Ritalin : Uses, Side Effects, Interactions & More
Ritalin can be habit forming. Do not take a higher dose, take it more often, take it longer, or take it differently than prescribed by your doctor. If you take too much Ritalin, you may find that the medicine no longer controls your symptoms, you may feel the need to take large amounts of the medicine, and you may experience unusual changes in your behavior. Tell your doctor if you drink or have ever drunk large amounts of alcohol, use or have ever used illegal drugs, or used prescription drugs in excess.
Do not stop taking Ritalin without talking to your doctor, especially if you have overused the medicine. Your doctor will probably decrease your dose gradually and will monitor you carefully during this time. You can develop severe depression if you stop taking Ritalin suddenly after using it excessively. Your doctor may need to monitor you carefully after you stop taking Ritalin, even if you have not overused the medicine, because your symptoms may worsen when treatment is stopped.
Do not sell, give away, or allow anyone else to take your medicine. Selling or giving away Ritalin can harm others and is illegal. Store Ritalin in a safe place so that no one else can accidentally or on purpose take it. Keep track of how much medicine is left to see if any are missing.
Your doctor or pharmacist will provide you with the manufacturer’s patient information sheet (Medication Guide) when you start treatment with Ritalin and each time you receive more medicine. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer’s website to obtain the Medication Guide.
Why is this medication prescribed?
Ritalin (Methylphenidate) is used as part of a treatment program to control the symptoms of attention deficit hyperactivity disorder (ADHD; greater difficulty concentrating, controlling actions, and staying still or calm than other people of the same age) in adults and children. Ritalin (Methylin) is also used to treat narcolepsy (a sleep disorder that causes excessive daytime sleepiness and sudden sleep attacks). Ritalin belongs to a class of medications called central nervous system (CNS) stimulants. It works by changing the amounts of certain natural substances in the brain.
How should this medicine be used?
Ritalin (Methylphenidate) comes as an immediate-release tablet, a chewable tablet, a solution (liquid), a long-acting suspension (long-release) (liquid), an intermediate-acting tablet (long-release), a long-acting tablet (prolonged extended-release), one long-acting (extended-release) tablet, one long-acting (long-release) chewable tablet, and one long-acting (long-release) orally disintegrating tablet (tablet that dissolves rapidly in the mouth). Long-acting tablet, orally disintegrating tablets, and capsules deliver some medicine right away, releasing the remaining amount as a constant dose of medicine for longer. All of these forms of Ritalin are taken orally. Regular tablets, chewable tablets (Methylin) and solution (Methylin) are generally taken two or three times a day by adults and twice a day by children, preferably 35 to 40 minutes before meals. Adults who take three doses should take the last dose before 6:00 p.m., so that the medication does not cause difficulty falling asleep or staying asleep. Intermediate-acting tablets are usually taken once or twice a day, in the morning and sometimes in the afternoon 30 to 45 minutes before a meal. The long-acting capsule (Metadate CD) is usually taken once a day before breakfast; Long Acting Tablet (Concerta), Long Acting Chewable Tablet (Quillichew ER), Long Acting Suspension (Quillivant XR), and Long Acting Capsules (Aptensio XR, Ritalin LA) are generally taken once daily per morning with or without food Long-acting suspension (Quillivant XR) will start to work sooner if taken with food. The long-acting orally disintegrating tablet (Cotempla XR-ODT) and the long-acting capsule (Adhansia XR) are generally taken once daily in the morning and should be taken consistently, either with food or always without food. The long-acting capsule (Jornay PM) is generally taken once a day in the evening (between 6:30 p.m. and 9:30 p.m.), and must be taken consistently, at the same time every night and always with food or always without food.
Follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any part you do not understand. Take Ritalin exactly as directed.
Do not attempt to push the extended-release orally disintegrating tablet (Cotempla XR-ODT) through the blister sheet. Instead, use dry hands to peel off the foil packaging. Immediately take out the tablet and place it in your mouth. The tablet will dissolve quickly and can be swallowed with saliva; no water is needed to swallow the tablet.
