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Overview: Methylphenidate is used to treat attention deficit hyperactivity disorder (ADHD) or narcolepsy. It may work by increasing natural chemicals in the brain called norepinephrine and dopamine. Common side effects may include decreased appetite, trouble sleeping, nausea and vomiting, or weight loss. Methylphenidate comes in several forms that are taken by mouth, including a capsule, chewable tablet, liquid, orally disintegrating tablet (ODT), and tablet. Methylphenidate also comes in short-acting (immediate-release) and long-acting (extended-release) forms.

Uses

What is methylphenidate used for?

Methylphenidate is commonly used to treat the following conditions.

These uses may vary depending on the specific methylphenidate product prescribed. Methylphenidate may also be used for other conditions as determined by your health care provider.

How does methylphenidate work (mechanism of action)?

Methylphenidate belongs to a group of medicines called stimulants. It may work by increasing levels of natural brain chemicals, such as norepinephrine and dopamine. These chemicals play a role in attention, alertness, and wakefulness. 

How is methylphenidate supplied (dosage forms)?

Brands and other names

  • Aptensio XR, Concerta, Cotempla XR-ODT, Jornay PM, Metadate CD, Methylin, Methylin ER, QuilliChew ER, Quillivant XR, Relexxii, Ritalin, Ritalin LA

Dosage forms and strengths

  • 2.5 mg, 5 mg, 10 mg chewable tablets
  • 20 mg, 30 mg, 40 mg extended-release chewable tablets
  • 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, 80 mg, 100 mg extended-release oral capsules
  • 25 mg/5 mL (5 mg/mL) extended-release oral suspension
  • 10 mg, 18 mg, 20 mg, 27 mg, 36 mg, 45 mg, 54 mg, 63 mg, 72 mg extended-release oral tablets
  • 8.6 mg, 17.3 mg, 25.9 mg extended-release orally disintegrating tablets
  • 5 mg/5 mL, 10 mg/5 mL oral solution
  • 5 mg, 10 mg, 20 mg oral tablets

Methylphenidate is also available as a patch that is applied to the skin. See Methylphenidate transdermal for more information. 

How should I store methylphenidate?

Methylphenidate should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when you’re transporting it. Store it in a cool, dry, and safe place, such as a locked cabinet. Protect it from light and moisture.

If you are taking methylphenidate orally disintegrating tablets, do not remove the tablet from the blister pack until you are ready to take it.

Throw away any expired, unwanted, or unused methylphenidate by following the instructions that come with your product. Ask your pharmacist or other health care provider if you are not sure how to throw away the medicine safely. 

Side Effects

What are the most common side effects of methylphenidate?

The most common side effects of methylphenidate are listed below. These side effects may vary depending on your age and the product you are taking. Tell your health care provider if you have any of these side effects that bother you.

  • Decreased or loss of appetite
  • Trouble sleeping
  • Nausea and vomiting
  • Upset stomach and stomach pain
  • Weight loss
  • Anxiety
  • Dizziness
  • Crankiness
  • Mood swings and restlessness
  • Fast heartbeat or a feeling of skipped heartbeats (see below)
  • Increased blood pressure (see below)
  • Headache
  • Dry mouth
  • Excessive sweating

There may be other side effects of methylphenidate that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of methylphenidate?

While less common, the most serious side effects of methylphenidate are described below, along with what to do if they happen.

Severe Allergic Reactions. Methylphenidate may cause allergic reactions, which can be serious. Stop taking methylphenidate and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Risk of Misuse and Addiction. Misusing methylphenidate can lead to serious side effects, such as substance use problems, overdose, or death. Misuse means taking a medicine in a way other than how it was prescribed. Methylphenidate can also cause physical dependence, which means your body relies on the medicine. Take methylphenidate exactly as prescribed. Tell your health care provider if you feel that methylphenidate is not working. Call your health care provider right away or go to the nearest emergency room if you have any of the following serious symptoms.

  • Sudden confusion or feeling disoriented
  • Feeling paranoid
  • Suicidal thoughts or actions
  • Seizures
  • Trouble breathing

Increased Blood Pressure and Heart Rate. Methylphenidate may increase your heart rate or blood pressure. Keep all appointments with your health care provider to check your blood pressure and heart rate before starting methylphenidate and during treatment. If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. Also call your health care provider or get medical attention right away if you have chest pain, a fast or irregular heartbeat, or if you faint or feel your heartbeat more than usual.

