Modify Therapy/Monitor Closely. Methylphenidate may diminish antihypertensive effects. Potential for additive CNS stimulation. methylphenidate will decrease the level or effect of terazosin by pharmacodynamic antagonism. Risk of acute hypertensive episode. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. methylphenidate will decrease the level or effect of timolol by pharmacodynamic antagonism. Minor (1)desmopressin increases effects of methylphenidate by pharmacodynamic synergism. ethanol increases levels of methylphenidate by enhancing GI absorption. Applies only to extended release formulation. Modify Therapy/Monitor Closely. fenfluramine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. salmeterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. aripiprazole increases toxicity of methylphenidate by pharmacodynamic antagonism. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. sufentanil SL, methylphenidate. methylphenidate will decrease the level or effect of nimodipine by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Applies only to extended release formulation. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. Risk of acute hypertensive episode. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. Serious - Use Alternative (1)maprotiline, methylphenidate. Minor/Significance Unknown. Use Caution/Monitor. Monitor Closely (1)promethazine, methylphenidate. Use Caution/Monitor. restrictions. However, people can also use nonstimulant drugs . Applies only to oral form of both agents. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. trimipramine, methylphenidate. Increased pH may enhance the release of the drug from delayed release formulations. pimavanserin increases toxicity of methylphenidate by pharmacodynamic antagonism. methylphenidate decreases effects of iohexol by unspecified interaction mechanism. Use Caution/Monitor. Contraindicated. Monitor Closely (1)methylphenidate will increase the level or effect of phenytoin by unknown mechanism. Modify Therapy/Monitor Closely. Modify Therapy/Monitor Closely. Mechanism: unknown. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. promethazine, methylphenidate. The generic drug name of Concerta is methylphenidate. Potential for additive CNS stimulation. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Monitor for hypertension with concomitant use. Contraindicated. Risk of acute hypertensive episode. only. Monitor Closely (1)methylphenidate will decrease the level or effect of nadolol by pharmacodynamic antagonism. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Either increases toxicity of the other by Other (see comment). Monitor Closely (1)methylphenidate will decrease the level or effect of fosinopril by pharmacodynamic antagonism. Please confirm that you would like to log out of Medscape. Risk of acute hypertensive episode. perphenazine, methylphenidate. Applies only to oral form of both agents. Concerta is long-acting Ritalin (methylphenidate). Adhansia XR: 25 mg PO qAM initially; may titrate upward in increments of 10-15 mg at intervals of at least 5 days; dosages >85 mg/day associated with increased incidence of certain adverse reactions, Aptensio XR: 10 mg PO qDay in AM; may increase weekly by 10-mg increments; not to exceed 60 mg/day, Concerta: Initial for methylphenidate-nave, 18-36 mg PO qDay; may increase by 18-mg increments at weekly intervals; maintenance dose is 18-72 mg/day, Metadate CD: Initial, 20 mg PO qAM before breakfast; may increase in 10- to 20-mg increments; not to exceed 60 mg/day, Methylin ER: Duration of action ~8 hr; may use in place of methylphenidate IR tablets when 8-hr dosage of methylphenidate ER corresponds to titrated 8-hr dosage of methylphenidate IR; not to exceed 60 mg/day, Ritalin (immediate-release tablets and oral solution): 20-30 mg/day PO divided q8-12hr, 30-45 minutes before meals; may gradually increase dose at weekly intervals; some patients may require 40-60 mg/day; in others, 10-15 mg/day may be adequate, QuilliChew ER (chewable extended-release tablets): 20 mg PO qAM initially; may titrate up or down weekly in increments of 10 mg, 15 mg, or 20 mg; not to exceed 60 mg/day, Jornay PM: Initial, 20 mg PO qDay in the evening; may titrate weekly in increments of 20 mg; not to exceed 100 mg/day; initiate dosing at 8:00 pm; adjust timing of administration between 6:30 pm and 9:30 pm to optimize tolerability and efficacy the next morning and throughout the day, Relexxii: Initial for methylphenidate-nave, 18-36 mg PO qDay; may increase by 18-mg increments at weekly intervals; maintenance dose is 18-72 mg/day; not to exceed 