How does Ritalin work? What will it do for me?
Methylphenidate belongs to the family of medications known as stimulants. It is used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy (uncontrollable need to sleep) in children over 6 years old and adults. It helps to increase attention and decrease restlessness in children and adults who have been diagnosed with ADHD. Other measures (e.g., psychological, educational, and social therapies) are used along with methylphenidate as part of an overall treatment program for ADHD. This medication also helps to stimulate people with narcolepsy so that they do not fall asleep at inappropriate times.
Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
How should I use Ritalin?
The dose of methylphenidate needs to be individualized according to the needs of the person taking the medication. The dose is usually started low and increased gradually to the dose that works best for the person. The usual starting dose for this medication is 5 mg to 10 mg two or three times daily. Doses above 60 mg daily are not recommended. If symptoms worsen or if side effects occur, contact your doctor for further instruction. In many cases for children, the medication does not need to be continued after puberty.
Take methylphenidate with or shortly after a meal or snack.
If you are taking the SR tablets, swallow the medication whole and do not crush or split the tablets.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones above, do not change the way that you are taking the medication without consulting your doctor.
It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue on with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue on with your regular dosing schedule. Do not take a double dose to make up for a missed one.
This medication is available under multiple brand names and in several different forms. Any specific brand name of this medication may not be available in all of the forms listed here. The forms available for the specific brand you have searched are listed under “What form(s) does this medication come in?”
What form(s) does Ritalin come in?
Each pale blue, round, flat-faced, beveled-edged tablet, scored and imprinted “AB” on one side with “CIBA” on the other, contains methylphenidate HCl 10 mg. Nonmedicinal ingredients: cornstarch, FD&C Green No. 3, lactose, magnesium stearate, polyethylene glycol, sugar and talc.
Each pale yellow, round, flat-faced, beveled-edged tablet, scored and imprinted “PN” on one side with “CIBA” on the other, contains methylphenidate HCl 20 mg. Nonmedicinal ingredients: D&C Yellow No. 10, lactose, magnesium stearate, polyethylene glycol, sugar, tragacanth and talc.
Some medications may have other generic brands available. Always ask your doctor or pharmacist about the safety of switching between brands of the same medication.
Who should NOT take Ritalin?
Methylphenidate should not be taken by anyone who:
is allergic to methylphenidate or to any of the ingredients of the medication
is taking an monoamine oxidase (MAO) inhibitor (e.g., phenelzine, tranylcypromine) or has taken one in the last 14 days
has advanced hardening of the arteries
has an overactive thyroid gland
has anxiety, tension, or agitation
has glaucoma (increased pressure in the eye)
has heart disease
has moderate-to-severe high blood pressure
has motor tics, Tourette’s syndrome, or a family history of Tourette’s syndrome
has pheochromocytoma (a condition that causes excess production of epinephrine and norepinephrine hormones)
What side effects are possible with Ritalin?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
agitation, nervousness, or anxiety
dizziness or drowsiness
loss of appetite
nausea or vomiting
skin rash or itching (mild)
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
hallucinations (hearing, seeing, or feeling things that are not actually there) or abnormal thoughts or behaviour
increased blood pressure
muscle twitching or tics
palpitations (feeling your heart beat quickly or irregularly)
pinpoint-sized red spots on skin or unusual bruising
prickling or tingling sensations in the hands, arms, feet, or legs
sore throat and fever
sudden high fever
symptoms of depression (e.g., losing interest in your usual activities, feeling sad, having thoughts of suicide – see below)
symptoms of liver damage (e.g., yellow skin or eyes, abdominal pain, loss of appetite, pale stools, dark urine)
symptoms of Tourette’s syndrome (involuntary, sudden body movements or uncontrolled vocal outbursts)
Stop taking the medication and seek immediate medical attention if any of the following occur:
peeling or blistering of the skin
signs of a serious allergic reaction (difficulty breathing; hives; swelling of the face, lips, eyes, mouth, or throat)
thoughts of suicide or hurting yourself
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for Ritalin?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Behaviour or mood changes: There have been reports of agitation, hallucinations, symptoms of depression, and thoughts of self-harm in people taking this medication. If you experience these types of symptoms while taking methylphenidate, contact your doctor immediately
Blood pressure: This medication may increase blood pressure. People with high blood pressure or heart problems talk to their doctor before taking this medication.
Drowsiness/reduced alertness: Methylphenidate may affect the mental or physical abilities needed to drive or operate machinery. People taking this medication are cautioned against undertaking these and other potentially hazardous activities until they determine if the medication affects them in this way.
Drug dependence: Abuse of methylphenidate is possible by certain individuals. This can lead to high levels of tolerance and psychological dependence, and a wide range of abnormal behaviours. People with a history of drug or alcohol dependence should be carefully monitored by their doctors while using this medication.
Epilepsy: There is some evidence that methylphenidate may increase the risk of seizures for people who have had seizures before.
Exercise: People participating in strenuous exercise or activities should consult their doctor before taking methylphenidate.
Heart problems: This medication can increase heart rate and blood pressure. It may also increase the risk of sudden death for people with heart problems. This medication should generally not be used by people with known heart problems, including an irregular heartbeat, known structural heart abnormalities (such as abnormal size, missing or poorly functioning heart valves, or problems with blood vessels connected to the heart), or a family history of sudden death related to heart disease.
Heart or brain circulation problems: People who have, or have a history of, heart or brain circulation problems should be closely monitored by their doctor while using this medication.
Long-term use: If you will be using this medication for a long period of time, you will need regular heart check-ups and lab tests to check your white blood cell counts.
Stopping the medication: Check with your doctor before stopping this medication.
Suppression of growth: Growth suppression (i.e., less increase in height or weight than usual) has been reported for children using stimulants such as methylphenidate for long periods of time. It is not known if the medication causes the growth suppression. However, children who need long-term therapy should be carefully monitored for growth. Their doctor may also recommend a “drug holiday,” where the medication is not given on weekends or during school holidays.
Vision: Rarely, people taking methylphenidate have experienced vision changes. If you notice any changes in your vision, contact your doctor.
Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if this medication passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of this medication have not been established for children under 6 years old. Methylphenidate should not be used by children of this age group.
What other drugs could interact with Ritalin?
There may be an interaction between methylphenidate and any of the following:
amphetamines (e.g., dextroamphetamine)
antidepressants (e.g., amitriptyline, imipramine, fluoxetine)
appetite suppressants (e.g., phentermine)
monoamine oxidase (MAO) inhibitors (e.g., phenelzine, tranylcypromine)
other medications for ADHD
sympathomimetic medications (e.g., epinephrine)
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
stop taking one of the medications,
change one of the medications to another,
change how you are taking one or both of the medications, or
leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.