Behavior, Thought, or Mood Changes. Methylphenidate may cause or worsen psychotic-like behaviors, such as hallucinations or mania. People who already have a mental health condition, such as bipolar disorder, may be at higher risk of these side effects. Tell your health care provider right away if you have any of the following symptoms, or if you have been told by others you have these symptoms.

  • Hearing, seeing, smelling, tasting, or otherwise perceiving things that others do not
  • Delusional thoughts, such as false beliefs that you are being controlled
  • Disorganized thoughts, such as jumping between topics or having a hard time focusing
  • Sudden decline in self-care, such as personal hygiene or academic/work performance
  • Aggressive behavior
  • Very increased energy
  • Significant trouble sleeping
  • Racing, fast-paced thoughts
  • Reckless behavior
  • Unusually grand ideas
  • Excessive happiness or crankiness
  • Talking more or faster than usual

Painful, Prolonged Erection (Priapism). Methylphenidate may cause an unwanted erection that is persistent, painful, and that may happen without sexual arousal. There can be permanent damage to the penis if priapism is not treated quickly. Stop taking methylphenidate and get emergency help if you have any of the following symptoms of priapism. 

  • Erection lasting for more than four hours 
  • Erection that is unrelated to sexual stimulation
  • Painful or tender penis

Blood Flow Problems. Methylphenidate may cause blood flow problems, including a condition called Raynaud's phenomenon, which happens when the blood vessels in your fingers and toes overreact and lead to low blood flow. Call your health care provider right away if you have any of the following symptoms.

  • Fingers or toes feeling numb, cool, painful, or sensitive to cold
  • Fingers or toes changing color from pale, to blue, to red
  • Unexplained wounds on fingers or toes

Slowed Growth in Children. Children taking methylphenidate may be at a higher risk of not gaining height and weight as expected. Keep all appointments with your health care provider to check your child’s height and weight before starting and during treatment with methylphenidate.

Glaucoma. Methylphenidate may increase pressure inside the eye and cause or worsen glaucoma, which can lead to blindness. People who have problems with close-up vision (farsightedness) may be at higher risk. Tell your health care provider right away if you have any of the following symptoms of glaucoma.

  • Changes in vision, including loss of vision
  • Eye pain or redness
  • Severe headache or vomiting
  • Seeing bright, colorful circles around lights (vision halos)

Tics. Methylphenidate may cause or worsen tics, which are sudden, repetitive movements or sounds that can be hard to control. Call your health care provider right away if you have any new or worsening tics.

Seizures. Some people who have taken methylphenidate have reported having seizures. There are many types of seizures, and some of them are not easy to recognize. Stop taking methylphenidate and call your health care provider if you have any of the following signs that a seizure is happening or could happen.

  • Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
  • Stiffening of your arms and legs
  • Feeling anxious, nervous, confused, or a sense of dread
  • Feeling dizzy or lightheaded
  • Falling or losing consciousness

Warnings & Precautions

Who should not use methylphenidate?

Allergies to Ingredients. People who are allergic to any of the following should not take methylphenidate.

  • Methylphenidate
  • Aptensio XR
  • Concerta
  • Cotempla XR-ODT
  • Jornay PM
  • Metadate CD
  • Methylin
  • QuilliChew ER
  • Quillivant XR
  • Relexxii
  • Ritalin
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific methylphenidate products they stock.

Drug Interactions. Methylphenidate should not be taken while you are using certain other medicines. Before taking methylphenidate, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Problems Digesting Certain Sugars. Some forms of methylphenidate may contain sugar and should not be taken if you have a rare inherited condition that makes you unable to digest or absorb certain sugars. These conditions include hereditary fructose intolerance or glucose-galactose malabsorption. Ask your pharmacist or other health care provider if you are not sure if your product contains sugar. 

What should I know about methylphenidate before using it?

Do not take methylphenidate unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share methylphenidate with other people, even if they have the same condition as you. It may harm them.

Keep methylphenidate out of the reach of children. Methylphenidate is a controlled substance because it can be misused or lead to dependence. Store methylphenidate in a safe place to protect it from theft. It is illegal to sell or give away this medicine.

There are multiple forms of methylphenidate available. They may be used to treat different conditions and are taken in different ways. Read and follow the instructions for the product you have and make sure you understand how to prepare, take, and throw it away properly. If you have any questions, talk to your health care provider.

