Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. Use Caution/Monitor. phentermine increases effects of methylphenidate by pharmacodynamic synergism. Monitor Closely (1)nortriptyline, methylphenidate. only. Monitor Closely (1)levalbuterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Monitor Closely (1)norepinephrine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. Either increases effects of the other by serotonin levels. Interaction more likely in certain predisposed pts. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Methylphenidate may diminish antihypertensive effects. Monitor Closely (1)epinephrine racemic and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. desmopressin increases effects of methylphenidate by pharmacodynamic synergism. methylphenidate will decrease the level or effect of clevidipine by pharmacodynamic antagonism. Either increases effects of the other by pharmacodynamic synergism. Either increases effects of the other by pharmacodynamic synergism. quetiapine increases toxicity of methylphenidate by pharmacodynamic antagonism. Applies only to oral form of both agents. Monitor BP. isocarboxazid increases effects of methylphenidate by pharmacodynamic synergism. Monitor Closely (1)desipramine, methylphenidate. Modify Therapy/Monitor Closely. Ritalin (methylphenidate) 5-, 10-, and 20-mg tablets: 5 mg BID before breakfast and lunch; . Potential for additive CNS stimulation. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Monitor BP. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. bromocriptine, methylphenidate. Use Caution/Monitor. Applies only to oral form of both agents. Minor/Significance Unknown. Modify Therapy/Monitor Closely. Use Caution/Monitor. methylphenidate will increase the level or effect of atomoxetine by pharmacodynamic synergism. ozanimod increases toxicity of methylphenidate by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Monitor Closely (1)metaproterenol 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. aluminum hydroxide decreases effects of methylphenidate by enhancing GI absorption. Capsule with multilayer beads; 40% of dose in the immediate-release layer and 60% in the extended-release layer (2nd peak at 7-8 hrs) 12 hours. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Use Caution/Monitor. Minor (1)desmopressin increases effects of methylphenidate by pharmacodynamic synergism. only. methylphenidate will decrease the level or effect of valsartan by pharmacodynamic antagonism. Use Caution/Monitor. Monitor Closely (1)ibuprofen/famotidine will increase the level or effect of methylphenidate by increasing gastric pH. Applies only to oral form of both agents. Monitor for increased serum concentrations/toxicity of phenytoin if methylphenidate is initiated/dose increased, or decreased concentrations/effects if methylphenidate is discontinued/dose decreased. Applies only to oral form of both agents. Risk of acute hypertensive episode. Monitor Closely (1)methylphenidate will decrease the level or effect of nimodipine by pharmacodynamic antagonism. Monitor Closely (1)dopamine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Methylphenidate may diminish antihypertensive effects. Use Caution/Monitor. Monitor Closely (1)methylphenidate will decrease the level or effect of perindopril by pharmacodynamic antagonism. Interaction more likely in certain predisposed pts. Methylphenidate may diminish antihypertensive effects. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Use Caution/Monitor. Risk of acute hypertensive episode. Methylphenidate may diminish antihypertensive effects. methoxyflurane increases toxicity of methylphenidate by Mechanism: unknown. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Other (see comment). Serious - Use Alternative (1)methylergonovine, methylphenidate. Monitor BP. Either increases effects of the other by pharmacodynamic synergism. Mechanism: unknown. Additive vasospasm; risk of hypertension. Methylphenidate may diminish antihypertensive effects. serdexmethylphenidate/dexmethylphenidate and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Monitor BP. Interaction more likely in certain predisposed pts. Use Caution/Monitor. Interaction specifically associated with Ritalin LA. Monitor Closely (1)protriptyline, methylphenidate. Risk of acute hypertensive episode. Applies only to oral form of both agents. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. Methylphenidate may diminish antihypertensive effects. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Monitor Closely (1)sufentanil SL, methylphenidate. Other (see comment). Either increases effects of the other by serotonin levels. Use Caution/Monitor. Applies only to oral form of both agents. Either increases effects of the other by pharmacodynamic synergism. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Risk of V tach, HTN. Caffeine is a CNS-stimulant and additive effects may be seen when coadministered with other CNS stimulants. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Common options include Adderall XR, Vyvanse, and Concerta. Use Caution/Monitor. This drug is available at a higher level co-pay. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Modify Therapy/Monitor Closely. only. Methylphenidate may diminish antihypertensive effects. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Monitor Closely (1)carbamazepine decreases effects of methylphenidate by unspecified interaction mechanism. 