Generic
Methylphenidate Hydrochloride
2 brands available in the market
At a glance
Methylphenidate Hydrochloride is a CNS stimulant used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy.
Description
Methylphenidate Hydrochloride is a central nervous system stimulant that improves the activity of certain parts of the brain by increasing the levels of norepinephrine and dopamine. It improves attention span, concentration and reduces impulsive behavior. At low doses, it selectively activates NE and DA neurotransmission in the prefrontal cortex which plays a prominent role in ADHD pathophysiology.
Indications
- Attention Deficit Hyperactivity Disorder (ADHD)
- Narcolepsy
Therapeutic class
CNS Stimulant Drugs
Pharmacological class
Central Nervous System Stimulant
Pharmacology
Methylphenidate (MPH) acts as a norepinephrine and dopamine reuptake inhibitor (NDRI), increasing the presence of these neurotransmitters in the extraneuronal space and prolonging their action. At low doses, it selectively activates NE and DA neurotransmission within the prefrontal cortex.
Mechanism of action
Improves attention and concentration and reduces impulsive behavior by increasing brain activity.
Dosage
Adult Dose:
- Narcolepsy and ADHD: 20-30 mg/day (2-3 divided doses), 30-45 minutes before meals
- 10-15 mg/day may be adequate for some patients; 40-60 mg/day for others
- Last dose should be taken before 6 pm (to avoid sleep problems)
Child Dose (6 years and older):
- Initial: 5 mg 1-2 times daily (30-45 min before breakfast and lunch)
- May increase by 5-10 mg/day at weekly intervals
- Maximum: 60 mg/day (2-3 divided doses)
- Under 6 years: Safety and efficacy not established
Administration
- Take on an empty stomach 30-45 minutes before meals
- Swallow tablet whole; do not chew, crush or break
- Take at the same time each day
- Last dose before 6 pm
Missed dose
If you miss a dose, skip it and continue with your normal schedule. Do not double the dose.
Side effects
Common Side Effects:
- Headache
- Insomnia (difficulty sleeping)
- Abdominal pain
- Nervousness
- Restlessness
- Dizziness
Rare Side Effects:
- Tremor, convulsion
- Rash, pruritus, urticaria
- Fever, arthralgia
- Alopecia, exfoliative dermatitis
- Thrombocytopenic purpura
- Leukopenia
- Liver damage (very rare)
Precautions & warnings
- High habit-forming potential - do not take more than prescribed
- Caution while driving (may cause dizziness, blurred vision)
- Monitor blood pressure and pulse
- Monitor height and weight in children regularly (may decrease appetite)
- Inform doctor if sudden mood changes or suicidal thoughts occur
- Do not stop without consulting your doctor
- Caution in mild hypertension; contraindicated in moderate/severe hypertension
Contraindications
- Marked anxiety, tension, agitation
- Glaucoma
- Tourette's syndrome or tics
- Severe structural cardiac abnormalities
- Cardiomyopathy
- Serious heart rhythm abnormalities
- Severe hypertension, heart failure
- Arrhythmia, hyperthyroidism
- Recent MI or angina
- Alcoholism, emotionally unstable patients
- Drug abusers
- Psychoses, epilepsy
- Hypersensitivity to methylphenidate
Drug interactions
- Antihypertensives: Reduced effects
- Carbamazepine: Decreased serum level
- CYP2D6 Inhibitors (chlorpromazine, fluoxetine, paroxetine, quinidine): Increased serum levels/effects
- Phenytoin, TCAs: Increased serum levels
- Sibutramine: Severe hypertension and tachycardia
- Alcohol: CNS depression
- Clonidine: Severe toxic reactions (potentially fatal)
- MAOIs: Risk of hypertensive crisis (potentially fatal)
Food interactions
Alcohol with Methylphenidate Hydrochloride may cause excessive drowsiness.
Use in pregnancy
Use in Pregnancy: Possibly unsafe. Limited human studies; animal studies show harmful effects on developing baby. Your doctor will weigh benefits and risks.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Probably unsafe. Limited human data suggests the drug may pass into breastmilk and harm the baby.
Pediatric use
Not recommended for children under 6 years. Pediatric dose established for children 6 years and older.
Geriatric use
No specific dose adjustment known for elderly, but caution advised.
Renal / hepatic impairment
Renal Impairment: Limited information available. Caution in underlying kidney disease. Consult your doctor.
Hepatic Impairment: Limited information available. Consult your doctor.
Overdose effects
Acute overdose symptoms: nausea, vomiting, agitation, convulsions, delirium, hallucinations, sweating, flushing, headache, hyperthermia, tachycardia, palpitations, mydriasis, dry mouth, coma. Symptomatic treatment.
Storage conditions
Store below 25°C in a cool and dry place, away from light. Keep out of reach of children.
Chemical structure
Methylphenidate Hydrochloride