount (tablespoon) of room temperature or cold food (e.g. applesauce, yoghurt). It must be taken immediately and not stored for future use.
Your doctor would start the medication at a low dose, and then slowly adjust the dose according to your response to the medication.
For Concerta® ER, the tablet does not dissolve completely after all the medication has been released and sometimes the tablet shell may appear in your stools. This is normal.

What should I do if I miss a dose?

If you forget to take a dose, take it as soon as you remember. Then take your next dose at the usual time. Do not take two doses to make up for the missed dose.