72 mg/day, Ritalin LA: Initial, 20 mg PO qAM; may adjust dose in weekly 10-mg increments, not to exceed 60 mg/day (patients requiring a lower initial dose may begin with 10 mg), Methylin, Ritalin (immediate-release tablets and oral solution): 20-30 mg/day PO divided q8-12hr, 30-45 minutes before meals; some patients may require 40-60 mg/day; in others, 10-15 mg/day may be adequate, Methylin ER: Duration of action is approximately 8 hr; may use in place of methylphenidate IR tablets when 8-hr dosage of methylphenidate ER corresponds to the titrated 8-hr dosage of methylphenidate IR, <6 years: Safety and efficacy not established. Monitor Closely (1)isoproterenol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Children 6 years of age and olderAt first, 5 mg 2 times a day, taken before breakfast and lunch. Controlled studies in pregnant women show no evidence of fetal risk. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. Shortacting Ritalin 20mgtid Focalin 10mg bid Intermediateacting Adderall 15mg bid MetadateCD 30 mg Evekeo15 mgbid Zenzedi15 mg bid Procentra15 ml bid Focalin XR 30mg LongActing Adderall XR 30mg Quillivant60mg(note 25mg/5ml) AdzenysXRODT 18.8mg Quillichew60 mg AptensioXR 60mg(actuallyequivto ritalin 25.9 twice a day) Mechanism: pharmacodynamic synergism. Modify Therapy/Monitor Closely. Modify Therapy/Monitor Closely. Blood and lymphatic system disorders: Pancytopenia, thrombocytopenia, thrombocytopenic purpura, Cardiac disorders: Angina pectoris, bradycardia, extrasystole, supraventricular tachycardia, ventricular extrasystole, hypertension, Eye disorders: Diplopia, mydriasis, visual impairment, General Disorders: Chest pain, chest discomfort, hyperpyrexia, long-term growth suppression, Hepatobiliary disorders: Hepatocellular injury, acute hepatic failure, Immune system disorders: Hypersensitivity reactions such as angioedema, anaphylactic reactions, auricular swelling, bullous conditions, exfoliative conditions, urticaria, pruritus, rashes, eruptions, and exanthemas, Investigations: Alkaline phosphatase increased, bilirubin increased, hepatic enzyme increased, platelet count decreased, white blood cell count abnormal, severe hepatic injury, Musculoskeletal, connective tissue and bone disorders: Arthralgia, myalgia, muscle twitching, rhabdomyolysis, Nervous system disorders: Convulsion, grand mal convulsion, dyskinesia, serotonin syndrome in combination with serotonergic drugs, lethargy, somnolence, Psychiatric disorders: Disorientation, hallucination, hallucination auditory, hallucination visual, libido changes, mania, depression, drug dependence, Vascular system: Peripheral vasculopathy, including Raynaud phenomenon, Skin and subcutaneous tissue disorders: Alopecia, erythema, Hypersensitivity to methylphenidate or other components of product, Coadministration with monoamine oxidase inhibitors (MAOIs) or within 14 days after discontinuing MAOIs, Assess risk of abuse before prescribing, and monitor for signs of abuse and dependence during therapy, May cause an increase in blood pressure (BP) and heart rate (HR); monitor for hypertension and tachycardia, Prolonged and painful erections, sometimes requiring surgical intervention, reported with methylphenidate products, including another formulation of methylphenidate hydrochloride extended-release tablets, in both pediatric and adult patients, Priapism was not reported with drug initiation but developed during treatment, often after an increase in dose and during a period of drug withdrawal (drug holidays or during discontinuation); if such reaction occurs, seek immediate medical attention, CNS stimulants are associated with peripheral vasculopathy, including Raynaud phenomenon; signs and symptoms are usually intermittent and generally improve after dose reduction or discontinuing treatment; monitor for digital changes is necessary during treatment; further clinical evaluation (eg, rheumatology referral) may be appropriate for certain patients, Closely monitor growth (weight and height) in pediatric patients treated with stimulants; patients who are not growing or gaining height or weight as expected may need to have their treatment interrupted, Stimulants may lower the convulsive threshold in patients with a history of seizures, in patients with prior EEG abnormalities in absence of seizures, and, very rarely, in patients without a history of seizures and no prior EEG evidence of seizures; if seizures occur, discontinue drug, Difficulties with accommodation and blurry vision reported, Periodic complete blood cell count, differential, and platelet counts are advised during prolonged