Ritalin

Generic Name: methylphenidate (meth il FEN i date)
Brand Names: Concerta, Metadate CD, Metadate ER, Methylin, Methylin ER, Ritalin, Ritalin LA, Ritalin-SR
What is Ritalin?

Ritalin is a central nervous system stimulant. It affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control.

Ritalin is used to treat attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and narcolepsy.

Ritalin may also be used for purposes other than those listed in this medication guide.
Do not use Ritalin if you have used an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam) within the past 14 days. Serious, life-threatening side effects can occur if you use Ritalin before the MAO inhibitor has cleared from your body. Do not use this medication if you are allergic to methylphenidate or if you have glaucoma, tics (muscle twitches) or Tourette's syndrome, depression, or severe anxiety, tension, or agitation (Ritalin can make these symptoms worse). Ritalin may be habit-forming and should be used only by the person it was prescribed for. Keep track of how many pills have been used from each new bottle you receive. Ritalin is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.
What should I discuss with my healthcare provider before taking Ritalin?
Do not take Ritalin if you have used an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam) within the past 14 days. Serious, life-threatening side effects can occur if you use Ritalin before the MAO inhibitor has cleared from your body.

Do not use this medication if you are allergic to Ritalin 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 (Ritalin can make these symptoms worse).

Some stimulants have caused sudden death in children and adolescents with serious heart problems or congenital heart defects.

Before using Ritalin, tell your doctor if you are allergic to any drugs, or if you have:

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a congenital heart defect;
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high blood pressure;
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heart failure, heart rhythm disorder, or recent heart attack;
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a personal or family history of mental illness, psychotic disorder, bipolar illness, depression, or suicide attempt;
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epilepsy or other seizure disorder; or
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a history of drug or alcohol addiction.

If you have any of these conditions, you may not be able to use Ritalin, or you may need a dosage adjustment or special tests during treatment.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether Ritalin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Long-term use of Ritalin can slow a child's growth. Tell your doctor if the child using this medication is not growing or gaining weight properly.
Do not give Ritalin to a child younger than 6 years old without the advice of a doctor.
How should I take Ritalin?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.
Take this medicine with a full glass (8 ounces) of water. Take this medication at least 30 minutes before a meal. The extended-release forms of methylphenidate (Ritalin-SR, Metadate ER, Metadate CD, Methylin ER, Concerta) can be taken with or without food. Do not crush, chew, or break an extended-release tablet. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking the pill would cause too much of the drug to be released at one time.

If you have trouble swallowing the extended-release capsule, you may open the capsule and sprinkle the medicine into a spoonful of applesauce to make swallowing easier. Swallow this mixture right away without chewing. Do not save the mixture for later use. Discard the empty capsule.

To prevent sleep problems, take this medication early in the day, no later than 6:00 pm.
Store Ritalin at room temperature away from moisture and heat. Ritalin may be habit-forming and should be used only by the person it was prescribed for. Keep track of how many pills have been used from each new bottle you receive. Ritalin is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.
What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at your next regularly scheduled time. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of this medicine. An overdose of Ritalin can be fatal.

Symptoms of a Ritalin overdose may include vomiting, agitation, tremors, muscle twitching, seizure (convulsions), confusion, hallucinations, sweating, fast or pounding heartbeat, blurred vision, dry mouth and nose, and fainting.
What should I avoid while taking Ritalin?
Ritalin can cause side effects that may impair your vision or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
Ritalin side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop taking Ritalin and call your doctor at once if you have any of these serious side effects:

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fast, pounding, or uneven heartbeats;
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feeling light-headed, fainting;
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increased blood pressure (severe headache, blurred vision, trouble concentrating, chest pain, numbness, seizure);
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fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
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aggression, restlessness, hallucinations, unusual behavior, or motor tics (muscle twitches); or
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easy bruising, purple spots on your skin.

Continue taking Ritalin and talk with your doctor if you have any of these less serious side effects:

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vision problems;
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mild skin rash;
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dizziness;
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nervous feeling, sleep problems (insomnia);
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nausea, vomiting, loss of appetite; or
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weight loss.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
What other drugs will affect Ritalin?

Before taking Ritalin, tell your doctor if you are using any of the following drugs:

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blood pressure medications;
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a blood thinner such as warfarin (Coumadin);
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clonidine (Catapres);
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seizure medicine such as phenytoin (Dilantin), phenobarbital (Luminal), primidone (Mysoline); or
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antidepressants such as amitriptyline (Elavil, Etrafon), amoxapine (Ascendin), citalopram (Celexa), escitalopram (Lexapro), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan),fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Janimine, Tofranil), nortriptyline (Pamelor), paroxetine (Paxil), protriptyline (Vivactil), sertraline (Zoloft), or trimipramine (Surmontil).

If you are using any of these drugs, you may not be able to use Ritalin, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect Ritalin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
Where can I get more information?

* Your pharmacist has information about Ritalin written for health professionals that you may read.

What does my medication look like?

Methylphenidate is available with a prescription under many brand names such as Ritalin, Methylin, Methylin ER, Metadate ER, Metadate CD, and Concerta. Generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

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Ritalin 5 mg- round, yellow tablets
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Ritalin 10 mg - round, pale-green, scored tablets
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Ritalin 20 mg - round, pale-yellow, scored tablets
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Ritalin SR 20 mg - round, white, coated tablets
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Ritalin LA 20 mg - white capsules
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Ritalin LA 30 mg - yellow capsules
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Ritalin LA 40 mg - light brown capsules

* Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
* Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
* Click here for more information on Ritalin from the manufacturer.

Copyright 1996-2006 Cerner Multum, Inc. Version: 7.05. Revision Date: 07/13/2007 12:04:08 P