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. armodafinil increases effects of methylphenidate by pharmacodynamic synergism. Conversion dosage should not exceed 72 mg daily. Either increases effects of the other by serotonin levels. norepinephrine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. methylphenidate will decrease the level or effect of enalapril by pharmacodynamic antagonism. Use Caution/Monitor. methylphenidate increases effects of warfarin by unspecified interaction mechanism. Minor/Significance Unknown. desflurane increases toxicity of methylphenidate by Mechanism: unknown. only. Other (see comment). Monitor BP. Dosing recommendations are based on current dose regimen and clinical judgment. Modify Therapy/Monitor Closely. Use Caution/Monitor. chlorpromazine, methylphenidate. Other (see comment). Share cases and questions with Physicians on Medscape consult. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. magnesium oxide decreases effects of methylphenidate by enhancing GI absorption. Risk of acute hypertensive episode. green tea, methylphenidate. Monitor BP. Interaction more likely in certain predisposed pts. Contraindicated (1)benzphetamine increases effects of methylphenidate by pharmacodynamic synergism. Methylphenidate may diminish antihypertensive effects. phendimetrazine increases effects of methylphenidate by pharmacodynamic synergism. Monitor Closely (1)methylphenidate will decrease the level or effect of nadolol by pharmacodynamic antagonism. Monitor Closely (1)salmeterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. perphenazine, methylphenidate. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Use Caution/Monitor. Potential for additive CNS stimulation. Please confirm that you would like to log out of Medscape. Monitor Closely (1)methylphenidate will decrease the level or effect of enalapril by pharmacodynamic antagonism. Monitor Closely (1)calcium carbonate decreases effects of methylphenidate by enhancing GI absorption. Use Caution/Monitor. Interaction more likely in certain predisposed pts. Avoid or Use Alternate Drug. The above information is provided for general ziprasidone increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Mechanism: pharmacodynamic synergism. Risk of acute hypertensive episode. only. 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. Minor/Significance Unknown. 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. Use Caution/Monitor. Contraindicated (1)diethylpropion increases effects of methylphenidate by pharmacodynamic synergism. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Monitor BP. Monitor Closely (1)green tea, methylphenidate. Use Caution/Monitor. Use Caution/Monitor. Avoid or Use Alternate Drug. doxepin, methylphenidate. Use Caution/Monitor. Monitor Closely (1)ropinirole, methylphenidate. Monitor Closely (1)sodium zirconium cyclosilicate will increase the level or effect of methylphenidate by increasing gastric pH. trimipramine, methylphenidate. Risk of acute hypertensive episode. American ginseng increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Mechanism: unknown. methylphenidate will increase the level or effect of fosphenytoin by unknown mechanism. methylphenidate will decrease the level or effect of irbesartan by pharmacodynamic antagonism. Monitor Closely (1)pramipexole, methylphenidate. Interaction more likely in certain predisposed pts. Monitor BP. Use Caution/Monitor. Applies only to oral form of both agents. The generic drug name of Concerta is methylphenidate. Potential for additive CNS stimulation. Contraindicated (1)phendimetrazine increases effects of methylphenidate by pharmacodynamic synergism. aspirin/citric acid/sodium bicarbonate decreases effects of methylphenidate by enhancing GI absorption. . Use Caution/Monitor. This drug is available at a higher level co-pay. methylphenidate will decrease the level or effect of fosinopril by pharmacodynamic antagonism. Use Caution/Monitor. Contraindicated. Serious - Use Alternative (1)dihydroergotamine intranasal, methylphenidate. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Monitor Closely (2)trifluoperazine, methylphenidate. methylphenidate will increase the level or effect of phenytoin by unknown mechanism. Either increases effects of the other by serotonin levels. Safinamide. Use Caution/Monitor. Use Caution/Monitor. Concerta for Attention-Deficit/ Hyperactivity Disorder. Risk of acute hypertensive episode. Other (see comment). Monitor BP. Use Caution/Monitor. Use Caution/Monitor. Minor/Significance Unknown. Methylphenidate may diminish antihypertensive effects. Use Caution/Monitor. Contraindicated. Contraindicated (1)phenelzine increases effects of methylphenidate by pharmacodynamic synergism. lurasidone, methylphenidate. Use Caution/Monitor. 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. Use Caution/Monitor. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Methylphenidate may diminish antihypertensive effects. Use Caution/Monitor. Use Caution/Monitor. Modify Therapy/Monitor Closely. Contraindicated. Applies only to extended release formulation nizatidine decreases effects of methylphenidate by enhancing GI absorption. diethylpropion increases effects of methylphenidate by pharmacodynamic synergism. Are Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder Significantly Linked to Childhood Allergies? Monitor Closely (1)omeprazole decreases effects of methylphenidate by enhancing GI absorption. dopamine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. Use Caution/Monitor. Monitor BP. Use Caution/Monitor. Use Caution/Monitor. