Methylphenidate is a central nervous system stimulant. It affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control.
Methylphenidate is used to treat attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and narcolepsy.
Methylphenidate may also be used for purposes not listed in this medication guide.
Important information
You should not use methylphenidate if you have glaucoma, tics or Tourette"s syndrome, or severe anxiety, tension, or agitation.
Do not use methylphenidate if you have taken an MAO inhibitor in the past 14 days, including isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
Methylphenidate may be habit forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction.
Using this medicine improperly can cause death or serious side effects on the heart.
Before taking this medicine
Do not use methylphenidate if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.
You should not use methylphenidate if you are allergic to it, or if you have:
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glaucoma;
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a personal or family history of tics (muscle twitches) or Tourette"s syndrome; or
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severe anxiety, tension, or agitation (stimulant medicine can make these symptoms worse).
Some stimulants have caused sudden death in certain people. Tell your doctor if you have:
To make sure methylphenidate is safe for you, tell your doctor if you or anyone in your family has ever had:
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depression, mental illness, bipolar disorder, psychosis, or suicidal thoughts or actions;
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motor tics (muscle twitches) or Tourette"s syndrome;
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blood circulation problems in the hands or feet;
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seizures or epilepsy;
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an abnormal brain wave test (EEG); or
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a history of drug or alcohol addiction.
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
It is not known whether methylphenidate passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Methylphenidate is not approved for use by anyone younger than 6 years old.
How should I take methylphenidate?
Take methylphenidate exactly as prescribed by your doctor. Using this medicine improperly can cause death or serious side effects on the heart.
Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.
Methylphenidate may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Selling or giving away this medicine is against the law.
Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.
To prevent sleep problems, take this medicine in the morning.
Some brands of methylphenidate should be taken at least 30 minutes before a meal. Extended-release methylphenidate can be taken with or without food. Follow the directions on your medicine label
Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking the pill may cause too much of the drug to be released at one time.
To make swallowing easier, you may open the capsule and sprinkle the medicine into a spoonful of pudding or applesauce. Swallow right away without chewing. Do not save the mixture for later use.
The chewable tablet must be chewed before you swallow it.
Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.
Shake the oral suspension (Quillivant) well just before you measure a dose.
While using methylphenidate, your doctor will need to check your progress at regular visits. Your heart rate, blood pressure, height and weight may also need to be checked often.
If you need surgery, tell the surgeon ahead of time that you are using methylphenidate. You may need to stop using the medicine for a short time.
Store at room temperature away from moisture and heat.
Keep track of the amount of medicine used from each new bottle. Methylphenidate is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is later than 6:00 p.m. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of methylphenidate could be fatal.
What should I avoid while taking methylphenidate?
Avoid drinking alcohol, especially if you take extended-release methylphenidate. Alcohol may cause the medicine to be released into the bloodstream too fast.
Methylphenidate may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Methylphenidate side effects
Get emergency medical help if you have signs of an allergic reaction to methylphenidate: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Methylphenidate can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using this medicine.
Stop taking methylphenidate and call your doctor at once if you have:
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chest pain, trouble breathing, feeling like you might pass out;
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hallucinations (seeing or hearing things that are not real), new behavior problems, aggression, hostility, paranoia;
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a seizure (convulsions);
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numbness, pain, cold feeling, unexplained wounds, or skin color changes (pale, red, or blue appearance) in your fingers or toes;
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muscle twitches (tics);
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changes in your vision;
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penis erection that is painful or lasts 4 hours or longer (rare); or
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unexplained muscle pain, tenderness, or weakness (especially if you also have fever, unusual tiredness, and dark colored urine).
Common methylphenidate side effects may include:
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Methylphenidate dosing information
Usual Adult Dose for Attention Deficit Disorder:
Immediate release tablets including chewable tablets (Ritalin, Methylin, methylphenidate):
Initial Dose: 10 mg orally 2 or 3 times daily, preferably 30 to 45 minutes before breakfast and lunch, and a third dose between 2 and 4 PM, if necessary. For patients who have trouble sleeping at night while receiving methylphenidate, the last dose should be taken before 6 PM.
Maintenance dose: Doses may be increased weekly in increments of 5 to 10 mg up to a maximum of 60 mg per day. In some patients, 10 to 15 mg daily may suffice. For patients who have trouble sleeping at night while receiving methylphenidate, the last dose should be taken before 6 PM.