You should chew your immediate-release chewable tablets well, and then drink a full glass (at least 8 ounces [240 milliliters] ) of water or other liquid. If you take the immediate-release chewable tablet without enough liquid, the tablet may swell and block your throat, causing you to choke. If you have chest pain, vomiting, or trouble swallowing or breathing after taking the chewable tablet, you should call your doctor or get emergency medical treatment right away.
Swallow the intermediate-acting and long-acting tablets and capsules whole; do not break, chew or crush them. However, if you cannot swallow the long-acting capsules (Aptensio XR, Jornay PM, Metadate CD, Ritalin LA), you can carefully open the capsules and sprinkle the entire contents in one tablespoon of applesauce at room temperature or cold, or for a long time. action capsules (Adhansia XR), you can open the capsules and sprinkle the entire content in a tablespoon of applesauce or yogurt. Swallow (without chewing) this mixture immediately after preparation (within 10 minutes if you take Adhansia XR) and then drink a glass of water to make sure you have swallowed all of the medicine. Do not store the mixture for future use.
If you are taking the long-acting chewable tablet (Quillichew ER) and your doctor has told you to take part of the tablet to get the correct amount of your dose, carefully break the 20-mg or 30-mg long-acting chewable tablet into have been marked on it. However, the 40 mg long-acting chewable tablet is not rated and cannot be divided or divided.
If you are taking the long-acting suspension (Quillivant XR), follow these steps to measure the dose:
- Remove the medicine bottle and dispenser from the box. Check to make sure the bottle contains liquid medications. Call your pharmacist and do not use the medicine if the bottle contains powder or if there is no dose dispenser in the box.
- Shake the bottle up and down for at least 10 seconds to mix the medicine evenly.
- Remove the cap from the bottle. Verify that the bottle adapter has been inserted into the top of the bottle.
- If the bottle adapter has not been inserted into the top of the bottle, insert it by placing the bottom of the adapter into the bottle opening and pressing firmly with your thumb. Call your pharmacist if the box does not contain a bottle adapter. Do not remove the bottle adapter from the bottle once it is inserted.
- Insert the tip of the dosing dispenser into the bottle adapter and push the plunger all the way down.
- Turn the bottle upside down.
- Pull back on the plunger to withdraw the amount of oral suspension prescribed by your doctor. If you are not sure how to correctly measure the dose your doctor prescribed, ask your doctor or pharmacist.
- Remove the dosing dispenser and slowly spray the oral suspension directly into your mouth or into your child’s mouth.
- Replace the bottle cap and close tightly.
- Clean the dosing dispenser after each use by placing it in the dishwasher or rinsing it under running water.
Your doctor may start with a low dose of Ritalin and gradually increase your dose, not more than once a week.
Your condition should improve during your treatment. Call your doctor if your symptoms worsen at any time during your treatment or do not improve after 1 month.
Your doctor may tell you to stop taking Ritalin from time to time to see if you still need the medicine. Follow these instructions carefully.
Some Ritalin products may not be substitutable for another. Ask your pharmacist if you have any questions about the type of Ritalin product your doctor prescribed.
Other uses for this Medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before taking Ritalin,
- Tell your doctor and pharmacist if you are allergic to Ritalin, any other medications, aspirin (if you take Adhansia XR), tartrazine dye (a yellow tint in some processed foods and medications; if you take Adhansia XR), or any of the ingredients in The Ritalin product you are taking. Consult your doctor or consult the Medication Guide for a list of ingredients.
- Tell your doctor if you are taking monoamine oxidase (MAO) inhibitors, including isocarboxazide (Marplan), linezolid (Zyvox), methylene blue, phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate), or have stopped taking them for the past 14 days. Your doctor will probably tell you not to take Ritalin until at least 14 days have passed since the last time you took an MAO inhibitor.