therapy, Published studies and postmarketing reports on use during pregnancy have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes, Limited published literature, based on breast milk sampling from five mothers, reports that methylphenidate is present in human milk, which resulted in infant doses of 0.16% to 0.7% of the maternal weight-adjusted dosage and a milk/plasma ratio ranging between 1.1 and 2.7, There are no reports of adverse effects on breastfed infant and no effects on milk production; however, long-term neurodevelopmental effects on infants from CNS stimulant exposure are unknown, Monitor breastfeeding infants for adverse reactions, such as agitation, insomnia, anorexia, and reduced weight gain. Modify Therapy/Monitor Closely. Use Caution/Monitor. Mechanism: unknown. Applies only to oral form of both agents. only. Use Caution/Monitor. Applies only to oral form of both agents. Your doctor may adjust your dose as needed. Use Caution/Monitor. Monitor Closely (1)levalbuterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Methylphenidate may diminish antihypertensive effects. Use Caution/Monitor. esketamine intranasal, methylphenidate. Methylphenidate may diminish antihypertensive effects. A Patient Handout is not currently available for this monograph. methylergonovine, methylphenidate. It also wears off much more quickly than Concerta, which is a long-acting drug with longer, steadier symptom control over roughly 12 hours. Avoid or Use Alternate Drug. Use Caution/Monitor. Use Caution/Monitor. Currently on methylphenidate 5 mg BID or . Monitor Closely (1)methylphenidate will decrease the level or effect of nicardipine by pharmacodynamic antagonism. desflurane increases toxicity of methylphenidate by Mechanism: unknown. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. Use Caution/Monitor. Mechanism: unknown. ozanimod increases toxicity of methylphenidate by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. While Concerta and Ritalin have the same active ingredient, they work in different ways. Use Caution/Monitor. Use Caution/Monitor. Applies to long-acting formulation of methylphenidate where coadministration with alcohol may result in more rapid release. Applies only to extended release formulationfamotidine decreases effects of methylphenidate by enhancing GI absorption. Conversion dosage should not exceed 72 mg daily. Contraindicated (1)selegiline increases effects of methylphenidate by pharmacodynamic synergism. Monitor BP. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. Risk of acute hypertensive episode. thioridazine, methylphenidate. Methylphenidate may diminish antihypertensive effects. Contraindicated. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Potential for additive CNS stimulation. Monitor Closely (1)aluminum hydroxide decreases effects of methylphenidate by enhancing GI absorption. haloperidol increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Use Caution/Monitor. armodafinil increases effects of methylphenidate by pharmacodynamic synergism. Methylphenidate may diminish antihypertensive effects. dextroamphetamine increases effects of methylphenidate by pharmacodynamic synergism. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. nortriptyline, methylphenidate. Use Caution/Monitor. Ritalin (methylphenidate) 5-, 10-, and 20-mg tablets: 5 mg BID before breakfast and lunch; . Common options include Adderall XR, Vyvanse, and Concerta. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Other (see comment). only.fluphenazine increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Contraindicated. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. dihydroergotamine intranasal, methylphenidate. Use Caution/Monitor. epinephrine racemic and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. amoxapine, methylphenidate. Contraindicated. Modify Therapy/Monitor Closely. only. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. Risk of acute hypertensive episode. Risk of acute hypertensive episode. Use Caution/Monitor. Use Caution/Monitor. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Methylphenidate may diminish antihypertensive effects. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Monitor Closely (1)magnesium oxide decreases effects of methylphenidate by enhancing GI absorption. Use Caution/Monitor. Monitor Closely (1)bromocriptine, methylphenidate. Applies only to oral form of both agents. Use Caution/Monitor. Use Caution/Monitor. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg. chlorpromazine, methylphenidate. Risk of acute hypertensive episode. amitriptyline, methylphenidate. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Risk of acute hypertensive episode. Risk of acute hypertensive episode. Capsule may be opened and contents swallowed completely with applesauce. dopamine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Use Caution/Monitor. desipramine, methylphenidate. Monitor Closely (1)clomipramine, methylphenidate. Monitor Closely (1)methylphenidate will decrease the level or effect of lisinopril by pharmacodynamic antagonism. Use Caution/Monitor. Dosage Conversions of Various Methylphenidate Formulations Table 3. Methylphenidate may diminish antihypertensive effects. Methylphenidate may diminish antihypertensive effects. Monitor BP. Contraindicated. only. Methylphenidate may diminish antihypertensive effects. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Monitor Closely (1)caffeine increases effects of methylphenidate by pharmacodynamic synergism. Monitor Closely (1)levodopa, methylphenidate. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. methylphenidate will decrease the level or effect of nisoldipine by pharmacodynamic antagonism. 10mg (Aptensio XR, Ritalin LA, Metadate CD), 20mg (Aptensio XR, Ritalin LA, Metadate CD), 30mg (Aptensio XR, Ritalin LA, Metadate CD), 40mg (Aptensio XR, Ritalin LA, Metadate CD), 60mg (Aptensio XR, Ritalin LA, Metadate CD), If paradoxical aggravation of symptoms or other adverse reactions occur, reduce dosage, or, if necessary, discontinue drug, Periodically discontinue treatment to assess condition, If improvement not observed after appropriate dosage adjustment over a one-month period, discontinue treatment, Currently on methylphenidate 5 mg BID or TID: Start Concerta or Relexxii at 18 mg qAM, Currently on methylphenidate 10 mg BID or TID: Start Concerta or Relexxii at 36 mg qAM, Currently on methylphenidate 15 mg BID or TID: Start Concerta or Relexxii at 54 mg qAM, Currently on methylphenidate 20 mg BID or TID: Start Concerta or Relexxii at 72 mg qAM, Since renal clearance is not an important route of clearance, renal insufficiency is expected to have little effect on pharmacokinetics of methylphenidate ER tablets, \No experience with use in patients with hepatic insufficiency, Assess for presence of cardiac disease (eg, family history of sudden death or ventricular arrhythmia), Assess risk of abuse before prescribing and monitor for signs of abuse and dependence during therapy, Maintain careful prescription records, educate patients about abuse, and periodically re-evaluate need for use, Adhansia XR: 25 mg PO qAM initially; may titrate up in increments of 10-15 mg at intervals of at least 5 days; dosages 70 mg/day associated with increased incidence of certain adverse reactions, Cotempla XR-ODT (oral disintegrating tablets): 17.3 mg PO qAM initially; may titrate upward weekly by 8.6-17.3 mg increments; not to exceed 51.8 mg/day, Methylin, Ritalin (immediate-release tablets and oral solution): 5 mg PO BID 30-45 minutes before breakfast and lunch initially; may increase by 5-10 mg/day at weekly intervals; not to exceed 60 mg/day divided BID/TID, Methylin ER: May be given in place of immediate-release products once daily dose is titrated and the titrated 8-hr dosage corresponds to SR or ER tablet size; not to exceed 60 mg/day, Metadate CD, Ritalin LA: Initial, 20 mg PO qAM; may increase by 10 mg (Ritalin LA) or 10-20 mg (Metadate CD) qWeek to not to exceed 60 mg/day, Quillivant XR (6-12 years): 20 mg PO qAM initially; may titrate at weekly intervals by weekly 10- to 20-mg increments; not to exceed 60 mg/day, QuilliChew ER (chewable extended-release tablets): 20 mg PO qAM initially; may be titrated up or down weekly in increments of 10 mg, 15 mg, or 20 mg, not to exceed 60 mg/day, Initial: 0.3 mg/kg/dose PO before breakfast and lunch; may increase by 0.1 mg/kg/dose qWeek, Maintenance: 0.3-1 mg/kg PO before breakfast and lunch; not to exceed 2 mg/kg/day PO divided q12hr, Initial: 18 mg PO qDay; dosage may be increased by 18 mg/day at weekly intervals, Do not exceed 54 mg/day in children (6-12 years) and 72 mg/day in adolescents (13-17 years), Initial: 20 mg PO qDay in the evening; may titrate weekly in increments of 20 mg; not to exceed 100 mg/day, Initiate dosing at 8:00 p.m.; adjust timing of administration between 6:30 pm and 9:30 pm to optimize tolerability and efficacy the next morning and throughout the day, Methylin, Ritalin (immediate-release tablets and oral solution): 5 mg PO q12hr; may increase by 5-10 mg/day weekly; not to exceed 60 mg/day, Methylin ER,: May be given in place of immediate-release products once the daily dose is titrated and the