$Unique_ID{BRK02029}
$Pretitle{}
$Title{METHYLPHENIDATE}
$Subject{methylphenidate hydrochloride (various manufacturers)
Ritalin (Ciba)
Ritalin-SR (Ciba)}
$Volume{}
$Log{
Ritalin*0202901.scf}

Copyright (C) 1991 Publications International, Ltd.


METHYLPHENIDATE
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BRAND NAMES (Manufacturers):
     methylphenidate hydrochloride (various manufacturers)
     Ritalin (Ciba)
     Ritalin-SR (Ciba)
TYPE OF DRUG:
     Adrenergic
INGREDIENT:
     methylphenidate
DOSAGE FORMS:
     Tablets (5 mg, 10 mg, and 20 mg)
     Sustained-release tablets (20 mg)
STORAGE:
     Methylphenidate should be stored at room temperature in tightly closed,
       light-resistant containers.

USES

     Methylphenidate is a central nervous system (brain and spinal cord)
stimulant that increases mental alertness and decreases fatigue.  It is used
in the treatment of narcolepsy (a disorder involving uncontrollable desires to
sleep or actual sleep attacks that occur in a rapid and unpredictable manner),
mild depression, and abnormal behavioral syndrome in children (hyperkinetic
syndrome or attention deficit disorder).  The way this medication works in
abnormal behavioral syndrome in children is not clearly understood.

TREATMENT

     In order to avoid stomach upset, you can take methylphenidate with food
or with a full glass of water or milk (unless your doctor directs you to do
otherwise).
     If methylphenidate is being used to treat narcolepsy or abnormal
behavioral syndrome in children, the first dose should be taken soon after
awakening.
     In order to avoid difficulty in falling asleep, the last dose of the
regular tablets should be taken four to six hours before bedtime each day (the
sustainedrelease tablets should be taken at least eight hours before bedtime).
     The sustained-release tablets should be swallowed whole.  Chewing,
crushing, or breaking these tablets destroys their sustained-release activity
and may increase the side effects.
     If you miss a dose, take the missed dose as soon as possible, unless it
is almost time for your next dose.  In that case, do not take the missed dose;
just return to your regular dosing schedule.  Do not double the next dose.

SIDE EFFECTS

     Minor.

     Abdominal pain, dizziness, drowsiness, dry mouth, headache, insomnia,
loss of appetite, nausea, nervousness, vomiting, or weakness.  These side
effects should disappear as your body adjusts to the medication.
     Dry mouth can be relieved by sucking on ice chips or a piece of hard
candy or by chewing sugarless gum.
     If you feel dizzy, sit or lie down for a while; get up from a sitting or
lying position slowly, and be careful on stairs.

     Major.

     Tell your doctor about any side effects that are persistent or
particularly bothersome.  IT IS ESPECIALLY IMPORTANT TO TELL YOUR DOCTOR about
chest pain, fever, hair loss, hallucinations, hives, joint pain, mood changes,
palpitations, rash, seizures, sore throat, uncoordinated movements, or unusual
bleeding or bruising.

INTERACTIONS

     Methylphenidate interacts with several other types of medications:
     1. Use of it within 14 days of a monoamine oxidase (MAO) inhibitor (such
as isocarboxazid, pargyline, phenelzine, tranylcypromine) can result in severe
high blood pressure.
     2. Methylphenidate can decrease the blood-pressure-lowering effects of
antihypertensive medications (especially guanethidine).
     3. Acetazolamide and sodium bicarbonate can decrease the elimination of
methylphenidate from the body, thereby prolonging its action and increasing
the risk of side effects.
     4. Methylphenidate can decrease the elimination and increase the side
effects of oral anticoagulants (blood thinners, such as warfarin), tricyclic
antidepressants (such as amitriptyline, desipramine, imipramine, and
nortriptyline), anticonvulsants (such as phenytoin, phenobarbital, and
primidone), and phenylbutazone.
     Before starting to take this medication, BE SURE TO TELL YOUR DOCTOR
about any medications you are currently taking, especially any of those listed
above.

WARNINGS

     * Tell your doctor about unusual or allergic reactions you have had to
any medications, especially to methylphenidate.  Tell your doctor if you have
ever had epilepsy, glaucoma, high blood pressure, motor tics, Tourette's
syndrome, anxiety, agitation, depression, or tension.
     * Methylphenidate can mask the symptoms of extreme fatigue and can cause
dizziness.  Your ability to perform tasks that require alertness, such as
driving a car or operating potentially dangerous machinery, may be decreased.
Appropriate caution should, therefore, be taken.  A child taking
methylphenidate should be careful while engaging in physical activity.
     * Before having surgery or any other medical or dental treatment, be sure
to tell your doctor that you are taking this medication.
     * Methylphenidate is related to amphetamine and may be habit-forming when
taken for long periods of time (both physical and psychological dependence can
occur).  You should not increase the dosage of this medication or take it for
longer than the prescribed time unless you first consult your doctor.  It is
also important that you not stop taking this medication abruptly; fatigue,
sleep disorders, mental depression, nausea, vomiting, or stomach cramps or
pain could occur.  Your doctor may want to decrease the dosage gradually in
order to prevent these side effects.
     * Methylphenidate can slow growth in children.  Therefore, if this
medication is being taken by a child, your doctor may recommend drug-free
periods during school holidays and summer vacations.  Growth spurts often
occur during these drug-free periods.
     * Children may be more sensitive to certain side effects such as loss of
appetite, stomach pain, trouble sleeping, and weight loss.
     * If cocaine is being used now or was used in the past, taking
methylphenidate may cause severe nervousness, irritability, trouble sleeping,
or possibly irregular heartbeat or seizures.
     * Be sure to tell your doctor if you are pregnant.  Effects of this drug
during pregnancy have not been thoroughly studied in either humans or animals.
Also, tell your doctor if you are breast-feeding an infant.  Small amounts of
methylphenidate may pass into breast milk.

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The material contained here is "FOR INFORMATION ONLY" and should not replace 
the counsel and advice of your personal physician.  Promptly consulting your 
doctor is the best path to a quick and successful resolution of any medical 
problem.
