Methylphenidate Hydrochloride interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Alcohol may exacerbate the adverse central nervous system effects of psychoactive drugs, including methylphenidate.

  What to do: Patients treated with methylphenidate should be advised to avoid alcohol or medications that contain alcohol.

  3 sources

  1. "Product Information. Metadate CD (methylphenidate)." Celltech Pharmaceuticals Inc (2022):
  2. "Product Information. Concerta (methylphenidate)." Alza (2002):
  3. "Product Information. Ritalin LA (methylphenidate)." Quality Care Products/Lake Erie Medical (2013):

Conditions

Conditions in which Methylphenidate Hydrochloride needs care, as documented in this source.

• Epilepsy

  Major

  There is some clinical evidence that methylphenidate may lower the seizure threshold, occasionally even in patients without a history of seizures or prior EEG abnormalities. Therapy with methylphenidate (racemic) or dexmethylphenidate (the more pharmacologically active d-enantiomer) should be administered cautiously in patients with or predisposed to seizures. The medication should be discontinued if seizures occur during its use.

  No sources recorded

• Glaucoma

  Major

  The use of most CNS stimulants is contraindicated in patients with glaucoma, as these agents exhibit sympathomimetic activity and may induce mydriasis provoking an increase in intraocular pressure.

  9 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals (2001):
  3. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  4. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  5. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc (2001):
  6. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  7. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  8. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):

  Show all 9 sourcesShow fewer sources

  9. "Product Information. Phendimetrazine Tartrate SR (phendimetrazine)." Sandoz Inc (2012):

• Heart Diseases

  Major

  The use of CNS stimulants is contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in adults and children taking CNS stimulant treatment. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

  13 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Provigil (modafinil)." Cephalon, Inc (2001):
  3. "Product Information. Dopram (doxapram)." West Ward Pharmaceutical Corporation (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  7. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  8. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Concerta (methylphenidate)." Alza (2002):
  10. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
  11. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
  12. "Product Information. Nuvigil (armodafinil)." Cephalon Inc (2007):
  13. "Product Information. Phendimetrazine Tartrate SR (phendimetrazine)." Sandoz Inc (2012):

• Hypertension

  Major

  CNS stimulant medications have shown to increase blood pressure, and their use might be contraindicated in patients with severe hypertension. Caution should be used when administering to patients with preexisting high blood pressure and other cardiovascular conditions. All patients under treatment should be regularly monitored for changes in blood pressure and heart rate.

  13 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Provigil (modafinil)." Cephalon, Inc (2001):
  3. "Product Information. Dopram (doxapram)." West Ward Pharmaceutical Corporation (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  7. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  8. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Concerta (methylphenidate)." Alza (2002):
  10. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
  11. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
  12. "Product Information. Nuvigil (armodafinil)." Cephalon Inc (2007):
  13. "Product Information. Phendimetrazine Tartrate SR (phendimetrazine)." Sandoz Inc (2012):

• Liver Diseases

  Major

  In general, CNS stimulants are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with CNS stimulants should be administered cautiously in patients with moderate to severe liver disease, and the dosage should be adjusted accordingly. Additionally, postmarketing reports have shown that atomoxetine can cause severe liver injury. Laboratory testing should be done at the first sign or symptom of liver dysfunction (jaundice, dark urine, upper quadrant tenderness) and treatment should be discontinued in patients with evidence of liver injury.

  13 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Provigil (modafinil)." Cephalon, Inc (2001):
  3. "Product Information. Dopram (doxapram)." West Ward Pharmaceutical Corporation (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  7. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  8. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Concerta (methylphenidate)." Alza (2002):
  10. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
  11. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
  12. "Product Information. Nuvigil (armodafinil)." Cephalon Inc (2007):
  13. "Product Information. Phendimetrazine Tartrate SR (phendimetrazine)." Sandoz Inc (2012):

• Mental Disorders

  Major

  The use of central nervous system (CNS) stimulants is contraindicated in patients with marked agitation and/or anxiety, since these symptoms may be aggravated. CNS stimulants may also exacerbate symptoms of behavior disturbance and thought disorder in psychotic patients, particularly children. Therapy with CNS stimulants should be administered cautiously in patients with a history of psychosis or a predisposition to agitated states.

  12 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Cylert (pemoline)." Abbott Pharmaceutical (2001):
  3. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc (2001):
  7. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  8. "Product Information. Prelu-2 (phendimetrazine)." Boehringer-Ingelheim (2001):

  Show all 12 sourcesShow fewer sources

  9. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  10. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals (2001):
  11. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  12. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):

• Mental Disorders

  Major

  The use of CNS stimulants can cause psychotic or maniac symptoms, suicidal ideation, aggression and can exacerbate symptoms of behavior disturbance and thought disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders, and all patients should be monitored closely, specially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. All patients receiving treatment should be screened for bipolar disease prior to initiation. If any psychiatric symptoms emerge or are exacerbated, treatment suspension should be considered. CNS stimulants are contraindicated in patients with marked agitation or anxiety.

  13 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Provigil (modafinil)." Cephalon, Inc (2001):
  3. "Product Information. Dopram (doxapram)." West Ward Pharmaceutical Corporation (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  7. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  8. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Concerta (methylphenidate)." Alza (2002):
  10. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
  11. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
  12. "Product Information. Nuvigil (armodafinil)." Cephalon Inc (2007):
  13. "Product Information. Phendimetrazine Tartrate SR (phendimetrazine)." Sandoz Inc (2012):

• Substance-Related Disorders

  Major

  Central nervous system (CNS) stimulants, especially amphetamines, have significant potential for habituation and abuse. Tolerance, psychological dependence and severe social dysfunction can develop after prolonged use. Frank psychotic episodes may also occur in association with chronic intoxication. Therapy with CNS stimulants should be administered cautiously, if at all, in patients with a history of alcohol or substance abuse. The use of amphetamines is considered by manufacturers to be contraindicated in such patients.