Sustained release tablets (Ritalin SR, Metadate ER):
Initial Dose: Methylphenidate is also available as a 10 mg and 20 mg sustained release tablets with a duration of action of approximately 8 hours. If dose of the sustained release tablet corresponds with the titrated dose of regular tablets (taken not more frequently than every 8 hours), then the sustained release tablets may be used instead of the regular tablets.
Maintenance Dose: The dose may be increased in weekly increments of 10 mg, up to a maximum of 60 mg/day, with the first dose taken before breakfast. Tablets should not be crushed or chewed.
Extended release capsules (Metadate CD):
Initial Dose: 20 mg orally once a day in the morning before breakfast.
Maintenance Dose: Doses may be increased weekly in increments of 20 mg up to a maximum of 60 mg once daily in the morning. The capsules should not be opened, chewed, or crushed.
Extended release oral suspension (Quillivant XR):
Initial Dose: 20 mg orally once a day in the morning before breakfast.
Maintenance Dose: Doses may be increased weekly in increments of 10 mg to 20 mg up to a maximum of 60 mg once daily in the morning.
Comments: Vigorously shake for at least 10 seconds before each dose. Administer only with the dosing dispenser provided. Wash dispenser after each use (dishwasher safe).
Extended release capsules (Ritalin LA):
Initial Dose: 20 mg orally once a day in the morning before breakfast.
For patients already receiving methylphenidate:
If switching from immediate release tablets 10 mg twice a day or sustained release tablets 20 mg/day: 20 mg once daily.
If switching from immediate release tablets 15 twice a day: 30 mg once daily.
If switching from immediate release tablets 20 mg twice a day or sustained release tablets 40 mg/day: 40 mg once daily.
If switching from immediate release tablets 30 twice a day or sustained release tablets 60 mg/day: 60 mg once daily.
Maintenance Dose: Doses may be increased weekly in increments of 10 mg up to a maximum of 60 mg once daily in the morning. For patients unable to swallow the capsule, the contents may be sprinkled on applesauce and administered.
Extended release tablets (Concerta):
Initial: (Methylphenidate- naive patients) 18 mg once daily in the morning before breakfast.
For patients already receiving methylphenidate:
If switching from immediate release tablets 5 mg 2 or 3 times a day: 18 mg once daily.
If switching from immediate release tablets 10 mg 2 or 3 times a day: 36 mg once daily.
If switching from immediate release tablets 15 mg 2 or 3 times a day: 54 mg once daily.
If switching from immediate release tablets 20 mg 2 or 3 times a day: 72 mg once daily.
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Maintenance: May increase by 18 mg increments at weekly intervals up to a maximum of 72 mg once daily in the morning before breakfast. Tablets should not be chewed, divided, or crushed.
Transdermal system (Daytrana):
Dose should be titrated to effect based on the following recommended titration schedule:
Week 1: 10 mg/9 hour patch daily
Week 2: 15 mg/9 hour patch daily
Week 3: 20 mg/9 hour patch daily
Week 4: 30 mg/9 hour patch daily
It is recommended to apply the patch topically to hip area 2 hours before an effect is needed and to remove the patch 9 hours after application. However, wear time should be individualized according to the needs and response of the individual patient.
Usual Adult Dose for Narcolepsy:
Immediate release tablets (Ritalin, Methylin, methylphenidate):
Initial Dose: 10 mg orally 2 or 3 times daily, preferably 30 to 45 minutes before meals.
Maintenance dose: Doses may be increased weekly in increments of 5 to 10 mg up to a maximum of 60 mg per day. In some patients, 10 to 15 mg daily may suffice. For patients who have trouble sleeping at night while receiving methylphenidate, the last dose should be taken before 6 PM.
Sustained release tablets (Ritalin SR, Metadate ER):
Initial Dose: Methylphenidate is also available as a 10 mg and 20 mg sustained release tablets with a duration of action of approximately 8 hours. If dose of the sustained release tablet corresponds with the titrated dose of methylphenidate regular tablets (taken not more frequently than every 8 hours), then the sustained release tablets may be used instead of the regular tablets.
Maintenance Dose: The dose may be increased in weekly increments of 10 mg, up to a maximum of 60 mg/day, with the first dose taken before breakfast. Tablets should not be crushed or chewed.
Extended release capsules (Metadate CD):
Initial Dose: 20 mg orally once a day in the morning before breakfast.
Maintenance Dose: Doses may be increased weekly in increments of 20 mg up to a maximum of 60 mg once daily in the morning. The capsules should not be opened, chewed, or crushed.
Extended release tablets (Concerta):
Initial: (Methylphenidate- naive patients) 18 mg once daily in the morning before breakfast.
