Precautions and Warnings With Methylphenidate

Specific Precautions and Warnings With Methylphenidate

Warnings and precautions to be aware of before taking methylphenidate include the following:
  • Stimulants (including methylphenidate) are often abused. Taking drugs of this nature for a long time can lead to dependence on them (see Ritalin Abuse). Because methylphenidate is commonly abused, there are special rules for prescribing it (see Ritalin: A Controlled Substance).
  • In people with psychotic disorders (such as schizophrenia or schizoaffective disorder), methylphenidate can make psychotic symptoms worse, including thought disorders and behavior problems.
  • Sudden death has been reported in children and adults with heart problems who were taking normal doses of the drug. If you or your child has heart problems, ask your healthcare provider whether methylphenidate is appropriate in your situation. Also, let your healthcare provider know if you or your child develops any chest tightness, chest pain, shortness of breath, or fainting.
  • Stimulants used to treat ADHD have been associated with problems in blood vessels in the fingers and toes, sometimes causing problems such as Raynaud's disease. Alert your healthcare provider to any signs of this problem, such as cold or numb toes or fingers. 
  • Methylphenidate can cause an increase in blood pressure and heart rate. In most cases, the increase is small and does not cause problems. However, there is an increased risk for people who already have high blood pressure, congestive heart failure, certain irregular heart rhythms (arrhythmias), or who have recently had a heart attack.
  • The drug can cause decreased weight gain and temporarily slow down the growth of children. This slowing down of growth is usually small (less than an inch and less than two pounds), and children usually catch up to their normal growth rates with time. Your child's growth should be monitored while he or she is taking methylphenidate.
  • There have been reports of priapism in people taking ADHD medications, including this one. This side effect is an abnormally long-lasting, painful erection and can cause serious, permanent damage to the penis. It can occur in males of any age. Young boys might not recognize this side effect, and males of any age might be hesitant to seek parental or medical attention, due to embarrassment. Prompt treatment is necessary to avoid damage.
Be especially on the lookout for this side effect whenever the dosage is increased or during a drug "holiday" or any other time when the drug is stopped.
  • Methylphenidate may affect your ability to perform tasks that require complete concentration, such as driving, operating machinery, or piloting an airplane, especially during the first few weeks of treatment. It is recommended that you discuss this with your healthcare provider prior to treatment.
  • Methylphenidate can interact with certain medications (see Drug Interactions With Methylphenidate).
  • Methylphenidate is considered a pregnancy Category C medication. This means that it may not be safe to use during pregnancy. Discuss the safety of the drug with your healthcare provider before using it during pregnancy (see Ritalin and Pregnant Women for more information).
  • It is not known if methylphenidate passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider.

Methylphenidate HCL

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