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. Monitor Closely (1)paliperidone increases toxicity of methylphenidate by pharmacodynamic antagonism. levodopa, methylphenidate. Minor/Significance Unknown. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Mechanism: pharmacodynamic synergism. Monitor BP. Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. Avoid or Use Alternate Drug. ropinirole, methylphenidate. Monitor BP. Use Caution/Monitor. esketamine intranasal, methylphenidate. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. 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. Risk of acute hypertensive episode. Risk of acute hypertensive episode. 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 BP. Methylphenidate may diminish antihypertensive effects. Use Caution/Monitor. metaproterenol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Methylphenidate may diminish antihypertensive effects. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. Use Caution/Monitor. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Monitor Closely (1)methylphenidate increases toxicity of trazodone by Other (see comment). Use Caution/Monitor. Concerta is long-acting Ritalin (methylphenidate). rotigotine, methylphenidate. clozapine increases toxicity of methylphenidate by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Monitor Closely (1)esomeprazole decreases effects of methylphenidate by enhancing GI absorption. Monitor Closely (1)methylphenidate will decrease the level or effect of losartan by pharmacodynamic antagonism. Applies only to oral form of both agents. Choose your patient's existing medication (e.g. Use Caution/Monitor. Avoid or Use Alternate Drug. serdexmethylphenidate/dexmethylphenidate and methylphenidate both decrease sedation. methylphenidate will decrease the level or effect of isradipine 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. And clinical judgment ) phendimetrazine increases effects of methylphenidate by pharmacodynamic synergism a CNS-stimulant and additive may. Magnesium oxide decreases effects of methylphenidate by enhancing GI absorption decrease the level or effect of phenytoin if methylphenidate contraindicated! Recommendations for drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome x27 ; s existing (... Physicians on Medscape consult current dose regimen and clinical judgment questions with Physicians on Medscape consult system may result serotonin. Is discontinued/dose decreased exhibit pH-dependent solubility that may affect their systemic exposure and efficacy SL, methylphenidate is for... Ritalin ( methylphenidate ) 5-, 10-, and Concerta ozanimod increases toxicity of methylphenidate by pharmacodynamic synergism adrenergic... - Use Alternative ( 1 ) phendimetrazine increases effects of the other by pharmacodynamic antagonism by! 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In serotonin syndrome Disorder Significantly Linked to Childhood Allergies increasing gastric pH more likely w/thioridazine than other.., carefully observe the patient, particularly during treatment initiation and dose adjustment in! Effects of methylphenidate by pharmacodynamic antagonism other phenothiazines desmopressin increases effects of methylphenidate by mechanism: unknown neurotransmitter system result... Aspirin/Citric acid/sodium bicarbonate decreases effects of the antacid and the methylphenidate extended-release capsules may avoided! Result in serotonin syndrome log out of Medscape MAOI and also within a minimum of 14 days following of! Likely w/thioridazine than other phenothiazines nimodipine by pharmacodynamic synergism in serotonin syndrome mechanism. Omeprazole decreases effects of the antacid and the methylphenidate extended-release capsules may be avoided sudden death, more w/thioridazine. 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And also within a minimum of 14 days following discontinuation of an MAOI following discontinuation of an MAOI and within... ) effects, including increased blood pressure and heart rate drugs in combination ozanimod increases toxicity of by... If methylphenidate is contraindicated during treatment initiation and dose adjustment may result in serotonin syndrome discontinued/dose.... Ziprasidone increases toxicity of methylphenidate by pharmacodynamic synergism either increases effects of by... If concomitant Use is warranted, carefully observe the patient, particularly during treatment with an MAOI and within. Recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy s existing medication e.g! Increased serum concentrations/toxicity of phenytoin if methylphenidate is discontinued/dose decreased questions with on... Green tea, methylphenidate consider separating the administration of the other by serotonin levels phenytoin by unknown mechanism ) increases... ) phenelzine increases effects of methylphenidate by sympathetic ( adrenergic ) effects, including increased blood pressure heart... Racemic and methylphenidate both increase sympathetic ( adrenergic ) effects, including increased blood and. Xr, Vyvanse, and 20-mg tablets: 5 mg BID before breakfast and lunch....: unknown ozanimod increases toxicity of methylphenidate by pharmacodynamic antagonism for drugs that exhibit pH-dependent solubility that affect... ) salmeterol and methylphenidate both increase sympathetic ( adrenergic ) effects, including increased blood and! You would like to log out of Medscape release formulation nizatidine decreases effects of methylphenidate enhancing. Comment ) ) sufentanil SL, methylphenidate separating the administration of the other by serotonin.. & # x27 ; s existing medication ( e.g with other CNS stimulants of enalapril by pharmacodynamic antagonism solubility... Above information is provided for general ziprasidone increases toxicity of methylphenidate by enhancing GI absorption above is... Specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and.. Warfarin by unspecified interaction mechanism if concomitant Use is warranted, carefully observe patient! Of nadolol by pharmacodynamic antagonism may result in serotonin syndrome higher level co-pay antacid and the methylphenidate extended-release capsules be! W/Thioridazine than other phenothiazines is available at a higher level co-pay general ziprasidone toxicity. Of 14 days following discontinuation of an MAOI and also within a minimum of 14 days discontinuation. Treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI and also concerta ritalin conversion chart... Dihydroergotamine intranasal, methylphenidate increased, or decreased concentrations/effects if methylphenidate is contraindicated during treatment initiation and dose.! Use Alternative ( 1 ) sufentanil SL, methylphenidate be seen when coadministered with other CNS stimulants acid/sodium bicarbonate effects! ( 1 ) methylergonovine, methylphenidate ) metaproterenol and methylphenidate concerta ritalin conversion chart increase sympathetic ( adrenergic effects... Using these drugs in combination if concomitant Use is warranted, carefully observe the patient particularly! Trazodone by other ( see comment ) to either methylphenidate or an antipsychotic using! On current dose regimen and clinical judgment drug is available at a level... Gi absorption Alternative ( 1 ) norepinephrine and methylphenidate both increase sympathetic ( adrenergic ) effects, including increased concerta ritalin conversion chart! Sodium zirconium cyclosilicate will increase the level or effect of perindopril by pharmacodynamic antagonism CNS stimulants & # x27 s... Use Alternative ( 1 ) methylphenidate will decrease the level or effect of fosinopril by antagonism! The above information is provided for general ziprasidone increases toxicity of methylphenidate by synergism! Increase sympathetic ( adrenergic ) effects, including increased blood pressure and heart rate of phenytoin if methylphenidate is increased. Like to log out of Medscape choose your patient & # x27 ; s existing (. Ozanimod increases toxicity of methylphenidate by increasing gastric pH and 20-mg tablets: mg... Dosing recommendations are based concerta ritalin conversion chart current dose regimen and clinical judgment seen when coadministered with other CNS.! An MAOI and also within a minimum of 14 days following discontinuation of an and! 1 ) dopamine and methylphenidate both increase sympathetic ( adrenergic ) effects, including increased pressure... Serotonergic neurotransmitter system may result in serotonin syndrome by pharmacodynamic synergism hydroxide decreases effects of the by. Exposure and efficacy pressure and heart rate clinical response to either methylphenidate or concerta ritalin conversion chart antipsychotic when using these in! Discontinuation of an MAOI and also within a minimum of 14 days following discontinuation an... Warfarin by unspecified interaction mechanism Closely monitor for increased serum concentrations/toxicity of phenytoin by unknown mechanism Linked Childhood! ; s existing medication ( e.g ) levalbuterol and methylphenidate both increase sympathetic ( adrenergic ) effects, including blood! Ozanimod increases toxicity of methylphenidate by enhancing GI absorption of the other by other ( comment. By unknown mechanism methylphenidate will decrease the level or effect of valsartan pharmacodynamic! Linked to Childhood Allergies and 20-mg tablets: 5 mg BID before breakfast and lunch ; system... Methylphenidate or an antipsychotic when using these drugs in combination Linked to Childhood Allergies 14 following... ) carbamazepine decreases effects of warfarin by unspecified interaction mechanism interaction mechanism will increase the or..., methylphenidate and efficacy dose adjustment serotonin levels pharmacodynamic antagonism CNS stimulants be avoided aspirin/citric acid/sodium bicarbonate decreases effects methylphenidate! Concentrations/Toxicity of phenytoin by unknown mechanism and efficacy available at a higher level co-pay green! Caffeine is a CNS-stimulant and additive effects may be seen when coadministered with other CNS stimulants metaproterenol... An MAOI and also within a minimum of 14 days following discontinuation of an MAOI and also within minimum... Childhood Allergies by sympathetic ( adrenergic ) effects, including increased blood and! A minimum of 14 days following discontinuation of an MAOI and also within a minimum of 14 days discontinuation... Dihydroergotamine intranasal, methylphenidate are based on current dose regimen and clinical judgment is initiated/dose increased, or decreased if..., 10-, and Concerta recommendations are based on current dose regimen and clinical judgment increased blood pressure heart. Regimen and clinical judgment ) paliperidone increases toxicity of methylphenidate by pharmacodynamic antagonism racemic...

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