MethylphenidateReturn to Methylphenidate overview
Methylphenidate can be used to treat the following conditions
Headmeds fills the medicines information gaps for young people - things you might want to know about meds like will it affect my sex life? Can I still study? Can I drink?
Headmeds does not give medical advice so this is just general information.
Each medicine has a balance of good and bad effects, and each person gets their own individual effects.
You might want to know just one thing about your medicine, but on each page we have given you the ‘safety headlines’. Please read them as they are important.
We have included lots of information about each medicine - but if you want all the details, please look at the patient information leaflet - which is inside every pack. These leaflets are also at www.medicines.org.uk - where there will be the most up-to-date information.
- If you have taken more methylphenidate than it said on the label, you must see a doctor quickly – even if you do not feel any different.
- Methylphenidate can sometimes cause serious side-effects: allergic reactions (difficulty breathing, swelling of your face or throat, itching skin lumps), and other symptoms that can be found here. Go to a hospital if you get any of these symptoms, with your medicine.
- Do not take methylphenidate if you have taken a monoamine oxidase inhibitor antidepressant (MAOI) like moclobemide, phenelzine, isocarboxazid or tranylcypromine in the last 14 days.
- Stopping methylphenidate suddenly can cause serious side-effects – if you are thinking of stopping or want to stop, talk to your doctor first.
- You might feel sleepy in the first few days after taking methylphenidate – do not drive a car, ride a bike or operate machines until you see how this affects you.
- If you take methylphenidate while you are pregnant, it may affect the developing baby. Use good contraception while you are taking methylphenidate. Talk to your doctor or midwife about this and get their help.
Methylphenidate is a Central Nervous Stimulant
A central nervous stimulant, sometimes called a CNS stimulant, makes more noradrenaline and dopamine available in your brain.
You can take methylphenidate as tablets or capsules
Methylphenidate comes as plain tablets in 5mg, 10mg and 20mg strengths.
It also comes in Modified-release Capsules (the ones with an XL by the name) which release methylphenidate slowly. These come in 5mg, 10mg, 20mg, 30mg, 40mg, 50mg and 60mg strengths.
It also comes in Modified-release Tablets (also with XL by the name). These come in 18mg, 27mg, 36mg and 54mg strengths.
The usual maximum dose to 60mg in a day.
Methylphenidate can be used to help with attention deficit hyperactivity disorder (ADHD).
- If you are 18 or under, the doctor can prescribe methylphenidate for you as a licensed medicine for treatment of attention deficit hyperactivity disorder (ADHD)
- If you are over 18, there is more research about its use and effectiveness in adults. And so specialists might prescribe it ‘off label’ if it is the best medicine for you.
Different brands contain lactose and wheat starch and gelatine – check your type if any of these are a problem for you
Ritalin®, Matoride XL® and Concerta XL® tablets may not be suitable for you if you have problems eating some sugars or dairy (milk-based) foods, as they contain lactose.
Ritalin® tablets contain wheat starch. This is still OK to take if you have coeliac disease, but not if you have chronic fatty loose poo (diarrhoea).
Ritalin® tablets, Equasym XL® capsules and Medikinet XL® capsules contain gelatine.
Some empty tablet cases might turn up in your poo
- Concerta® XL tablets may not fully dissolve in the gut.
- This means that the methylphenidate goes into the body, but the empty tablet ‘case’ goes straight through.
- So you may see the empty case in the toilet when you go for a poo.
- Don't worry – it has still worked.
Some brands of methylphenidate tablets and capsules can help people who have trouble swallowing medicines
Ritalin® tablets can be broken in half - or crushed and mixed with a small amount of soft food such as yogurt, honey or jam - to make them easier to swallow.
Equasym XL® and Medikinet XL® capsules can be opened, and the contents can be sprinkled on a tablespoon of apple sauce (or yoghurt with Medikinet XL) for swallowing without chewing.
Methylphenidate is a ‘controlled drug’
- This means that the pharmacy has to store the tablets extra securely by locking them in a cupboard.
- The doctor has to write extra things on the prescription, like the total amount needed in words and figures to make it harder for a genuine prescription to be altered.
- A prescription for methylphenidate has to be dispensed by the pharmacy within 28 days of the prescription being written (you can keep most other prescriptions for 6 months).
- You cannot get an emergency supply of methylphenidate without a prescription.
