Ritalin (methylphenidate) is a central nervous system stimulant. It affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control.

Ritalin is used to treat attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and narcolepsy.

Ritalin may also be used for purposes not listed in this medication guide.

Before taking this medicine

Do not use Ritalin if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

You should not use Ritalin if you are allergic to it, or if you have:

•    glaucoma;
•    a personal or family history of tics (muscle twitches) or Tourette's syndrome; or
•    severe anxiety, tension, or agitation (stimulant medicine can make these symptoms worse).

Some stimulants have caused sudden death in certain people. Tell your doctor if you have:

•    heart problems or a congenital heart defect;
•    high blood pressure; or
•    a family history of heart disease or sudden death.

How should I take Ritalin?

Take Ritalin exactly as prescribed by your doctor. Using this medicine, improperly can cause death or serious side effects on the heart.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

To prevent sleep problems, take this medicine in the morning.

Ritalin normal release tablets should be taken at least 30 to 45 minutes before a meal. Extended-release Ritalin LA capsules or Ritalin SR tablets can be taken with or without food. Follow the directions on your medicine label

Do not crush, chew, or break an extended-release Ritalin SR tablet. Swallow the tablet whole. Breaking the tablet may cause too much of the drug to be released at one time.

To make swallowing easier, you may carefully open the Ritalin LA capsule and sprinkle the beads over a spoonful of applesauce. The applesauce should not be warm as it could affect the release properties of the medicine. Swallow the applesauce and medicine mixture without chewing. Do not save the mixture for later use. Follow with a drink of water or other liquid. Never chew or crush the capsule or the medicine beads inside the capsule.

While using this medicine, your doctor will need to check your progress at regular visits. Your heart rate, blood pressure, height and weight may also need to be checked often.

If you need surgery, tell the surgeon ahead of time that you are using Ritalin. You may need to stop using the medicine for a short time.

Store at room temperature away from moisture and heat.

Ritalin side effects

Get emergency medical help if you have signs of an allergic reaction to Ritalin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Methylphenidate can affect growth in children. Tell your doctor if your child is not growing at a standard rate while using this medicine.

Stop taking Ritalin and call your doctor at once if you have:

•    chest pain, trouble breathing, feeling like you might pass out;
•    hallucinations (seeing or hearing things that are not real), new behaviour problems, aggression, hostility, paranoia;
•    a seizure (convulsions);
•    numbness, pain, cold feeling, unexplained wounds, or skin colour changes (pale, red, or blue appearance) in your fingers or toes;
•    muscle twitches (tics);
•    changes in your vision;
•    penis erection that is painful or lasts 4 hours or longer (rare); or
•    unexplained muscle pain, tenderness, or weakness (especially if you also have a fever, unusual tiredness, and dark-coloured urine).

Common Ritalin side effects may include:

•    feeling nervous or irritable, sleep problems (insomnia);
•    loss of appetite;
•    nausea, stomach pain; or
•    headache.

Dosage

Adults

Tablets: Administer in divided doses 2 or 3 times daily, preferably 30 to 45 minutes before meals. The average dosage is 20 to 30 mg daily. Some patients may require 40 to 60 mg daily. In others, 10 to 15 mg daily will be adequate. Patients who are unable to sleep if medication is taken late in the day should take the last dose before 6 p.m.

SR Tablets: Ritalin-SR tablets have a duration of action of approximately 8 hours. Therefore, Ritalin-SR tablets may be used in place of Ritalin tablets when the 8-hour dosage of Ritalin-SR corresponds to the titrated 8-hour dosage of Ritalin. Ritalin-SR tablets must be swallowed whole and never crushed or chewed.

Children (6 years and over)

Ritalin should be initiated in small doses, with gradual weekly increments. Daily dosage above 60 mg is not recommended.

If improvement is not observed after appropriate dosage adjustment over a 1-month period, the drug should be discontinued.

Tablets: Start with 5 mg twice daily (before breakfast and lunch) with gradual increments of 5 to 10 mg weekly.

SR Tablets: Ritalin-SR tablets have a duration of action of approximately 8 hours. Therefore, Ritalin-SR tablets may be used in place of Ritalin tablets when the 8-hour dosage of Ritalin-SR corresponds to the titrated 8-hour dosage of Ritalin. Ritalin-SR tablets must be swallowed whole and never crushed or chewed.

If paradoxical aggravation of symptoms or other adverse effects occur, reduce dosage, or, if necessary, discontinue the drug.

Ritalin should be periodically discontinued to assess the child’s condition. Improvement may be sustained when the drug is either temporarily or permanently discontinued.

Drug treatment should not and need not be indefinite and usually may be discontinued after puberty.