Methylphenidate

What is this medication for?

Methylphenidate is used in the treatment of attention deficit hyperactivity disorder (ADHD). It works by stimulating the brain to increase attention, concentration, reduce impulsive and hyperactive behaviour and manage certain sleep disorders.

Methylphenidate is available as an immediate-release preparation or modified-release preparations.

The immediate-release preparation releases the medication relatively quickly in the body and the effects gradually wear-off over a few hours.

Modified-release preparations mean that the medication is released slowly during the day, for a longer duration of effects. These preparations have the letters ‘LA’ (long-acting), ‘SR’ (sustained-release), ‘MR’ (modified-release) ‘ER’(extended-release) or ‘PR’(prolonged-release) after the brand name, and may differ in their duration of effects.

• Methylphenidate Tablet (Ritalin®, Rubifen®)
• Methylphenidate LA Capsule (Ritalin® LA)
• Methylphenidate SR Capsule (Ritalin® SR)
• Methylphenidate MR Capsule (Medikinet® MR)
• Methylphenidate ER Tablet (Concerta® ER)
• Methylphenidate PR Tablet (Neurofind)

How should I take or use this medication?

• Do not stop taking your medication without checking with your healthcare professional.
• Most methylphenidate preparations can be taken with or without food, except for Medikinet® MR. Medikinet® MR should be taken with or after food as it may affect the absorption of the medication into the body.
• For immediate-release preparations, do not take it too late in the evening as it may cause trouble sleeping.
• If you are taking the modified-release preparations, the capsules/tablets must not be crushed or chewed. For Ritalin® LA and Medikinet® MR, the capsules may be opened and the contents sprinkled onto a small amount (tablespoon) of room temperature or cold food (e.g. applesauce, yoghurt). It must be taken immediately and not stored for future use.
• Your doctor would start the medication at a low dose, and then slowly adjust the dose according to your response to the medication.
• For Concerta® ER and Neurofind PR, the tablet does not dissolve completely after all of the medication has been released and sometimes the tablet shell may appear in your stools. This is normal.

What should I do if I forget to take or use this medication?

If you forget to take a dose, take it as soon as you remember if it is not close to the next dose. Otherwise, you should skip the dose and take the next dose at the usual time. Do not take two doses together to make up for the missed dose.

What precautions should I take when taking or using this medication?

Inform your healthcare professional if:

• You are allergic to this medication or any of the other ingredients of this medication
• You are pregnant, planning to become pregnant, or breastfeeding
• You are taking any other medications, including supplements, traditional medications and herbal remedies currently or in the last two weeks.
• You have a history of or current medical conditions such as blood vessel disease, high blood pressure, stroke, heart disease, mental health disorders, glaucoma, overactive thyroid, seizures (fits), hard-to-control or repeated twitching of any parts of the body or you repeat sounds and words (Tourette’s syndrome or tics disorder)

What are some common side effects of this medication? ​

This include:

• Stomach discomfort e.g. stomach pain, nausea, vomiting
  • Take it after food to minimise these side effects.
• Dry mouth
• Mild headache, body ache
• Nervousness, not being able to sleep
  • Avoid taking the medication too late in the day as it may keep you awake
• Dizzy or lightheadedness
  • Stand up slowly from a lying position
• Loss of appetite – weight loss may occur during the first few months of treatment

Most of these side effects will get better or go away as your body gets used to the medication.

Inform your doctor if the side effects above become severe and bothersome.

What are some rare but serious side-effects that I need to seek medical advice immediately? 

The symptoms of a drug allergy include one or more of the following:

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

Very rarely, this medication may cause:

• Fast or irregular heartbeat (palpitations)
• Uncontrolled speech and/or tics (uncontrolled and repeated body movements)
• Seizures, confusion
• Changes in eyesight e.g. blurred vision
• Prolonged and/or painful erections (for males) lasting up to 4 hours and beyond.
• Increase in blood pressure
• New or worsening signs of delusions (false beliefs), hallucinations (seeing or hearing things that are not real), mania (abnormally high or excited mood) or any other changes in mood or behaviour
• Worsening agitation, restlessness, violent behaviour, or new or worsening thoughts of harming yourself or ending your life

Please inform your doctor as soon as possible, or for your family or caregiver to inform your doctor if you are unable to seek treatment on your own.

What food or medication should I avoid when I take or use this medication?

Avoid taking alcohol when you are taking this medication as alcohol may interact with your medication and increase the risk of side-effects.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How do I throw away this medication safely? ​

Pack the medication into a bag and bring it back to the pharmacy where you received the medication from.