- This is all because methylphenidate can make people without ADHD feel high, and it might be sold as a street drug.
- If you have to take it to school, it might have to be locked in a safe place.
Methylphenidate is mainly used to treat Attention Deficit Hyperactivity Disorder (ADHD)
It is used to treat Attention Deficit Hyperactivity Disorder (ADHD). It can also be used by specialists to treat narcolepsy (where you keep falling asleep), but it is not licensed for this.
Methylphenidate can help to improve your concentration by adjusting the chemicals in your brain
- It might seem odd that you would use a stimulant as a treatment for hyperactivity.
- In people with ADHD, stimulant medicines do not make them more active (as they do in other people), but instead these medicines make them better able to focus.
- Methylphenidate stimulates centres in the brain that are underactive in people with ADHD, such as the bits of the brain involved with concentration.
- Methylphenidate helps people with ADHD to increase their attention span and concentration. It also helps them to stop acting on impulse without thinking.
- Two of the chemicals in the brain are called noradrenaline and dopamine. These transmitters carry messages between nerve cells in the brain. (Noradrenaline is called norepinephrine in the USA)
- Methylphenidate works by blocking noradrenaline and dopamine from being taken back up into the nerve cells in the brain after being released.
- This results in higher levels of noradrenaline and dopamine between the nerve cells because these chemicals hang around for longer.
- Higher levels of noradrenaline and dopamine in the brain help to make people alert and ready for action. They feel like they have more energy and wellbeing.
- The stimulant seems to give people a better focus for their energy.
- With higher levels of noradrenaline and dopamine in the brain, many other effects occur in different parts of the body, including the heart, the gut, and the lungs.
- Overall, this leads to the good effects of the medicine, but can also produce unwanted effects (side effects).
- It is hard to control how much of each effect happens as every person is different.
- In people with narcolepsy, the action of methylphenidate (as explained above) helps them to stay awake and alert.
How you should take methylphenidate depends on which preparation you are prescribed
- You will get the best effect from your methylphenidate if you do not miss any doses.
- Try to get into a routine to help you to remember to take your medicines, such as taking them with meals or when you brush your teeth.
- Make sure that you know your dose. If it is not written on the label, check it with your pharmacist or doctor.
- Taking methylphenidate with food can help you to avoid side effects of feeling sick, being sick, or having stomach pains (but see below if you take the Equasym XL brand of methylphenidate).
- Avoid taking your methylphenidate doses after 4pm. If you take methylphenidate after 4pm, it could make it harder for you to get to sleep.
- However, some people find that an evening dose of methylphenidate can actually help them concentrate enough to go to sleep.
- The ‘plain’ methylphenidate tablets need to be taken two or three times a day. Plain methylphenidate tablets can be taken with or without food, but taking them with meals might help you to remember to take them.
- The plain methylphenidate tablets can be broken in half, or crushed and mixed with a small amount of soft food such as yogurt, honey or jam to make them easier to swallow.
- There are a number of brands of ‘slow release’ methylphenidate tablets or capsules (they may also be referred to as ‘modified release’ or ‘XL’).
- These release some of the methylphenidate straight away, but release the rest of the methylphenidate slowly throughout the day. For this reason, they can be taken less often.
- The different brands of slow-release methylphenidate differ in how much of the dose they release straight away compared to how much of the dose they release slowly.
- The Equasym XL brand of methylphenidate needs to be taken in the morning before breakfast. Some people who take this brand may find that it wears off in the late afternoon or early evening, in which case the doctor may prescribe a dose of the plain methylphenidate tablet for you to take at this time.
- The Medikinet XL brand of methylphenidate should be taken in the morning, with or after breakfast.
- The Concerta XL, Xenidate XL, and Matoride XL brands of methylphenidate should be taken in the morning, but this can be before, with, or after breakfast.
- It is important not to break or chew the slow-release methylphenidate tablets or capsules. This is because they have a special system in them to deliver the medicine into your body slowly (over a few hours), which could be damaged if you chew or break them.
- However, you can empty out the contents of Equasym® XL and Medikinet XL® capsules on to a tablespoon of apple sauce and swallow it without chewing. Medikinet XL® can also be added to yogurt.
What should I do if I forget to take a dose of methylphenidate?
What to do if you miss a dose:
- If you remember later during the morning, take it as soon as possible.
- If you forget to take it by lunchtime, just start again on the next day.
