Controlled Substance Schedule II
Pregnancy Risk Category C
How supplied
Tablets: 5 mg, 10 mg, 20 mg
Tablets (sustained-release): 20 mg
Action
Unknown. Probably promotes nerve impulse transmission by releasing stored norepinephrine from nerve terminals in the brain. Main site of activity appears to be the cerebral cortex and the reticular activating system. In children with hyperkinesis, methylphenidate has a paradoxical calming effect.
Indications & dosage
Attention deficit disorder with hyperactivity--
Children ages 6 and older: initial dose, 5 to 10 mg P.O. daily before breakfast and lunch. Dosage increased in 5- to 10-mg increments weekly, p.r.n., up to 60 mg daily.
Narcolepsy--
Adults: 10 mg P.O. b.i.d. or t.i.d. 30 to 45 minutes before meals. Dosage varies with patient needs.
Adverse reactions
CNS: nervousness, insomnia, Tourette syndrome, dizziness, headache, akathisia, dyskinesia, seizures, drowsiness.
CV: palpitations, angina, tachycardia, changes in blood pressure and pulse rate, arrhythmias.
GI: nausea, abdominal pain, anorexia.
Hematologic: thrombocytopenia, thrombocytopenic purpura, leukopenia, anemia.
Metabolic: weight loss.
Skin: rash, urticaria, exfoliative dermatitis, erythema multiforme.
Interactions
Drug-drug. Centrally acting antihypertensives: decreased antihypertensive effect. Monitor blood pressure.
MAO inhibitors: may cause severe hypertension, possibly hypertensive crisis. Don't use together or within 14 days of discontinuation of MAO inhibitor therapy.
Tricyclic antidepressants: increased plasma levels of these drugs. Avoid concomitant use.
Drug-food. Beverages containing caffeine: may increase amphetamine and related amine effects. Avoid concomitant use.
Effects on diagnostic tests
None reported.
Contraindications
Contraindicated in patients with hypersensitivity to drug and in those with glaucoma, motor tics, family history or diagnosis of Tourette syndrome, or history of marked anxiety, tension, or agitation.
Nursing considerations
Patient teaching
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING