Use Caution/Monitor. Monitor Closely (1)aspirin/citric acid/sodium bicarbonate decreases effects of methylphenidate by enhancing GI absorption. Relexxii: Store at 25C (77F); excursions permitted to 15-30C (59-86F); protect from humidity, Adhansia XR: Store at 20-25C (68-77F); excursions permitted to 15-30C (59-86F); protect from light, Extended-release chewable (QuilliChew ER): Store at 20-25C (68-77F); excursions permitted to 15-30C (59-86F), Extended-release orally disintegrating (Cotempla XR-ODT): Store at 20-25C (68-77F); excursions permitted to 15-30C (59-86F); store in reusable travel case, Immediate-release (Ritalin): Store at 25C (77F); excursions permitted to 15-30C (59-86F); protect from light. 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. Either increases effects of the other by serotonin levels. Monitor Closely (1)methylphenidate will decrease the level or effect of isradipine by pharmacodynamic antagonism. Medscape Education. Use Caution/Monitor. levalbuterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Monitor Closely (1)clomipramine, methylphenidate. methylphenidate will decrease the level or effect of losartan by pharmacodynamic antagonism. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. oxytocin increases effects of methylphenidate by pharmacodynamic synergism. Either increases effects of the other by serotonin levels. Monitor BP. 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. Monitor Closely (2)lurasidone, methylphenidate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Monitor Closely (1)thioridazine, methylphenidate. Risk of acute hypertensive episode. Vyvanse) in the right column ADHDMedCalc.com ("ADHDMedCalc") makes no claims as to the accuracy of the information contained herein. Caffeine should be avoided or used cautiously. 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. Other (see comment). Access your plan list on any device mobile or desktop. Modify Therapy/Monitor Closely. Use Caution/Monitor. Potential for additive CNS stimulation. Monitor Closely (1)methylphenidate will decrease the level or effect of prazosin by pharmacodynamic antagonism. Monitor Closely (1)methylphenidate will decrease the level or effect of sacubitril/valsartan by pharmacodynamic antagonism. Applies only to oral form of both agents. Monitor BP. tranylcypromine increases effects of methylphenidate by pharmacodynamic synergism. Monitor BP. Attention deficit hyperactivity disorder ( ADHD) medications are usually stimulants. Minor/Significance Unknown. Use Caution/Monitor. Monitor BP. Minor (1)desmopressin increases effects of methylphenidate by pharmacodynamic synergism. methylphenidate will decrease the level or effect of ramipril by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Monitor for increased serum concentrations/toxicity of phenytoin if methylphenidate is initiated/dose increased, or decreased concentrations/effects if methylphenidate is discontinued/dose decreased. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Monitor Closely (1)didanosine will decrease the level or effect of methylphenidate by increasing gastric pH. Monitor Closely (1)pimozide increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Interaction more likely in certain predisposed pts. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. Modify Therapy/Monitor Closely. Are Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder Significantly Linked to Childhood Allergies? For example, Ritalin 10 mg q4h is converted to Concerta 36 mg. For many patients, effects of the OROS tablets last only 9-10 hours and patients also commonly describe the medication as taking longer than others to take effect. Use Caution/Monitor. Contraindicated. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Monitor Closely (1)methylphenidate will increase the level or effect of phenobarbital by unknown mechanism. Dosage Conversions of Various Methylphenidate Formulations Table 3. Applies only to oral form of both agents. bromocriptine, methylphenidate. Risk of acute hypertensive episode. Use Caution/Monitor. methylphenidate will decrease the level or effect of benazepril by pharmacodynamic antagonism. Monitor for hypertension with concomitant use. Monitor BP. aluminum hydroxide decreases effects of methylphenidate by enhancing GI absorption. Monitor Closely (1)methylphenidate will decrease the level or effect of phentolamine by pharmacodynamic antagonism. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Applies only to oral form of both agents. Risk of acute hypertensive episode. Use Caution/Monitor. methylphenidate will decrease the level or effect of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. Monitor BP. Additive vasospasm; risk of hypertension. Applies only to oral form of both agents. This drug is available at a higher level co-pay. Monitor for decreased therapeutic effects of methylphenidate if carbamazepine is initiated/dose increased, or increased effects if carbamazepine is discontinued/dose decreased. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Monitor BP. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Risk of acute hypertensive episode. Methylphenidate may diminish antihypertensive effects. Monitor Closely (1)methylphenidate will decrease the level or effect of ramipril by pharmacodynamic antagonism. Monitor Closely (1)hydrocodone, methylphenidate. Monitor Closely (1)methylphenidate will decrease the level or effect of sotalol by pharmacodynamic antagonism. Other (see comment). Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. 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. Risk of acute hypertensive episode. Monitor BP. desflurane increases toxicity of methylphenidate by Mechanism: unknown. Use Caution/Monitor. Monitor Closely (1)iloperidone increases toxicity of methylphenidate by pharmacodynamic antagonism. Please confirm that you would like to log out of Medscape. epinephrine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. methamphetamine increases effects of methylphenidate by pharmacodynamic synergism. Additive pressor effect. Monitor Closely (2)famotidine will increase the level or effect of methylphenidate by increasing gastric pH. Use Caution/Monitor. Use Caution/Monitor. Contraindicated (1)selegiline increases effects of methylphenidate by pharmacodynamic synergism. . Methylphenidate may diminish antihypertensive effects. Use Caution/Monitor. Risk of acute hypertensive episode. Dosing recommendations are based on current dose regimen and clinical judgment. Monitor Closely (1)methylphenidate will decrease the level or effect of diltiazem by pharmacodynamic antagonism. Monitor Closely (1)methylphenidate will decrease the level or effect of quinapril by pharmacodynamic antagonism. However, Ritalin is a short-acting stimulant that boosts focus and attention quickly. Use Caution/Monitor. Use Caution/Monitor. Monitor BP. Risk of acute hypertensive episode. Use Caution/Monitor. Avoid or Use Alternate Drug. Minor/Significance Unknown. Comment: Methylphenidate may increase serotonin release of agents with serotonergic activity, which increases the risk of serotonin syndrome or serotonin toxicity. Modify Therapy/Monitor Closely. Use Caution/Monitor. Modify Therapy/Monitor Closely. Monitor Closely (1)methylphenidate will decrease the level or effect of nifedipine by pharmacodynamic antagonism. Applies only to oral form of both agents. Monitor Closely (1)levalbuterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Comment: Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Monitor BP. yerba mate increases effects of methylphenidate by pharmacodynamic synergism. pirbuterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Modify Therapy/Monitor Closely. Monitor Closely (1)cocaine topical increases effects of methylphenidate by pharmacodynamic synergism. Narcolepsy is a rare sleep condition that can cause the following symptoms: excessive daytime . Modify Therapy/Monitor Closely. Use Caution/Monitor. 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. Methylphenidate may diminish antihypertensive effects. Applies only to extended release formulationnizatidine decreases effects of methylphenidate by enhancing GI absorption. Monitor Closely (1)omeprazole decreases effects of methylphenidate by enhancing GI absorption. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Methylphenidate may diminish antihypertensive effects. Monitor BP. Risk of acute hypertensive episode. Use Caution/Monitor. Monitor Closely (2)fluphenazine, methylphenidate. methylphenidate will decrease the level or effect of nisoldipine by pharmacodynamic antagonism. Risk of acute hypertensive episode. Safinamide. Concerta and Ritalin share the same active ingredient. Methylphenidate may diminish antihypertensive effects. Either increases effects of the other by pharmacodynamic synergism. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. Other (see comment). Use Caution/Monitor. Minor/Significance Unknown. Risk of acute hypertensive episode. Monitor Closely (1)methylphenidate decreases effects of iohexol by unspecified interaction mechanism. Applies only to oral form of both agents. Other (see comment). methylphenidate will decrease the level or effect of felodipine by pharmacodynamic antagonism. Either increases effects of the other by pharmacodynamic synergism. prochlorperazine, methylphenidate. Modify Therapy/Monitor Closely. Controlled studies in pregnant women show no evidence of fetal risk. Use Caution/Monitor. Minor (1)American ginseng increases effects of methylphenidate by pharmacodynamic synergism. Serious - Use Alternative (1)methylergonovine, methylphenidate. Applies only to oral form of both agents. Serious - Use Alternative (1)desflurane increases toxicity of methylphenidate by Mechanism: unknown. Use Caution/Monitor.serdexmethylphenidate/dexmethylphenidate and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Use Caution/Monitor. This drug is available at a higher level co-pay. Monitor BP. Use Caution/Monitor. yohimbe, methylphenidate. Use Caution/Monitor. Use Caution/Monitor. clomipramine, methylphenidate. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. Mechanism: unknown. Monitor Closely (1)chlorpromazine, methylphenidate. Monitor Closely (1)methylphenidate, epinephrine inhaled. Risk of acute hypertensive episode. Avoid or Use Alternate Drug. Use Caution/Monitor. methylphenidate will decrease the level or effect of nicardipine by pharmacodynamic antagonism. Additive vasospasm; risk of hypertension. Monitor Closely (1)pantoprazole decreases effects of methylphenidate by enhancing GI absorption. Potential for additive CNS stimulation. This website also contains material copyrighted by 3rd parties. Methylphenidate may diminish antihypertensive effects. Mechanism: pharmacodynamic synergism. Monitor Closely (1)imipramine, methylphenidate. Potential for additive CNS stimulation. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Methylphenidate may diminish antihypertensive effects. Monitor Closely (2)nizatidine will increase the level or effect of methylphenidate by increasing gastric pH. Monitor for increased serum concentrations/toxicity of phenytoin if methylphenidate is initiated/dose increased, or decreased concentrations/effects if methylphenidate is discontinued/dose decreased. Minor/Significance Unknown. Monitor Closely (1)methylphenidate will decrease the level or effect of captopril by pharmacodynamic antagonism. Monitor Closely (1)methylphenidate will decrease the level or effect of felodipine by pharmacodynamic antagonism. Interaction more likely in certain predisposed pts. Monitor Closely (1)salmeterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Methylphenidate may diminish antihypertensive effects. Monitor Closely (1)protriptyline, methylphenidate. Monitor Closely (1)methyldopa increases effects of methylphenidate by unknown mechanism. Use Caution/Monitor. Risk of acute hypertensive episode. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate. Risk of V tach, HTN. Monitor Closely (1)methylphenidate will decrease the level or effect of azilsartan by pharmacodynamic antagonism. Use Caution/Monitor. desipramine, methylphenidate. Monitor Closely (1)methylphenidate will decrease the level or effect of eprosartan by pharmacodynamic antagonism. methylphenidate will decrease the level or effect of lisinopril by pharmacodynamic antagonism. arformoterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Potential for additive CNS stimulation. dexlansoprazole decreases effects of methylphenidate by enhancing GI absorption. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Methylphenidate may diminish antihypertensive effects. Aptensio XR. Use Caution/Monitor. Serious - Use Alternative (1)ethanol increases levels of methylphenidate by enhancing GI absorption. Use Caution/Monitor. trifluoperazine increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Monitor Closely (1)sufentanil SL, methylphenidate. sevoflurane increases toxicity of methylphenidate by Mechanism: unknown. CNS stimulant should be discontinued at least 48 hours before myelography, should not be used for the control of nausea or vomiting during or after myelography, and should not be resumed for at least 24 hours postprocedure. Modify Therapy/Monitor Closely. Use Caution/Monitor. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Methylphenidate may diminish antihypertensive effects. Drug . Risk of V tach, HTN. Use Caution/Monitor. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Use Caution/Monitor. 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. Adhansia XR: 25 mg PO qAM initially; may titrate upward in increments of 10-15 mg at intervals of at least 5 days; dosages >85 mg/day associated with increased incidence of certain adverse reactions, Aptensio XR: 10 mg PO qDay in AM; may increase weekly by 10-mg increments; not to exceed 60 mg/day, Concerta: Initial for methylphenidate-nave, 18-36 mg PO qDay; may increase by 18-mg increments at weekly intervals; maintenance dose is 18-72 mg/day, Metadate CD: Initial, 20 mg PO qAM before breakfast; may increase in 10- to 20-mg increments; not to exceed 60 mg/day, Methylin ER: Duration of action ~8 hr; may use in place of methylphenidate IR tablets when 8-hr dosage of methylphenidate ER corresponds to titrated 8-hr dosage of methylphenidate IR; not to exceed 60 mg/day, Ritalin (immediate-release tablets and oral solution): 20-30 mg/day PO divided q8-12hr, 30-45 minutes before meals; may gradually increase dose at weekly intervals; some patients may require 40-60 mg/day; in others, 10-15 mg/day may be adequate, QuilliChew ER (chewable extended-release tablets): 20 mg PO qAM initially; may titrate up or down weekly in increments of 10 mg, 15 mg, or 20 mg; not to exceed 60 mg/day, Jornay PM: 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 pm; adjust timing of administration between 6:30 pm and 9:30 pm to optimize tolerability and efficacy the next morning and throughout the day, Relexxii: Initial for methylphenidate-nave, 18-36 mg PO qDay; may increase by 18-mg increments at weekly intervals; maintenance dose is 18-72 mg/day; not to exceed 72 mg/day, Ritalin LA: Initial, 20 mg PO qAM; may adjust dose in weekly 10-mg increments, not to exceed 60 mg/day (patients requiring a lower initial dose may begin with 10 mg), Methylin, Ritalin (immediate-release tablets and oral solution): 20-30 mg/day PO divided q8-12hr, 30-45 minutes before meals; some patients may require 40-60 mg/day; in others, 10-15 mg/day may be adequate, Methylin ER: Duration of action is approximately 8 hr; may use in place of methylphenidate IR tablets when 8-hr dosage of methylphenidate ER corresponds to the titrated 8-hr dosage of methylphenidate IR, <6 years: Safety and efficacy not established. This means that you only need to take. Caffeine is a CNS-stimulant and additive effects may be seen when coadministered with other CNS stimulants. Modify Therapy/Monitor Closely. Contraindicated. Methylphenidate may diminish antihypertensive effects. Risk of acute hypertensive episode. Contraindicated. prescription products. