$Unique_ID{BRK03230} $Pretitle{} $Title{methylphenidate} $Subject{hydrochloride Ciba Ritalin Ritalin-SR Adrenergic methylphenidate central nervous system brain spinal cord stimulant mental alertness decreases fatigue narcolepsy sleep attacks mild depression abnormal behavioral syndrome children hyperkinetic attention deficit disorder} $Volume{} $Log{ Ritalin*0323001.scf} Copyright (C) 1993 Publications International, Ltd. methylphenidate ------------------------------------------------------------------------------ BRAND NAMES (Manufacturers) methylphenidate hydrochloride (various manufacturers) Ritalin (Ciba) Ritalin-SR (Ciba) TYPE OF DRUG Adrenergic INGREDIENT methylphenidate DOSAGE FORMS Tablets (5 mg, 10 mg, and 20 mg) Sustained-release tablets (20 mg) STORAGE Methylphenidate should be stored at room temperature in tightly closed, light-resistant containers. USES Methylphenidate is a central nervous system (brain and spinal cord) stimulant that increases mental alertness and decreases fatigue. It is used in the treatment of narcolepsy (a disorder involving uncontrollable desires to sleep or actual sleep attacks that occur in a rapid and unpredictable manner), mild depression, and abnormal behavioral syndrome in children (hyperkinetic syndrome or attention deficit disorder). The way this medication works in abnormal behavioral syndrome in children is not clearly understood. TREATMENT In order to avoid stomach upset, you can take methylphenidate with food or with a full glass of water or milk (unless your doctor directs you to do otherwise). If methylphenidate is being used to treat narcolepsy or abnormal behavioral syndrome in children, the first dose should be taken soon after awakening. In order to avoid difficulty in falling asleep, the last dose of the regular tablets should be taken four to six hours before bedtime each day (the sustained-release tablets should be taken at least eight hours before bedtime). The sustained-release tablets should be swallowed whole. Chewing, crushing, or breaking these tablets destroys their sustained-release activity and may increase the side effects. If you miss a dose, take the missed dose as soon as possible, unless it is almost time for your next dose. In that case, do not take the missed dose; just return to your regular dosing schedule. Do not double the next dose. SIDE EFFECTS Minor. Abdominal pain, dizziness, drowsiness, dry mouth, headache, insomnia, loss of appetite, nausea, nervousness, vomiting, or weakness. These side effects should disappear as your body adjusts to the medication. Dry mouth can be relieved by sucking on ice chips or a piece of hard candy or by chewing sugarless gum. If you feel dizzy, sit or lie down for a while; get up from a sitting or lying position slowly, and be careful on stairs. Major. Tell your doctor about any side effects that are persistent or particularly bothersome. IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about chest pain, fever, hair loss, hallucinations, hives, joint pain, mood changes, palpitations, rash, seizures, sore throat, uncoordinated movements, or bleeding or bruising. INTERACTIONS Methylphenidate interacts with several other types of medications: 1. Use of it within 14 days of a monoamine oxidase (MAO) inhibitor (such as isocarboxazid, pargyline, phenelzine, tranylcypromine) can result in severe high blood pressure. 2. Methylphenidate can decrease the blood-pressure-lowering effects of antihypertensive medications (especially guanethidine). 3. Acetazolamide and sodium bicarbonate can decrease the elimination of methylphenidate from the body, thereby prolonging its action and increasing the risk of side effects. 4. Methylphenidate can decrease the elimination and increase the side effects of oral anticoagulants (blood thinners, such as warfarin), tricyclic antidepressants (such as amitriptyline, desipramine, imipramine, and nortriptyline), anticonvulsants (such as phenytoin, phenobarbital, and primidone), and phenylbutazone. Before starting to take this medication, BE SURE TO TELL YOUR DOCTOR about any medications you are currently taking, especially any of those listed above. WARNINGS * Tell your doctor about unusual or allergic reactions you have had to any medications, especially to methylphenidate. * Tell your doctor if you have ever had epilepsy, glaucoma, high blood pressure, motor tics, Tourette's syndrome, anxiety, agitation, depression, or tension. * Methylphenidate can mask the symptoms of extreme fatigue and can cause dizziness. Your ability to perform tasks that require alertness, such as driving a car or operating potentially dangerous machinery, may be decreased. Appropriate caution should, therefore, be taken. A child taking methylphenidate should be careful while engaging in physical activity. * Before having surgery or any other medical or dental treatment, be sure to tell your doctor that you are taking this medication. * Methylphenidate is related to amphetamine and may be habit-forming when taken for long periods of time (both physical and psychological dependence can occur). You should not increase the dosage of this medication or take it for longer than the prescribed time unless you first consult your doctor. It is also important that you not stop taking this medication abruptly; fatigue, sleep disorders, mental depression, nausea, vomiting, or stomach cramps or pain could occur. Your doctor may want to decrease the dosage gradually in order to prevent these side effects. * Methylphenidate can slow growth in children. Therefore, if this medication is being taken by a child, your doctor may recommend drug-free periods during school holidays and summer vacations. Growth spurts often occur during these drug-free periods. * Children may be more sensitive to certain side effects such as loss of appetite, stomach pain, trouble sleeping, and weight loss. * If cocaine is being used now or was used in the past, taking methylphenidate may cause severe nervousness, irritability, trouble sleeping, or possibly irregular heartbeat or seizures. * Be sure to tell your doctor if you are pregnant. Effects of this drug during pregnancy have not been thoroughly studied in either humans or animals. Also, tell your doctor if you are breast-feeding an infant. Small amounts of methylphenidate may pass into breast milk. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.