Concerta

History of drug dependence or alcoholism; monitor. Increased risk of sudden death, stroke, and MI; assess for presence of cardiac disease before initiating. Avoid in known structural cardiac abnormalities, cardiomyopathy, serious arrhythmias, coronary artery disease, and other cardiac problems. Pre-existing psychotic disorder. Bipolar disorder. Screen for risk factors of developing a manic episode prior to initiation. Consider discontinuing if new psychotic/manic symptoms occur. Monitor for new or worsening aggressive behavior or hostility. Seizure disorder. Peripheral vasculopathy, including Raynaud's Phenomenon; monitor for digital changes. Preexisting GI narrowing. Monitor growth (esp. children), BP, HR, CBCs, differential, platelet counts. Reduce dose or discontinue if paradoxical aggravation of symptoms occurs. Reevaluate periodically. Pregnancy (Cat.C). Nursing mothers.