Ritalin

( Methylphenidate Hcl, Methylphenidate )

Medically Reviewed by Harshi Dhingra, M.D.

Last Reviewed: Jun 27, 2022

Warnings

What are the risks of taking methylphenidate (Ritalin)?

Methylphenidate can cause serious health problems, especially in certain high-risk patients. Please talk to your healthcare professionals about other treatment options for ADHD or narcolepsy if these risks are concerning for you.

Some of the risks of methylphenidate include:

Habit-Forming: Methylphenidate has a potential for abuse and addiction. Take the medicine exactly as directed by your healthcare provider. People with a personal or family history of substance abuse should not take this medicine.
Heart Problems: People taking methylphenidate may be at a higher risk of heart attack, stroke, and death. This medication is not recommended for people with known heart defects or heart problems. Seek medical care immediately if you experience signs and symptoms such as unexplained fainting or chest pain with physical activity. Talk to your doctor about how to avoid these problems.
Psychiatric Problems: Methylphenidate can worsen psychiatric symptoms like hallucinations, delusions, mania, hostility, and aggressive behaviors. The risk is higher in people with a history of mental health conditions like bipolar disorder or psychotic episodes. Therefore, this medicine should be used with extreme caution in such individuals.
Decreased appetite: Methylphenidate can cause weight loss in adults due to appetite suppression. In children, decreased appetite can lead to growth suppression (failure to gain height and weight). Tell your child’s healthcare provider if you notice significant weight loss while on methylphenidate treatment.
Circulation problems: Rarely, methylphenidate can cause problems with circulation, leading to the formation of open sores. Tell your healthcare provider if you notice numbness, tingling, feeling cold in your hands or feet, unexplained wounds, or skin color change.
Priapism: This is a complication in which there are painful and prolonged erections. It can occur after increasing the dose of methylphenidate, after taking the medication for some time, and even after stopping it. Priapism is a medical emergency. Seek medical help immediately if you have a painful and prolonged erection that lasts for more than 4 hours.

If you are at a high risk of complications from citalopram use, your doctor or pharmacist can help you find other treatments for your condition.

What should I tell my doctor before starting methylphenidate (Ritalin)?

Please tell your doctor if you have an allergy to methylphenidate, any of the active or inactive ingredients in methylphenidate (Ritalin), or any other medication. Your pharmacist can give you a list of ingredients in methylphenidate products.

Also, give your doctor a complete list of your medications, including over-the-counter medicines, prescription drugs, dietary supplements, vitamins, as well as herbal/natural products to help avoid serious interactions.

Tell your health care professional about all your medical conditions. Methylphenidate may not be suitable for people with certain health conditions. Be sure to tell your doctor if you have a personal or family history of Tourette’s syndrome (motor tics), glaucoma (increased eye pressure), or an overactive thyroid gland.

Tell your doctor if you or anyone in your family has or has ever had an irregular heartbeat or died suddenly. Also, tell your doctor if you have recently had a heart attack, have a heart defect, irregular heartbeat, blood vessel problems, high blood pressure, cardiomyopathy (heart muscle thickening), circulation problems, or any other heart problems. Methylphenidate may not be suitable for you if you have a heart condition or are at a high risk of developing a heart condition.

Give your doctor complete information about mental health conditions such as depression, mania, bipolar disorder, or suicide attempts in yourself or a family member. Also, tell your doctor if you have or ever had seizures or an abnormal EEG test (electroencephalogram).

Tell your doctor if you are pregnant, could be pregnant, or plan to become pregnant. Also, tell your doctor if you are breastfeeding or plan to breastfeed. If you take methylphenidate while breastfeeding, you should watch your baby for symptoms such as agitation, sleep difficulties, reduced appetite, and weight loss.

Methylphenidate may not be safe for older adults (age 65 and above). Talk to your doctor about other treatment options.

People who have a condition called phenylketonuria (PKU) should know that the immediate-release and extended-release chewable tablets of methylphenidate hydrochloride contain aspartame, which can form phenylalanine.

Methylphenidate should be used as part of a comprehensive treatment plan for ADHD, including special education and counseling. Please follow your healthcare provider’s instructions to get the maximum benefits from this medication.

What precautions should I take while on methylphenidate (Ritalin)?

Keep all your appointments with your healthcare provider. Your doctor may increase the dose of methylphenidate gradually. They might want to see you regularly to check your response to the medicine. Also, they might want to keep an eye on your heart rate, blood pressure, and certain lab tests. Methylphenidate is a Schedule II controlled substance, and the prescription is not refillable without scheduled regular appointments with a doctor.

If you become pregnant while on methylphenidate, tell your doctor.

If you are having surgery, including dental surgery, tell your healthcare professionals that you take methylphenidate.

What are methylphenidate (Ritalin) interactions?

Taking methylphenidate with certain other medications can affect how the drug works or increase the risk of severe side effects. Your physician may choose a different medication for you, change the dose or frequency of one or both medicines, and/or monitor you carefully for side effects if there are known drug interactions between methylphenidate and your other medicines.

Taking methylphenidate is not recommended if you are taking a monoamine oxidase inhibitor (MAOI) such as linezolid (Zyvox), isocarboxazid (Marplan), phenelzine (Nardil), methylene blue, selegiline (Eldepryl, Emsam, Zelapar), rasagiline (Azilect), and tranylcypromine (Parnate), or if you have stopped a monoamine oxidase inhibitor within the past 14 days. You will need to wait at least 14 days from your last dose of a monoamine oxidase inhibitor before taking methylphenidate.

Methylphenidate may have interactions with the following medications:

Anticoagulants or blood thinners like warfarin (Coumadin, Jantoven)
Cough and cold medications (decongestants)
Medications for the treatment of heartburn or ulcers, for example, esomeprazole (Nexium), omeprazole (Prilosec), famotidine (Pepcid), or pantoprazole (Protonix)
Venlafaxine (Effexor)

Medications for the treatment of high blood pressure
Medications for the treatment of seizures, such as phenobarbital, phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
Methyldopa
Sodium bicarbonate (baking soda)

Antidepressants like imipramine (Tofranil), desipramine (Norpramin), and clomipramine (Anafranil)
Antidepressants like selective serotonin reuptake inhibitors (SSRIs), for example, escitalopram (Lexapro), citalopram (Celexa), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), sertraline (Zoloft), and paroxetine (Paxil)

If you take the extended-release formulation Ritalin LA, tell your doctor if you also take heartburn or ulcer medications or antacids. Your doctor may need to change the doses of your medications and monitor you carefully for side effects.

This list does not describe all possible methylphenidate interactions. Give your healthcare provider a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, vitamins, and natural/herbal products. Also, tell your healthcare provider if you smoke cigarettes, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when combined with methylphenidate.

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