Composition
Tab 10 mg: Methylphenidate HCI 10 mg. MR Tab 18 mg/36 mg: Methylphenidate HCI 18 mg/36 mg.
Indications & Dosage
Attention deficit hyperactivity disorder: Adult: Initially 5 mg 2-3 times a day, dose is increased if necessary at weekly intervals according to response, up to 100 mg daily in 2-3 divided doses, if effect wears off in evening (with rebound hyperactivity) a dose at bedtime may be appropriate. Treatment may be started using a modified-release preparation (MR Tab) Children 6-17 yrs: Initially 5 mg 1-2 times a day, increased in steps of 5-10 mg daily if required, at weekly intervals, up to 60 mg daily in 2-3 divided doses, increased if necessary up to 2.1 mg/kg daily in 2-3 divided doses, discontinue if no response after 1 month, if effect wears off in evening (with rebound hyperactivity) a dose at bedtime may be appropriate. Treatment may be started using a modified-release preparation (MR Tab). Narcolepsy: Adult: 10-60 mg daily in divided doses; usual dose 20-30 mg daily in divided doses, dose to be taken before meals.
Contraindications
Cardiovascular disease, cerebrovascular disorders, anorexia nervosa, arrhythmias, cardiomyopathy, heart failure, hyperthyroidism, phaeochromocytoma, psychosis, severe depression, severe hypertension, structural cardiac abnormalities, suicidal ideation, uncontrolled bipolar disorder, vasculitis, hypersensitivity to methylphenidate.
Precautions
Agitation, anxiety, epilepsy (discontinue if increased seizure frequency), alcohol dependence, drug dependence, family history of Tourette syndrome, susceptibility to angle-closure glaucoma, tics. In psychotic patients this drug may exacerbate symptoms of behavioural disturbances and thought disorders. Prolonged use can lead to marked tolerance, psychic dependence.
Interactions
Hypertensives, antihypertensives, MAOIs, tricyclic antidepressants, coumarin, some anticonvulsants and phenylbutazone.
Pregnancy
Avoid unless potential benefit outweighs risk.
Lactation
Caution advised or avoid
Side Effects
Aggression, alopecia, anorexia, arrhythmias, arthralgia, asthenia, drowsiness, changes in blood pressure, depression, GI disturbance, dyspepsia, dizziness, dry mouth, fever, headache, insomnia, irritability, movement disorders, nasopharyngitis, nervousness, palpitation, pruritus, rash, tachycardia, tics, vomiting, abnormal dreams, confusion, dyspnea, epistaxis, haematuria, muscle cramps, suicidal ideation, urinary frequency, bradycardia, convulsions. Rare: Angina, sweating, visual disturbances, supraventricular tachycardia