Methylphenidate Hydrochloride
This medication is a Schedule II drug.
Brand Names: Ritalin, Methylin, Metadate, Concerta, Quillichew, Quillivant XR
Generic Available
Common Dosage Forms:
Tablets (Ritalin, Methylin): 5 mg, 10 mg, 20 mg
Tablets, sustained-release (Ritalin SR, Methylin ER, Metadate ER): 10 mg, 20 mg
Capsules, controlled-release (Ritalin LA, Metadate CD): 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg
Tablets, extended-release (Concerta): 18 mg, 27 mg, 36 mg, 54 mg
Tablets, chewable (Methylin): 2.5 mg, 5 mg, 10 mg
Solution (Methylin): 5 mg/5 mL, 10 mg/5 mL
Tablets, extended-release (Quillichew): 20 mg, 30 mg, 40 mg
Suspension, extended-release (Quillivant XR): 25 mg/5 mL after reconstitution
*Not all extended-release forms are AB-rated substitutions.
FDA Indications/Dosages:
For the treatment of attention-deficit disorders in children (>6 years): Initially 5 mg twice a day before breakfast and lunch with gradual increases in increments of 5-10 mg weekly.
For the treatment of narcolepsy in adults: 10-60 mg daily in 2-3 divided doses.
SR tablets can be given in two divided doses.
CD/LA/ER forms can be given once daily in the morning.
Pharmacology/Pharmacokinetics: Methylphenidate presumably activates the brain stem arousal system and cortex to produce its stimulant effect. Peak plasma levels are reached in 2 hours with the tablets and in 5 hours with the SR tablets. Half-life of immediate-release tablets range from 1-3 hours with effects lasting for 4-6 hours. Each bead-filled capsule of the LA formulation provides an immediate release of methylphenidate for rapid onset of action, and a second release of medication approximately 4 hours after administration. The bimodal release formulation of LA capsules provides two peak concentrations of medications.
Drug Interactions: May produce hypertensive crises when used with MONOAMINE OXIDASE INHIBITORS. May increase serum levels of phenytoin, phenobarbital, warfarin, and serotonin-reuptake inhibitors. Serious adverse effects have occurred when used with clonidine.
Contraindications/Precautions: Use is contraindicated in patients with anxiety, tension, agitations, in patients with glaucoma or motor tics, and in patients with a gamily history or diagnosis of Tourette’s syndrome. CNS STIMULANTS HAVE A HIGH POTENTIAL FOR ABUSE. Use is contraindicated in patients currently taking or within 14 days of taking a monoamine oxidase inhibitor. Use with caution in patients with seizures. Stimulants may increase blood pressure and heart rate and caution should be used in patients with hypertension or any other cardiac abnormality. Use with caution in emotionally unstable patients, such as those with a history of drug dependance or alcoholism, and in patients with bipolar disorder. Methylphenidate should not be used in patients under six years of age. Pregnancy Category C.
Adverse Effects: Nervousness, insomnia, anorexia, nausea, dizziness, palpitations, headache, angina, and drowsiness.
Patient Consultation:
Take last dose early in the evening to avoid insomnia.
WARNING: This medication may be habit-forming.
This prescription cannot be refilled.
Store in a cool, dry place away from sunlight and children.
Contact a physician if the above side effects are severe or persistent.
If a dose is missed, skip it and return to normal dosing schedule.
LA capsules may be swallowed whole, or the contents sprinkled over soft food and ingested without chewing.
Swallow extended-release tablets whole, do not break, chew, or crush.