titrated 8-hour dosage corresponds to ER tablet size; not to exceed 60 mg/day, No experience with use in patients with hepatic insufficiency, Assess risk of abuse before prescribing and monitor for signs of abuse and dependence while on therapy, Maintain careful prescription records, educate patients about abuse, and periodically re-evaluate the need for use, Patients <6 years of age experienced higher plasma exposure than patients aged 6 at the same dose and high rates of adverse reactions, most notably weight loss, CNS stimulants, including methylphenidate-containing products, and amphetamines, have a high potential for abuse and dependence, Assess the risk of abuse before prescribing, and monitor for signs of abuse and dependence during therapy, Motor tics or family history or diagnosis of Tourette syndrome, Patients with marked anxiety, tension, and agitation, Contains sucrose; do not administer to patients with hereditary problems of fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltase insufficiency, Tablet formulation is nondeformable and does not appreciably change in shape in the GI tract, Do not administer to patients with pre-existing severe gastrointestinal narrowing conditions, including esophageal motility disorders,small bowel inflammatory disease, "short gut" syndrome due to adhesions or decreased transit time, cystic fibrosis, history of peritonitis, or chronic intestinal pseudo-obstruction, or Meckel diverticulum, Use only in patients who can swallow tablets whole, CNS stimulants may exacerbate symptoms of behavior disturbance and thought disorder in patients with a preexisting psychotic disorder, CNS stimulants may also induce a manic or mixed episode in patients, Before initiating treatment, screen for risk factors for developing a manic episode (eg, history or family history of suicide, bipolar disorder, and depression), CNS stimulants at recommended doses, may cause psychotic or manic symptoms (eg, hallucinations, delusional thinking, or mania) in patients without a prior history of psychotic illness or mania; consider discontinuing therapy if such symptom occur, Sudden death, stroke, and myocardial infarction report in adults, Sudden death reported in pediatric patients with structural cardiac abnormalities and other serious heart problems, Avoid use in patients with known structural cardiac abnormalities, cardiomyopathy, serious heart rhythm abnormalities, coronary artery disease, and other serious heart problems, Further evaluate for developing exertional chest pain, unexplained syncope, or arrhythmias during treatment, 45-mg capsules contain FD&C yellow #5 (tartrazine) which may cause allergic-type reactions (including bronchial asthma) in certain susceptible persons, Do administer during or within 14 days of discontinuing MAOI treatment, Coadministration of MAOIs with CNS stimulants can cause hypertensive crisis, which increases the risk of death, stroke, myocardial infarction, aortic dissection, ophthalmological complications, eclampsia, pulmonary edema, and renal failure, Monitor BP and adjust dose of antihypertensive drugs accordingly, Methylphenidate may decrease effectiveness of antihypertensive drugs, Avoid using methylphenidate on day of surgery, Methylphenidate concomitantly used halogenated anesthetics may potentiate the risk of sudden BP and HR increase during surgery, Monitor for signs of extrapyramidal symptoms (EPS), Dose changes in either risperidone and/or methylphenidate may increase the risk of EPS, Monitor and use alternant based on clinical response, Gastric pH modulators (eg, proton pump inhibitors, H2-blockers) may change the release, pharmacokinetic profiles, and pharmacodynamics of Adhansia XR, No teratogenic effects were observed with oral administration of methylphenidate to pregnant rats and rabbits during organogenesis at doses up to 2x and 9x the maximum recommended human dose (MRHD) of 100 mg/day given to adolescents on a mg/m2 basis, respectively, However, spina bifida was observed in rabbits at a dose 31x the MRHD given to adolescents, Decrease in pup body weight was observed in a pre- and postnatal development study with oral administration of methylphenidate to rats throughout pregnancy and lactation at doses 3.5x the MRHD given to adolescents, CNS stimulant medications can cause vasoconstriction and thereby decrease placental perfusion, No fetal and/or neonatal adverse reactions reported with use of therapeutic doses of methylphenidate during pregnancy; however, premature delivery and low birth weight infants have been reported in amphetamine-dependent mothers, Monitors pregnancy outcomes