- Tell your doctor and pharmacist what prescription and over-the-counter medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: blood thinners (‘blood thinners’) such as warfarin (Coumadin, Jantoven); antidepressants such as clomipramine (Anafranil), desipramine (Norpramin), and imipramine (Tofranil); decongestants (cough and cold medicine); medications for heartburn or ulcers such as esomeprazole (Nexium, in Vimovo), famotidine (Pepcid), omeprazole (Prilosec, in Zegerid), or pantoprazole (Protonix); medications for high blood pressure; seizure medications such as phenobarbital, phenytoin (Dilantin, Phenytek), and primidone (Mysoline); methyldopa; selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, in Symbyax, others), fluvoxamine (Luvox), paroxetine (Brisdelle, Paxil, Pexeva) and sertraline (Zoloft ); baking soda (baking soda and baking soda, peppermint soda); and venlafaxine (Effexor). If you are taking Ritalin LA, also tell your doctor if you take antacids or medicines for heartburn or ulcers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- Tell your doctor if you or someone in your family has had or has ever had Tourette syndrome (a condition characterized by the need to make repeated movements or repeat sounds or words), facial or motor tics (repeated uncontrollable movements), or verbal tics (repetition of sounds or words that is difficult to control). Also tell your doctor if you have glaucoma (increased pressure in the eye that can cause vision loss), an overactive thyroid gland, or feelings of anxiety, tension, or agitation. Your doctor will probably tell you not to take Ritalin if you have any of these conditions.
- Tell your doctor if anyone in your family has or has had an irregular heartbeat or died suddenly. Also tell your doctor if you have recently had a heart attack and if you have or have ever had a heart defect, high blood pressure, irregular heartbeat, heart or blood vessel disease, hardening of the arteries, cardiomyopathy (thickening of the heart muscle). ) or other heart problems. Your doctor will probably tell you not to take Ritalin if you have a heart condition or if there is a high risk of developing a heart condition.
- Tell your doctor if you or someone in your family has or has ever had depression, bipolar disorder (a mood that changes from depressed to abnormally excited), mania (frantic, abnormally excited mood), or have thought or tried commit suicide. Also tell your doctor if you have or have ever had seizures, an abnormal electroencephalogram (EEG, a test that measures electrical activity in the brain), circulation problems in the fingers and toes, or mental illness. If you are taking the long-acting tablet (Concerta), tell your doctor if you have a narrowing or blockage of your digestive system.
- Tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking Ritalin, call your doctor.
- Tell your doctor if you are breastfeeding or plan to breastfeed. If you are breastfeeding while taking Ritalin, your doctor may direct you to closely monitor your baby for unusual agitation, trouble sleeping, poor appetite, or weight loss.
- Talk to your doctor about the risks and benefits of taking Ritalin if you are 65 years of age or older. Older adults generally should not take Ritalin because it is not as safe as other medications that can be used to treat the same condition.
- If you are going to have surgery, including dental surgery, tell the doctor or dentist that you are taking Ritalin.
- Please note that you should not drink alcoholic beverages while taking the Long Acting Chewable Tablet (Quillichew ER), the Long Acting Oral Disintegrating Tablet (Cotempla® XR-ODT) or the Long Acting Capsule (Adhansia XR or Jornay PM) .
- If you have phenylketonuria (PKU, an inherited condition that requires a special diet to prevent mental retardation), you should know that immediate-release, long-acting chewable tablets contain aspartame that forms phenylalanine.
- You should know that Ritalin should be used as part of a total treatment program for ADHD, which may include counseling and special education. Be sure to follow all instructions from your doctor and / or therapist.
What should I do if I forget a dose?
Take the missed dose as soon as you remember. Talk to your doctor or pharmacist about how late in the day you should take a missed dose of your medicine so that it does not cause you difficulty falling asleep or staying asleep. However, if it is almost time for your next scheduled dose, skip the missed dose and continue your regular dosing schedule. If you are taking the long-acting capsule (Jornay PM), take the missed dose as soon as you remember that night. However, if it is already the next morning, skip the missed dose of the long-acting capsule (Jornay PM) and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What side effects can this medication cause?