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. only. Monitor Closely (1)clozapine increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Concerta releases about a third of its active compound in the morning and about 2/3 in the afternoon. Use Caution/Monitor. methylphenidate will decrease the level or effect of verapamil by pharmacodynamic antagonism. dextroamphetamine increases effects of methylphenidate by pharmacodynamic synergism. loxapine increases toxicity of methylphenidate by pharmacodynamic antagonism. Monitor Closely (1)amitriptyline, methylphenidate. 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg. Contraindicated. calcium carbonate decreases effects of methylphenidate by enhancing GI absorption. Additive vasospasm; risk of hypertension. Applies only to oral form of both agents. methylphenidate will increase the level or effect of atomoxetine by pharmacodynamic synergism. Table 3. Applies only to oral form of both agents. only. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. ephedrine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. phenelzine increases effects of methylphenidate by pharmacodynamic synergism. Either increases toxicity of the other by Other (see comment). Applies only to oral form of both agents. Monitor Closely (1)nortriptyline, methylphenidate. 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. Mechanism: pharmacodynamic antagonism. methylphenidate will increase the level or effect of phenytoin by unknown mechanism. Interaction more likely in certain predisposed pts. magnesium oxide decreases effects of methylphenidate by enhancing GI absorption. Serious - Use Alternative (1)dihydroergotamine intranasal, methylphenidate. Modify Therapy/Monitor Closely. Either increases toxicity of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. The recommended dose of CONCERTA for patients who are currently taking methylphenidate twice daily or three times daily at doses of 10 to 60 mg/day is provided in Table 2. epinephrine racemic and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. To view formulary information first create a list of plans. Monitor Closely (1)epinephrine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Use Caution/Monitor. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Use Caution/Monitor. 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. Risk of acute hypertensive episode. Use Caution/Monitor. Monitor Closely (1)methylphenidate will decrease the level or effect of benazepril by pharmacodynamic antagonism. Avoid or Use Alternate Drug. lofepramine, methylphenidate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Risk of acute hypertensive episode. Use Caution/Monitor. Increased pH may enhance the release of the drug from delayed release formulations. Use Caution/Monitor. Modify Therapy/Monitor Closely. Mechanism: pharmacodynamic synergism. Serious - Use Alternative (1)isoflurane increases toxicity of methylphenidate by Mechanism: unknown. Use Caution/Monitor. Modify Therapy/Monitor Closely. Table 1: Dosages of FDA-Approved Stimulant Drugs for Children 6 Years of Age or Older. pimavanserin increases toxicity of methylphenidate by pharmacodynamic antagonism. Contraindicated. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Potential for additive CNS stimulation. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. sufentanil SL, methylphenidate. Monitor BP. Risk of acute hypertensive episode. terbutaline and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Monitor BP. Contraindicated. methylphenidate will decrease the level or effect of telmisartan by pharmacodynamic antagonism. Methylphenidate may diminish antihypertensive effects. Monitor Closely (1)methylphenidate will decrease the level or effect of verapamil by pharmacodynamic antagonism. ether increases toxicity of methylphenidate by Mechanism: unknown. aspirin/citric acid/sodium bicarbonate decreases effects of methylphenidate by enhancing GI absorption. Use Caution/Monitor. Risk of acute hypertensive episode. Modify Therapy/Monitor Closely. Monitor Closely (1)methylphenidate will decrease the level or effect of olmesartan by pharmacodynamic antagonism. Concerta is long-acting Ritalin (methylphenidate). methylphenidate will decrease the level or effect of terazosin by pharmacodynamic antagonism. Monitor Closely (1)green tea, methylphenidate. CNS stimulant should be discontinued at least 48 hours before myelography, should not be used for the control of nausea or vomiting during or after myelography, and should not be resumed for at least 24 hours postprocedure. hydralazine, methylphenidate. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Applies only to oral form of both agents. Monitor BP.
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