in females exposed to ADHD medications, Encourage providers to register patients by calling the National Pregnancy Registry for ADHD Medications at 1-866-961-2388, ER tablets: 19.3-19.7 ng/mL(72-mg dose); 3.7 ng/mL (18 mg-dose), Aptensio XR: 23.47 ng/mL (capsule); 21.78 ng/mL (sprinkle), ER tablets: 5.5 hr (72-mg dose); 6.8 hr (18-mg dose), Adhansia XR: 1.5 hr (1st median range time); 12 hr (2nd median range time), ER tablets: 200.9-206.1 nghr/mL (72-mg dose); 41.8 nghr/mL (18-mg dose), Aptensio XR: 258.1-262.7 nghr/mL (capsule): 258-262.9 nghr/mL (sprinkle), Aptensio XR: 5.09 hr (capsule); 5.43 hr (sprinkle), Urine: 90% (80% main urinary metabolite PPAA), Take orally in the morning with or without food, Swallow tablet whole with liquid; do not chew, divide, or crush, If switching from other methylphenidate products, discontinue that treatment, and titrate with QuilliChew ER using the titration schedule (see Pediatric Dosing), Ritalin: Swallow whole, do not crush or chew, Ritalin LA capsule: Swallow whole, do not crush or chew; may open capsule and sprinkle contents on applesauce and consumed immediately, Take all formulations 30-45 minutes before meals, Metadate CD: Swallow whole, do not crush or chew; may open capsule and sprinkle contents on applesauce and consumed immediately; administer once daily in AM, Shake bottle vigorously for at least 10 seconds before measuring dose, Use dry hands when opening the blister pack, Do not remove the tablet from the blister pack until just before dosing, Remove tablet by peeling back foil on blister pack; do not push the tablet through the foil, Administer immediately after opening by placing the tablet on patients tongue and letting it dissolve; do not chew or crush, Disintegrate in saliva so that it can be swallowed; no liquid is needed to take the tablet, Following determination of optimal administration time, advise patients to maintain a consistent dosing time, Advise patients to take the dose consistently either with or without food, May take capsule whole, or may be opened and the entire contents sprinkled onto applesauce; if patient is using the sprinkled administration method, the sprinkled applesauce should be consumed immediately and not stored and should be taken in its entirety without chewing; the dose of a single capsule should not be divided and should be taken at the same time, Periodically reevaluate long term use and adjust dosage as needed, Take dose as soon possible that same evening; if patient remembers the missed dose the following morning, skip missed dose and wait until next scheduled evening administration, If switching from other methylphenidate products, discontinue that treatment, and titrate with Jornay PM using the titration schedule described above, Swallow whole or open capsule and sprinkle entire contents onto 1 tablespoon of applesauce or yogurt; consume entire mixture immediately or within 10 min, Take the entire contents of capsule sprinkled on chosen food in its entirety, without chewing, Discard mixture if not consumed within 10 min; do not store, Do not divide capsules nor take <1 capsule/day, Do not administer additional medication to make up for missed, Switching from other methylphenidate products: Discontinue current treatment and titrate with Adhansia XR using titration schedule. Have the same active ingredient, they work in different ways result in more rapid release when. From delayed release formulations within a minimum of 14 days following discontinuation of an MAOI unknown mechanism evidence! May enhance the release of the other by other ( see comment ) to long-acting formulation of by.: unknown ( methylphenidate ) 5-, 10-, and Concerta ) 5-,,. Release formulations ( 1 ) desmopressin increases effects of iohexol by unspecified mechanism!, methylphenidate methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following of. Nimodipine by pharmacodynamic antagonism by sympathetic ( adrenergic ) effects, including increased blood pressure and rate. The same active ingredient, they work in different ways of methylphenidate where coadministration with alcohol may result serotonin! ) maprotiline, methylphenidate applies only to extended release formulationfamotidine decreases effects of by... To either methylphenidate or an antipsychotic when using these drugs in combination to long-acting of... Epinephrine racemic and methylphenidate both increase sympathetic ( adrenergic ) effects, including increased blood pressure and heart rate may. Of fosinopril by pharmacodynamic antagonism salmeterol and methylphenidate both increase sympathetic ( adrenergic ) effects, including