  12 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Cylert (pemoline)." Abbott Pharmaceutical (2001):
  3. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc (2001):
  7. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  8. "Product Information. Prelu-2 (phendimetrazine)." Boehringer-Ingelheim (2001):

  Show all 12 sourcesShow fewer sources

  9. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  10. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals (2001):
  11. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  12. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):

• Tics

  Major

  Central nervous system (CNS) stimulants have been reported to exacerbate Tourette's syndrome and other motor and phonic tics. Therapy with CNS stimulants, if necessary, should be administered cautiously in patients with tic disorders or family history of Tourette's syndrome. The manufacturers of the CNS stimulants, methylphenidate (racemic) and dexmethylphenidate (the more pharmacologically active d-enantiomer), consider their use to be contraindicated in such patients.

  12 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Cylert (pemoline)." Abbott Pharmaceutical (2001):
  3. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc (2001):
  7. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  8. "Product Information. Prelu-2 (phendimetrazine)." Boehringer-Ingelheim (2001):

  Show all 12 sourcesShow fewer sources

  9. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  10. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals (2001):
  11. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  12. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):

• Bipolar Disorder

  Moderate

  Central nervous system (CNS) stimulants may induce a mixed/manic episode in patients with bipolar disorder. Prior to initiating treatment, screen patients for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or a family history of suicide, bipolar disorder, and depression). Close monitoring is recommended when using these agents in patients with bipolar disorders.

  12 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Cylert (pemoline)." Abbott Pharmaceutical (2001):
  3. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc (2001):
  7. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  8. "Product Information. Prelu-2 (phendimetrazine)." Boehringer-Ingelheim (2001):

  Show all 12 sourcesShow fewer sources

  9. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  10. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals (2001):
  11. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  12. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):

• Epilepsy

  Moderate

  Due to general central nervous system stimulation, therapy with CNS stimulant drugs may cause seizures. These drugs may lower the convulsive threshold in patients with prior history of seizures or EEG abnormalities, and very rarely in patients with no previous history of seizures. Therapy with CNS stimulants should be used with caution in patients with or predisposed to seizures. If seizures appear, therapy should be discontinued.

  13 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Provigil (modafinil)." Cephalon, Inc (2001):
  3. "Product Information. Cylert (pemoline)." Abbott Pharmaceutical (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  7. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  8. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Concerta (methylphenidate)." Alza (2002):
  10. "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company (2002):
  11. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
  12. "Product Information. Nuvigil (armodafinil)." Cephalon Inc (2007):
  13. "Product Information. Phendimetrazine Tartrate SR (phendimetrazine)." Sandoz Inc (2012):

• Hematologic Diseases

  Moderate

  Hematologic toxicity, including thrombocytopenia, easy bruisability, epistaxis, leukopenia, anemia and eosinophilia, has been reported rarely during use of methylphenidate. However, a causal relationship has not been established. Therapy with methylphenidate (racemic) or dexmethylphenidate (the more pharmacologically active d-enantiomer) should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Periodic hematologic monitoring may be appropriate in all patients during prolonged therapy.

  2 sources

  1. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals (2001):
  2. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):

• Intestinal Obstruction

  Moderate

  The extended-release formulation of methylphenidate (Concerta) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. The extended-release formulation of methylphenidate should ordinarily not be administered in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic (e.g., small bowel inflammatory disease, "short gut" syndrome due to adhesions or decreased transit time, past history of peritonitis, cystic fibrosis, chronic intestinal pseudo-obstruction, or Meckel's diverticulum). The medication should only be used in patients who are able to swallow the tablet whole.

  1 source

  1. "Product Information. Concerta (methylphenidate)." Alza (2002):

• Kidney Diseases

  Moderate

  Overall CNS stimulants should be administered with caution in patients with significantly impaired renal function as the reduction in the rate of elimination may alter the therapeutic response. The dosage should be adjusted accordingly.

  5 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Provigil (modafinil)." Cephalon, Inc (2001):
  3. "Product Information. Dopram (doxapram)." West Ward Pharmaceutical Corporation (2001):
  4. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  5. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):

• Psychotic Disorders

  Moderate

  Central nervous system (CNS) stimulants may exacerbate symptoms of behavior disturbance and thought disorder in patients with a preexisting psychotic disorder. Close monitoring is recommended when using these agents in patients with psychotic disorders.

  13 sources

  1. "Product Information. Fastin (phentermine)." SmithKline Beecham (2001):
  2. "Product Information. Cylert (pemoline)." Abbott Pharmaceutical (2001):
  3. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals (2001):
  4. "Product Information. Desoxyn (methamphetamine)." Abbott Pharmaceutical (2001):
  5. "Product Information. Dexedrine (dextroamphetamine)." SmithKline Beecham (2001):
  6. "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc (2001):
  7. "Product Information. Didrex (benzphetamine)." Pharmacia and Upjohn (2001):
  8. "Product Information. Prelu-2 (phendimetrazine)." Boehringer-Ingelheim (2001):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals (2001):
  10. "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals (2001):
  11. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc (2001):
  12. "Product Information. Vyvanse (lisdexamfetamine)." Shire US Inc (2007):
  13. "Product Information. Fintepla (fenfluramine)." Zogenix, Inc (2020):

Therapeutic duplication

Drug classes that overlap with Methylphenidate Hydrochloride, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• cerebral stimulants

  The recommended maximum number of medicines in the 'cerebral stimulants' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'cerebral stimulants' category.

  Example product in the source data (US market): Migraten