Some methylphenidate capsules and tablets should not be chewed, cut, or crushed. 

After taking some methylphenidate tablets, you may notice a tablet shell in your poop. This is normal and does not mean the medicine did not work. The medicine is released in the body while the outer shell may stay intact. Talk with your health care provider if you have any questions.

If you cannot swallow methylphenidate capsules, some capsules may be opened and sprinkled on a small amount of applesauce. Ask your pharmacist or other health care provider whether you can do this with your methylphenidate product and how to mix and swallow the mixture properly. 

If you are taking methylphenidate liquid, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Also, some forms of methylphenidate liquid must be shaken well before drawing up each dose. Ask your pharmacist what measuring device to use and whether your liquid must be shaken. 

Keep all appointments, including for bloodwork and heart checkups, before and during treatment with methylphenidate. This will help your health care provider make sure it is safe for you to use methylphenidate.

What should I tell my health care provider before using methylphenidate?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if methylphenidate is right for you.

In particular, make sure that you discuss any of the following.

Substance Use Disorder. Tell your health care provider if you have ever misused alcohol, prescription medicines, or street drugs. Methylphenidate has a risk of being misused.

Mental Health Problems. Tell your health care provider if you or anyone in your family has had mental health problems, including psychosis, bipolar disorder, mania, depression, or suicide. Methylphenidate may worsen certain mental health conditions.

Heart Problems. People who have serious heart disease or heart defects may be at risk of sudden death if they take methylphenidate. Tell your health care provider if you have any heart problems, including heart disease, heart defects, cardiomyopathy, or an abnormal heart rhythm (arrhythmia). Also tell your health care provider if anyone in your family has heart problems.

Other Current and Past Health Conditions. Tell your health care provider if you have or have had any of the following.

Phenylketonuria. Some forms of methylphenidate, such as certain chewable tablets, may contain phenylalanine, which can be dangerous for people with phenylketonuria (PKU). Tell your pharmacist and other health care providers if you have PKU before taking methylphenidate.

Pregnancy. It is not known if or how methylphenidate could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should take methylphenidate while you are pregnant or trying to get pregnant. If you become pregnant while taking methylphenidate, you can sign up for the National Pregnancy Registry for ADHD Medications by calling 866-961-2388 or at womensmentalhealth.org/research/pregnancyregistry/adhd-medications. This registry collects safety information about the use of psychiatric medicines during pregnancy.

Breastfeeding. Methylphenidate passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take methylphenidate while breastfeeding.

Interactions

Does methylphenidate interact with foods or drinks?

Some forms of methylphenidate should be taken before breakfast or 30 to 45 minutes before a meal. Other forms of methylphenidate can be taken with or without food, but some may need to be taken the same way each time. Ask your pharmacist or other health care provider how to take the methylphenidate form you are prescribed.

You should not drink alcohol while taking some methylphenidate products because it may cause a faster release of your methylphenidate dose. This can cause higher levels of methylphenidate in your blood and increase the risk of side effects.

With some methylphenidate products, it is unknown if drinking alcohol will affect methylphenidate, but the risk of dizziness or other side effects may be increased. Talk with your health care provider before drinking alcohol while you are taking methylphenidate.

Does methylphenidate interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking methylphenidate.

  • A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s disease
  • A medicine for high or low blood pressure
  • Risperidone, which is a medicine used to treat schizophrenia, bipolar disorder, and crankiness seen with autism
  • An H2 blocker, such as cimetidine (Tagamet), famotidine (Pepcid), ranitidine (Zantac), or nizatidine (Axid)
  • A proton pump inhibitor (PPI), such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), or rabeprazole (Aciphex)
  • Warfarin, which is a blood thinner
  • Any medicine for seizures, such as phenobarbital, phenytoin, or primidone
  • A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
  • A selective serotonin reuptake inhibitor (SSRI), such as fluoxetine, paroxetine, or sertraline, which is a medicine commonly used for anxiety and depression
  • An anesthetic, which is a medicine that is used to put you to sleep before surgery

This may not be a complete list of medicines that can interact with methylphenidate. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much methylphenidate?

If you or someone else has used too much methylphenidate, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of methylphenidate?

If you miss a dose, ask your health care provider what to do. The advice may vary based on the specific methylphenidate product you are taking. Do not take double or extra doses.