- Do not take a double dose.
What might happen?
- If you forget to take it for a few days, your symptoms may come back.
- You may get an unwanted effect of depression as the chemicals in your brain change their balance, with less noradrenaline and dopamine beimg around.
There are tablets and capsules that you can take once a day. If this would help you to remember, ask your doctor about them. What keeps you well may be a combination of different brands and plain methylphenidate. Methylphenidate itself once it is absorbed in to your body is short acting so timings can be quite important. Your brands of methylphenidate should only change with the advice of a specialist in your treatment.
You must go to A&E if you take too much
What to do if you take too much:
- If you have taken more methylphenidate than it said on the label, you must get help quickly – even if you don’t feel any different.
- Go to A&E. Take your medicine with you, to show to the doctors. Tell them how much you have taken.
- Get a friend or family member to go with you, if you can, just in case you feel ill on the way.
You might get any of the following signs:
- being sick
- feeling very happy or agitated or confused
- shaking or muscle movements that you cannot control
- having a fit (seizure), which can lead to a coma
- seeing, feeling or hearing things that are not real (hallucinations)
- sweating or flushing or high fever
- changes in your heartbeat (slow, fast or uneven)
- high blood pressure
- your eye pupils getting bigger (dilating)
- dry nose and mouth
It can take 2-3 weeks for methylphenidate to start helping
It can take a few weeks for methylphenidate to show its full effect.This is likely to be because the brain takes time to adapt to give you the good effects of the methylphenidate.
- You should see improvements in your concentration and other symptoms within one month of starting the medicine.
- Your doctor might start you on a low dose and then increase it slowly over 2-4 weeks to your full dose.
Many people take methylphenidate for a year, and then check to see if they still need it
You and your doctor should talk about how long you need to take methylphenidate.
- You may not get the full effect for 2-3 weeks.
- You should probably take it for at least a year - otherwise your symptoms can come back.
- After a year, the doctor may stop the medicine (drug ‘holiday’) to see if you still need it. They will probably do this during a holiday if you are at school.
- You may need to take methylphenidate for longer than a year, and some people find that they need to take methylphenidate for several years.
- You may find that it continues to help once you are an adult
Methylphenidate works best as part of a wider treatment programme
Medication is just one part of treatment for ADHD. Methylphenidate is prescribed as part of a wider treatment plan including educational, social and psychological counselling.
The doctor will do regular checks while you are taking methylphenidate
Before you start taking methylphenidate, and at least every 6 months after you start, the doctor will do some tests to check that methylphenidate is (still) right for you.
- They will check your appetite, as methylphenidate can make you want to eat less
- They will check your weight and height, as methylphenidate can make you grow more slowly
- They will check your heart rate and blood pressure, as this is a stimulant that can have side-effects on the heart and blood vessels
- They will ask you about your mood and how you are feeling, to check that the medicine is working but also whether you are having any side-effects.
For more information about these possible side-effects, please see Warnings and side effects section.
Search www.medicines.org.uk to find patient information leaflets and prescribing information on methylphenidate. Tablets and capsules are listed by brand. The SmPC lists all the inactive ingredients in the product so you can check against any allergies. If you are still unsure about this then speak to your pharmacist.
- British National Formulary (BNF) and British National Formulary for children. Download the BNF/BNFC app (blue background) on to your mobile device. No longer available for public access via the web
- Taylor D, Barnes T, Young A. Maudsley Prescribing Guidelines in Psychiatry, 13th edition. Oxford: John Wiley & Sons, May 2018. ISBN: 978-1-119-44260-8
- Royal Pharmaceutical Society. Medicines Ethics and Practice (42nd edition). London: RPS, 2018. Standards for pharmacists to work to. It is not a free publication
- World Anti Doping Agency WADA Prohibited List https://www.wada-ama.org/en/resources/science-medicine/prohibited-list-documents
- Choiceandmedication; an independent source of information on many mental health conditions and their medicines with easy to read fact sheets www.choiceandmedication.org Personal subscriptions to download the app available for £1 per month (with proportionate discounts for longer periods) but your local mental health Trust may subscribe and provide information sheets for free.
- Best Use of Medicines in Pregnancy (BUMPS). Information sheets on drugs in pregnancy http://www.medicinesinpregnancy.org/
- Drugs and Lactation Database (LactMed). Information on drugs in breastfeeding https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm