Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For methylphenidate, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to methylphenidate. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies on effects in pregnancy have not been done in either humans or animals.

Breast-feeding—It is not known whether methylphenidate passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with the doctor.

Children—Loss of appetite, trouble in sleeping, stomach pain, fast heartbeat, and weight loss may be especially likely to occur in children, who are usually more sensitive than adults to the effects of methylphenidate. Some children who used medicines like methylphenidate for a long time grew more slowly than expected. It is not known whether long-term use of methylphenidate causes slowed growth. The doctor should regularly measure the height and weight of children who are taking methylphenidate. Some doctors recommend stopping treatment with methylphenidate during times when the child is not under stress, such as on weekends.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of methylphenidate in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking methylphenidate, it is especially important that your health care professional know if you are taking any of the following:

• Amantadine (e.g., Symmetrel) or
• Amphetamines or
• Appetite suppressants (diet pills) or
• Bupropion (e.g., Wellbutrin, Zyban) or
• Caffeine (e.g., NoDoz) or
• Chlophedianol (e.g., Ulone) or
• Cocaine or
• Medicine for asthma or other breathing problems or
• Medicine for colds, sinus problems, hay fever or other allergies (including nose drops or sprays) or
• Nabilone (e.g., Cesamet) or
• Pemoline (e.g., Cylert)—Using these medicines with methylphenidate may cause severe nervousness, irritability, trouble in sleeping, or possibly irregular heartbeat or seizures

• Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])—Taking methylphenidate while you are taking or less than 2 weeks after taking an MAO inhibitor may cause sudden extremely high blood pressure and severe convulsions; at least 14 days should be allowed between stopping treatment with an MAO inhibitor and starting treatment with methylphenidate

• Pimozide (e.g., Orap)—Pimozide is not used to treat tics that are caused by medicines. Before tics are treated with pimozide, the doctor should find out if the tics are caused by methylphenidate

Other medical problems—The presence of other medical problems may affect the use of methylphenidate. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse (or history of) or
• Drug abuse or dependence (or history of)—Dependence on methylphenidate may be more likely to develop

• Epilepsy or other seizure disorders—The risk of having convulsions (seizures) may be increased

• Gilles de la Tourette's disorder (or family history of) or
• Glaucoma or
• High blood pressure or
• Psychosis or
• Severe anxiety, agitation, tension, or depression or
• Tics (other than Tourette's disorder)—Methylphenidate may make the condition worse