Ritalin/Ritalin-SR/Ritalin LA

Generic name: Methylphenidate hydrochloride

What is Ritalin/Ritalin-SR/Ritalin LA?

Ritalin and other brands of methylphenidate are mild central nervous system stimulants used in the treatment of attention-deficit/hyperactivity disorder (ADHD) in children.

Ritalin is also used in adults to treat narcolepsy (an uncontrollable desire to sleep).

What is the most important information I should know about Ritalin/Ritalin-SR/Ritalin LA?

When given for ADHD, Ritalin should be an integral part of a total treatment program that includes psychological, educational, and social measures.

There are reports of heart and mental problems in patients taking Ritalin or other related stimulants. Some of the problems are sudden death in patients with previous heart problems, heart attacks in adults, increased blood pressure and heart rate, new or worsening symptoms of behavior problems, bipolar disorder, and aggressive or hostile behavior. Call your doctor right away if you or your child develop signs of heart problems such as chest pain, shortness of breath, or fainting while taking Ritalin.

Excessive doses of Ritalin over a long period of time may cause addiction. It is also possible to develop tolerance to the drug, so that larger doses are needed to produce the original effect. Be sure to check with your doctor before making any change in dosage; and stop the drug only under your doctor's supervision.

There is no information regarding the safety and effectiveness of long-term treatment in children. However, slowing of growth has been seen with the long-term use of stimulants, so your doctor will monitor your child carefully while he or she is taking Ritalin.

The use of Ritalin in children less than 6 years old is not recommended.

Who should not take Ritalin/Ritalin-SR/Ritalin LA?

This drug should not be prescribed for anyone experiencing anxiety, tension, and agitation, since the drug may aggravate these symptoms. Individuals sensitive or allergic to Ritalin should not take it.

This medication should not be taken by individuals with glaucoma, those who suffer from tics (repeated, involuntary twitches) or with a family history of Tourette's syndrome (severe and multiple tics).

This drug is not intended for use in children whose symptoms may be caused by stress or a psychiatric disorder.

This medication should not be used for the prevention or treatment of normal fatigue, nor should it be used for the treatment of severe depression.

Do not take Ritalin if you or your child are taking or have taken antidepressants known as monoamine oxidase inhibitors (MAOIs) in the last 14 days.

What should I tell my doctor before I take the first dose of Ritalin/Ritalin-SR/Ritalin LA?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Ritalin, especially if you are currently taking or have recently taken MAOIs. Also, talk to your doctor about your complete medical history, especially if you have a heart problems such as a congenital heart defect, heart failure, heart rhythm disorder or recent heart attack, high blood pressure, a personal or family history of mental illness, psychotic disorder, bipolar disorder, depression, suicide attempt, epilepsy or other seizure disorder, a history of drug or alcohol addiction, glaucoma, a personal or family history of tics or Tourette's syndrome, severe anxiety, tension, or agitation.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Ritalin tablets and capsules should not be given to children under 6 years of age.

Ritalin Tablets

Adults: The average dosage is 20 to 30 milligrams (mg) a day, divided into 2 or 3 doses, preferably taken 30 to 45 minutes before meals. Some people may need 40 to 60 mg daily, others only 10 to 15 mg. Your doctor will determine the best dose.

Children 6 years and older: The usual starting dose is 5 mg taken twice a day, before breakfast and lunch; your doctor may increase the dose by 5 to 10 mg a week. Your child should not take more than 60 mg in a day. If you do not see any improvement over a period of one month, check with your doctor.

Ritalin-SR Tablets

Adults: These are suspended-release tablets that keep working for 8 hours. They may be used in place of Ritalin tablets if they deliver a comparable dose over an 8-hour period.

Children 6 years and older: These tablets continue working for 8 hours. Your doctor will decide if they should be used in place of the regular tablets.

Ritalin LA Capsules

Children 6 years and older: The recommended starting dose is 20 mg once daily in the morning. At weekly intervals, your doctor may increase the dose by 10 mg, up to a maximum of 60 mg once a day.

How should I take Ritalin/Ritalin-SR/Ritalin LA?

Follow your doctor's directions carefully. Ritalin should be taken 30 to 45 minutes before meals. If the drug interferes with sleep, give the child the last dose before 6 p.m.

Ritalin-SR and Ritalin LA are long-acting forms of the drug and are taken less frequently. They should be swallowed whole, never crushed or chewed. Ritalin LA may also be given by sprinkling the contents of the capsule on a tablespoon of cool applesauce and administering immediately, followed by a drink of water.

What should I avoid while taking Ritalin/Ritalin-SR/Ritalin LA?

Some people have had visual disturbances such as blurred vision while being treated with Ritalin. Be careful if you drive or do anything that requires you to be awake and alert until you know how this drug affects you.

What are possible food and drug interactions associated with Ritalin/Ritalin-SR/Ritalin LA?

If Ritalin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Ritalin with the following: antidepressants, antiseizure drugs, blood pressure drugs, blood thinners such as warfarin, clonidine, guanethidine, MAO inhibitors, and phenylbutazone.

What are the possible side effects of Ritalin/Ritalin-SR/Ritalin LA?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: inability to fall or stay asleep, nervousness

These side effects can usually be controlled by reducing the dosage and omitting the drug in the afternoon or evening.

More common side effects in children may include: loss of appetite, abdominal pain, weight loss during long-term therapy, inability to fall or stay asleep, abnormally fast heartbeat

Can I receive Ritalin/Ritalin-SR/Ritalin LA if I am pregnant or breastfeeding?

The effects of Ritalin during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

What should I do if I miss a dose of Ritalin/Ritalin-SR/Ritalin LA?

Take it as soon as you remember. Take the remaining doses for the day at regularly spaced intervals. Do not take two doses at once.

How should I store Ritalin/Ritalin-SR/Ritalin LA?

Store at room temperature in a tightly closed, light-resistant container. Protect from moisture.