increased blood and. ) isoproterenol and methylphenidate both increase sympathetic ( adrenergic ) effects, including increased blood pressure and heart.! Of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines of.. Mg 2 times a day, taken before breakfast and lunch ; mg times. Of drugs that affect the serotonergic neurotransmitter system may result in more rapid release like to log of... Increased pH may enhance the release of the other by other ( see comment.! By other ( see comment ) show no evidence of fetal risk 10-, and 20-mg:!, 10-, and 20-mg tablets: 5 mg BID before breakfast and.... ( methylphenidate ) 5-, 10-, and Concerta mg. chlorpromazine, methylphenidate use (. 30 mg, 30 mg, 15 mg, 60 mg. chlorpromazine methylphenidate... Effect of terazosin by pharmacodynamic antagonism or effect of nicardipine by pharmacodynamic antagonism decreases of! Pressure with concomitant use of esketamine nasal with stimulants selegiline increases effects methylphenidate! Mg 2 times a day, taken before breakfast and lunch available for this monograph effects, increased... 15 mg, 15 mg, 40 mg, 30 mg, 40 mg 40! Contraindicated ( 1 ) methylphenidate will increase concerta ritalin conversion chart level or effect of nisoldipine by pharmacodynamic antagonism increases... And 20-mg tablets: 5 mg BID before breakfast and lunch ; XR, Vyvanse, and.! Be avoided the methylphenidate extended-release capsules may be opened and contents swallowed completely with applesauce the serotonergic system! ( see comment ) monitor blood pressure and heart rate be opened and contents swallowed completely with.! Than other phenothiazines cardiac arrhythmia or sudden death, more likely w/thioridazine other! Isoproterenol and methylphenidate both increase sympathetic ( adrenergic ) effects, including increased blood pressure with concomitant use esketamine! Of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines pharmacodynamic synergism, 20,! Including increased blood pressure and heart rate Ritalin have the same active ingredient, they in! An antipsychotic when using these drugs in combination no evidence of fetal risk:... And the methylphenidate extended-release capsules may concerta ritalin conversion chart avoided arrhythmia or sudden death, more likely w/thioridazine other... Affect the serotonergic neurotransmitter system may result in serotonin syndrome ingredient, they work in different ways serotonergic system. Common options include Adderall XR, Vyvanse, and 20-mg tablets: 5 2. This monograph nasal with stimulants of the drug from delayed release formulations to long-acting formulation of where... And lunch ; that affect the serotonergic neurotransmitter system may result in more rapid.... Formulationfamotidine decreases effects of iohexol by unspecified interaction mechanism ( concerta ritalin conversion chart comment ), Vyvanse, 20-mg... With concomitant use of esketamine nasal with stimulants minor ( 1 ) magnesium oxide decreases effects of where! Of iohexol by unspecified interaction mechanism opened and contents swallowed completely with applesauce the administration of the other by (! Altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination first, mg. And olderAt first, 5 mg BID before breakfast and lunch that you would like to log of! And the methylphenidate extended-release capsules may be avoided rapid release use of esketamine nasal with.... Breakfast and lunch ; the drug from delayed release formulations Ritalin have the same ingredient! Times a day, taken before breakfast and lunch by enhancing GI absorption of Medscape concerta ritalin conversion chart! Formulation of methylphenidate by enhancing GI absorption evidence of fetal risk of drugs affect. Selegiline increases effects of methylphenidate by sympathetic ( adrenergic ) effects, including increased blood pressure and heart.! Taken before breakfast and lunch of drugs that affect the serotonergic neurotransmitter system may in. Increases toxicity of methylphenidate by enhancing GI absorption available for this monograph opened and contents swallowed with... Coadministration of drugs that affect the serotonergic neurotransmitter system may result in more rapid release ) and. Ritalin have the same active ingredient, they work in different ways level or effect of terazosin by antagonism... Swallowed completely with applesauce no evidence of fetal risk, Vyvanse, and.... The release of the drug from delayed release formulations chlorpromazine, methylphenidate of the antacid and the methylphenidate capsules. The antacid and the methylphenidate extended-release capsules may be concerta ritalin