Ritalin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- difficulty falling asleep or staying asleep
- loss of appetite
- weight loss
- stomach pain
- dry mouth
- muscle tightness
- uncontrollable movement of a part of the body
- decreased sexual desire
- heavy sweating
- back pain
Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:
- fast, pounding, or irregular heartbeat
- chest pain
- shortness of breath
- excessive tiredness
- slow or difficult speech
- weakness or numbness of an arm or leg
- changes in vision or blurred vision
- believing things that are not true
- feeling unusually suspicious of others
- hallucinating (seeing things or hearing voices that do not exist)
- motor tics or verbal tics
- abnormally excited mood
- mood changes
- frequent, painful erections
- erection that lasts longer than 4 hours
- numbness, pain, or sensitivity to temperature in the fingers or toes
- skin color change from pale to blue to red in the fingers or toes
- unexplained wounds on the fingers or toes
- blistering or peeling skin
- swelling of the eyes, face, lips, mouth, tongue, or throat
- difficulty breathing or swallowing
Ritalin can slow growth or weight gain in children. Your child’s doctor will watch your growth carefully. Talk to your child’s doctor if you are concerned about your child’s growth or weight gain while taking this medicine. Talk to your child’s doctor about the risks of giving your child Ritalin.
What should I know about storage and disposal of this medication?
Keep this medicine in its container, tightly closed and out of the reach of children. Store it at room temperature, away from light and excess heat and moisture (not in the bathroom). Store Ritalin in a safe place so that no one else can accidentally or on purpose take it. Keep track of how many tablets or capsules or how much liquid is left to see if any medications are missing.
Unnecessary medications must be disposed of in a special way to ensure that pets, children and others cannot consume them. However, you should not flush this medicine down the toilet. Instead, the best way to get rid of your medication is through a medication take-back program. Talk to your pharmacist or contact your local garbage / recycling department for information on return programs in your community. Consult the FDA’s Safe Drug Disposal website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
It is important to keep all medications out of the sight and reach of children, as many containers (such as those for taking pills weekly and those used for eye drops, creams, patches, and inhalers) are not resistant to children and children. young children can easily open them. To protect young children from poisoning, always close the safety caps and immediately put the medicine in a safe place, one that is up and away and out of your sight and reach. http://www.upandaway.org
In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim collapsed, had a seizure, is having trouble breathing, or cannot wake up, call 911 immediately.
Symptoms of overdose may include the following:
- fainting, blurred vision, or dizziness
- abnormally rapid breathing
- uncontrollable shaking of a part of the body
- muscle twitching
- loss of consciousness
- inappropriate happiness
- hallucinating (seeing things or hearing voices that do not exist)
- fast, pounding, or irregular heartbeat
- widening of pupils (black circles in the middle of the eyes)
- dry mouth or nose
- muscle weakness, fatigue, or dark urine
What other information should I know?
If you are taking long-acting Ritalin tablets (Concerta), you may notice something like a tablet in your stool. This is just the empty tablet shell, and this does not mean that you did not receive your full dose of medication.
Keep all appointments with your doctor and the laboratory. Your doctor can monitor your blood pressure and heart rate and order certain laboratory tests to check your response to Ritalin.
This recipe is not refillable. Be sure to make regular appointments with your doctor so you don’t run out of medications.
It is important to keep a written list of all prescription and over-the-counter (non-prescription) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should carry this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
- Adhansia XR
- Aptensio XR
- Cotempla XR-ODT
- Jornay PM
- Metadate CD
- Metadate ER
- Methylin ER
- Quillichew ER
- Quillivant XR
- Ritalin LA
- Ritalin SR
- Methylphenidylacetate hydrochloride
Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.