Methylphenidate

— THERAPEUTIC CATEGORIES —
  • ADHD
  • Sleep-wake disorders

Methylphenidate Generic Name & Formulations

General Description

Methylphenidate HCl 5mg, 10mg+, 20mg+; tabs; dye-free; +scored.

Pharmacological Class

CNS stimulant.

How Supplied

Tabs, ext-rel tabs, chew tabs—contact supplier; Oral soln—500mL

Methylphenidate Indications

Indications

Attention deficit hyperactivity disorder.

Methylphenidate Dosage and Administration

Adult

10–60mg daily in 2–3 divided doses preferably 30–45 mins before meals. Chew tabs: take with 8oz of water or other fluid.

Children

<6yrs: not established. ≥6yrs: initially 5mg twice a day before breakfast and lunch. Increase gradually by 5–10mg per week if needed; max 60mg daily.

Methylphenidate Contraindications

Contraindications

During or within 14 days of MAOIs. Marked anxiety, tension, agitation. Glaucoma. Motor tics. Tourette's syndrome in patient or family.

Methylphenidate Boxed Warnings

Boxed Warning

Drug abuse and dependence.

Methylphenidate Warnings/Precautions

Warnings/Precautions

History of drug dependence or alcoholism; monitor for abnormal behavior. 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 before 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. Monitor growth (esp. children), BP, HR, CBCs, differential, platelet counts. Reduce dose or discontinue if paradoxical aggravation of symptoms occur. Reevaluate periodically. Pregnancy (Cat.C). Nursing mothers.

Methylphenidate Pharmacokinetics

See Literature

Methylphenidate Interactions

Interactions

See Contraindications. Avoid alcohol. Hypertensive crisis with MAOIs. Caution with pressor agents. Antagonizes guanethidine. May potentiate coumarin anticoagulants, anticonvulsants (eg, phenobarbital, phenytoin, primidone), phenylbutazone, tricyclics, SSRIs. May antagonize antihypertensive drugs; monitor and adjust dose of antihypertensives as needed. Concomitant risperidone may increase risk of extrapyramidal symptoms; monitor.

Methylphenidate Adverse Reactions

Adverse Reactions

Insomnia, nervousness, CNS overstimulation, anorexia, weight loss, abdominal pain, nausea, dizziness, headache; priapism, hypertension, tachycardia, visual disturbances.

Methylphenidate Clinical Trials

See Literature

Methylphenidate Note

Not Applicable

Methylphenidate Patient Counseling

See Literature

Methylphenidate Generic Name & Formulations

General Description

Methylphenidate HCl 5mg, 10mg+, 20mg+; tabs; dye-free; +scored.

Pharmacological Class

CNS stimulant.

How Supplied

Tabs, ext-rel tabs, chew tabs—contact supplier; Oral soln—500mL

Methylphenidate Indications

Indications

Narcolepsy.

Methylphenidate Dosage and Administration

Adult

10–60mg daily in 2–3 divided doses preferably 30–45 mins before meals. Chew tabs: take with 8oz of water or other fluid.

Children

<6yrs: not established. ≥6yrs: initially 5mg twice a day before breakfast and lunch. Increase gradually by 5–10mg per week if needed; max 60mg daily.

Methylphenidate Contraindications

Contraindications

During or within 14 days of MAOIs. Marked anxiety, tension, agitation. Glaucoma. Motor tics. Tourette's syndrome in patient or family.

Methylphenidate Boxed Warnings

Boxed Warning

Drug abuse and dependence.

Methylphenidate Warnings/Precautions

Warnings/Precautions

History of drug dependence or alcoholism; monitor for abnormal behavior. 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 before 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. Monitor growth (esp. children), BP, HR, CBCs, differential, platelet counts. Reduce dose or discontinue if paradoxical aggravation of symptoms occur. Reevaluate periodically. Pregnancy (Cat.C). Nursing mothers.

Methylphenidate Pharmacokinetics

See Literature

Methylphenidate Interactions

Interactions

See Contraindications. Avoid alcohol. Hypertensive crisis with MAOIs. Caution with pressor agents. Antagonizes guanethidine. May potentiate coumarin anticoagulants, anticonvulsants (eg, phenobarbital, phenytoin, primidone), phenylbutazone, tricyclics, SSRIs. May antagonize antihypertensive drugs; monitor and adjust dose of antihypertensives as needed. Concomitant risperidone may increase risk of extrapyramidal symptoms; monitor.

Methylphenidate Adverse Reactions

Adverse Reactions

Insomnia, nervousness, CNS overstimulation, anorexia, weight loss, abdominal pain, nausea, dizziness, headache; priapism, hypertension, tachycardia, visual disturbances.

Methylphenidate Clinical Trials

See Literature

Methylphenidate Note

Not Applicable

Methylphenidate Patient Counseling

See Literature