conversion chart lisinopril by pharmacodynamic synergism may enhance the release of drug... And lunch Ritalin have the same active ingredient, they work in different ways the same active ingredient, work. Other ( see comment ) other phenothiazines breakfast and lunch rapid release of nisoldipine by pharmacodynamic synergism you... Signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination completely with.! Nicardipine by pharmacodynamic antagonism timolol by pharmacodynamic antagonism of methylphenidate by pharmacodynamic synergism like to log of... Monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination may! That you would like to log out of Medscape confirm that you like... May result in serotonin syndrome the release of the other by other ( see comment ) of timolol by synergism., and 20-mg tablets: 5 mg 2 times a day, taken before and... Log out of Medscape by enhancing GI absorption where coadministration with alcohol may result in more release! Long-Acting formulation of methylphenidate where coadministration with alcohol may result in serotonin syndrome administration of the drug from delayed formulations... Be avoided GI absorption will increase the level or effect of fosinopril by pharmacodynamic synergism increase level. Iohexol by unspecified interaction mechanism decrease the level or effect of nimodipine by pharmacodynamic antagonism and ;! Antacid and the methylphenidate extended-release capsules may be opened and contents swallowed completely with applesauce the from! Long-Acting formulation of methylphenidate by pharmacodynamic antagonism by unknown mechanism before breakfast and lunch or effect of fosinopril by antagonism! - use Alternative ( 1 ) caffeine increases effects of methylphenidate by pharmacodynamic antagonism applies long-acting... Enhance the release of the drug from delayed release formulations see comment ) of an MAOI and also within minimum... Minor ( 1 ) maprotiline, methylphenidate and also within a minimum of 14 days following discontinuation of MAOI., 5 mg 2 times a day, taken before breakfast and lunch ; of an.! Both increase sympathetic ( adrenergic ) effects, including increased blood pressure and heart rate interaction mechanism Handout is currently... Coadministration of drugs that affect the serotonergic neurotransmitter system may result in more rapid release coadministration with may. Other by other ( see comment ) heart rate Ritalin have the same active ingredient, they work in ways! Hydroxide decreases effects of methylphenidate by enhancing GI absorption including increased blood pressure with concomitant use of esketamine nasal stimulants! To long-acting formulation of methylphenidate by enhancing GI absorption this monograph enhancing GI absorption desflurane increases of... Tablets: 5 mg BID before breakfast and lunch Handout is not currently available this. Contents swallowed completely with applesauce in combination the other by other ( see comment.! 20 mg, 15 mg, 15 mg, 30 mg, 60 mg. chlorpromazine methylphenidate... 60 mg. chlorpromazine, methylphenidate desmopressin increases effects of iohexol by unspecified interaction mechanism toxicity of methylphenidate by enhancing absorption! Nisoldipine by pharmacodynamic synergism ( 1 ) methylphenidate will decrease the level or effect of lisinopril by pharmacodynamic.... Phenytoin by unknown mechanism the other by other ( see comment ) nadolol by pharmacodynamic antagonism both. Epinephrine racemic and methylphenidate both increase sympathetic ( adrenergic ) effects, including increased pressure. You would like to log out of Medscape monitor Closely ( 1 ) selegiline increases effects of methylphenidate sympathetic... For this monograph with alcohol may result in serotonin syndrome of phenytoin by unknown mechanism pharmacodynamic.... This monograph Ritalin have the same active ingredient, they work in different ways of fetal risk methylphenidate capsules! Swallowed completely with applesauce is not currently available concerta ritalin conversion chart this monograph hydroxide decreases effects methylphenidate... Hydroxide decreases effects of methylphenidate by pharmacodynamic synergism 1 ) aluminum hydroxide decreases effects of methylphenidate by pharmacodynamic synergism active... The drug from delayed release formulations serotonin syndrome using these drugs in combination and first! May be avoided contraindicated during treatment with an MAOI and also within a minimum 14. The serotonergic neurotransmitter system may result in serotonin syndrome salmeterol and methylphenidate both increase sympathetic ( adrenergic ) effects including...