For patients already receiving methylphenidate:
If switching from immediate release tablets 5 mg 2 or 3 times a day: 18 mg once daily.
If switching from immediate release tablets 10 mg 2 or 3 times a day: 36 mg once daily.
If switching from immediate release tablets 15 mg 2 or 3 times a day: 54 mg once daily.
If switching from immediate release tablets 20 mg 2 or 3 times a day: 72 mg once daily.
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Maintenance: May increase by 18 mg increments at weekly intervals up to a maximum of 72 mg once daily in the morning before breakfast. Tablets should not be chewed, divided, or crushed.
Usual Adult Dose for Depression:
The manufacturers warn that methylphenidate should not be used for severe depression of either exogenous or endogenous origin.
Some studies have shown methylphenidate to be an effective adjuvant medication when used along with other standard antidepressant drug therapy (SSRIs or TCAs) for depression. However, no specific coadministered antidepressant medication or dose of methylphenidate has been generally accepted as optimum therapy. Therefore, no specific therapy or dose can be recommended at this time for use in patients with depression.
Usual Pediatric Dose for Attention Deficit Disorder:
6 years or older:
Immediate release tablets including chewable tablets (Ritalin, Methylin, methylphenidate):
Initial Dose: 2.5 to 5 mg orally twice daily, taken 30 to 45 minutes before breakfast and lunch.
Maintenance dose: Doses may be increased weekly in increments of 5 to 10 mg up to a maximum of 60 mg/day in 2 or 3 divided doses. For patients who have trouble sleeping at night while receiving methylphenidate, the last dose should be taken before 6 PM.
Sustained release tablets (Ritalin SR, Metadate ER):
Initial Dose: Methylphenidate is also available as a 10 mg and 20 mg sustained release tablets with a duration of action of approximately 8 hours. If dose of the sustained release tablet corresponds with the titrated dose of methylphenidate regular tablets (taken not more frequently than every 8 hours), then the sustained release tablets may be used instead of the regular tablets.
Maintenance Dose: The dose may be increased in weekly increments of 10 mg, up to a maximum of 60 mg/day, with the first dose taken before breakfast. Tablets should not be crushed or chewed.
Extended release capsules (Metadate CD):
Initial Dose: 20 mg orally once a day in the morning before breakfast.
Maintenance Dose: Doses may be increased weekly in increments of 20 mg up to a maximum of 60 mg once daily in the morning. Capsules should not be opened, chewed, or crushed.
Extended release oral suspension (Quillivant XR):
Initial Dose: 20 mg orally once a day in the morning before breakfast.
Maintenance Dose: Doses may be increased weekly in increments of 10 mg to 20 mg up to a maximum of 60 mg once daily in the morning.
Comments: Vigorously shake for at least 10 seconds before each dose. Administer only with the dosing dispenser provided. Wash dispenser after each use (dishwasher safe).
Extended release tablets (Concerta):
Initial: (Methylphenidate- naive patients) 18 mg once daily in the morning before breakfast.
If switching from immediate release tablets 5 mg 2 or 3 times a day: 18 mg once daily.
If switching from immediate release tablets 10 mg 2 or 3 times a day: 36 mg once daily.
If switching from immediate release tablets 15 mg 2 or 3 times a day: 54 mg once daily.
If switching from immediate release tablets 20 mg 2 or 3 times a day: 72 mg once daily.
Maximum dose: 6 years to 12 years: 54 mg/day, over 12 years: 72 mg/day; do not exceed 2 mg/kg/day.
Maintenance: May increase by 18 mg increments at weekly intervals up to a maximum of 72 mg once daily in the morning before breakfast. Tablets should not be chewed, divided, or crushed.
Transdermal system (Daytrana):
Dose should be titrated to effect based on the following recommended titration schedule:
Week 1: 10 mg/9 hour patch daily
Week 2: 15 mg/9 hour patch daily
Week 3: 20 mg/9 hour patch daily
Week 4: 30 mg/9 hour patch daily
It is recommended to apply the patch topically to hip area 2 hours before an effect is needed and to remove the patch 9 hours after application. However, wear time should be individualized according to the needs and response of the individual patient.
What other drugs will affect methylphenidate?
Tell your doctor about all your current medicines and any you start or stop using, especially:
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an antidepressant;
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blood pressure medication;
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a blood thinner such as warfarin (Coumadin, Jantoven);
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a cold or allergy medicine that contains a decongestant such as pseudoephedrine or phenylephrine; or
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seizure medicine.
This list is not complete. Other drugs may interact with methylphenidate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
