Methylphenidate

Methylphenidate can start to work after the first dose, but it may take a few weeks for you to feel the full effects. Further improvements in your symptoms can then increase with time.

Your doctor might start you on a low dose and then increase it slowly over two to four weeks, sometimes longer. The doctor will monitor your symptoms and find the dose that works best for you. You should see improvements in your concentration and other symptoms within one month of starting the medicine, usually within the first week of taking it.

Methylphenidate can sometimes affect your growth. Your doctor will check your height and weight at least every six months when you are on methylphenidate.

Up to one in ten children and young people who take methylphenidate might not grow as fast as their friends. If this happens to you, your doctor might stop the methylphenidate for a while.

Methylphenidate can also affect your weight. It makes some people want to eat less, and this might result in weight loss. Weight loss is more common, but methylphenidate can also cause weight gain.
It is very difficult to know how this will affect each person who takes it.

Talk to your doctor or pharmacist if you are concerned about your weight, or changes to your weight, while taking methylphenidate.

A very common side effect of methylphenidate is a dry mouth. Over a long time, this can increase your risk of developing tooth decay or gum disease. Make sure you brush your teeth well and have regular dental check-ups. Speak to your dentist, doctor or pharmacist about things you can do to help.

You may want to let your family and friends know you are taking methylphenidate so they can support you and help you look out for side effects.

Methylphenidate is a stimulant and can therefore affect your sleep by keeping you awake. Talk to your doctor about this if it is a problem for you.

To get the best chance of sleeping normally, you should take your tablets early in the day, and ideally no later than lunchtime or early afternoon.

This advice may vary depending on whether your medicine is an immediate release or slow release product.

Depending on your lifestyle, studying or work, you may find taking a dose of your medication later in the day manages your symptoms better in the evening and helps you more. Discuss this with your doctor to work out what works best for you.

For some people, it can make you feel more drowsy than normal.

If the medication helps to improve your ADHD symptoms, this may also help to improve your sleep.

Alcohol

Drinking alcohol while taking methylphenidate can make the effect of the medication greater and you could experience side effects as if you have taken too much of it.

It is recommended that you don’t drink alcohol until you know how the medicine affects you.

If you decide to drink alcohol, only drink in small amounts and see how it affects you.

When combined, methylphenidate and alcohol can cause unpredictable effects. The combination may increase your blood pressure and heart rate. Methylphenidate can also reduce the effects of alcohol which may mean you end up drinking more than you realise which could be very dangerous.

It is advisable not to drink alone, so that there is someone else there to help you if you need it.

Drinking alcohol every day, or in large amounts, can make your symptoms worse and may mean you won’t get the maximum benefit from your medication.

Street drugs

Methylphenidate is dangerous to take with cocaine, ecstasy or amfetamines. This is because they are all stimulants and may together put too much pressure on your heart and the blood vessels in your brain.

Tetrahydrocannabinol (THC) is a compound found in cannabis. If mixed with methylphenidate this can increase your pulse and blood pressure putting more strain on your heart and blood vessels.

Cannabis and other drugs may have their own side effects on your mental health, like anxiety or psychosis.

There is limited information about the effects of mixing methylphenidate with opioid drugs like heroin or methadone, but this could result in effects which are dangerous and unpredictable.

Methylphenidate is a stimulant, so some people want to use it as a drug to get high or misuse methylphenidate as a ‘performance-enhancer’ to help them work harder or revise for exams. People taking methylphenidate from their doctor can be targeted at school and bullied to give away or sell their medicine. If someone is asking you to give away or sell your medicine, please ask your parent, teacher or doctor to help you. Never share or sell your medicine to anyone else – this is dangerous and illegal.

Methylphenidate can produce a false positive test for amfetamines and LSD on a urine drug screen. Talk to your doctor about this if it is a problem for you.

There are many other street drugs, but we don’t know what effect taking them with methylphenidate will have, so it’s best to be cautious. There is no regulation of street drugs or ‘legal highs’, so even if there are no known issues with the medication you take, the supply you receive might be mixed with other substances that could be dangerous.

Get more advice on our drugs and alcohol guide.

Methylphenidate does not mix well with some other medicines and herbal remedies.

Do not take methylphenidate if you are taking a medicine called a monoamine oxidase inhibitor (MAOI) used for depression, or if you have taken a MAOI in the last 14 days. MAOIs include isocarboxazid, phenelzine, tranylcypromine and moclobemide. Taking a MAOI with methylphenidate may cause a sudden dangerous increase in your blood pressure.

If you are taking other medicines, check with your doctor or pharmacist before taking methylphenidate, as it may affect how well they work or cause side effects.

Tell the doctor if you are going to have an operation. You may need to stop methylphenidate for that day as it does not mix well with some anaesthetics used in surgery. You also need to tell the team doing your operation if you are taking methylphenidate well in advance of it taking place.

Look at the leaflet inside your medicine box for more information about other medicines that can interact with methylphenidate. With some medicines your doctor may need to adjust the dose of your medicines if you take them together. Ask a doctor or pharmacist for more information if you have any questions.

Different brands of methylphenidate contain lactose, wheat starch and gelatine. Check your type if any of these are a problem for you.

Affenid®, Ritalin®, Delmosart®, Matoride XL®,Xaggitin XL® and Concerta XL® tablets may not be suitable for you if you have problems eating some sugars or dairy foods, as they contain lactose. Xenidate XL contains sucrose. An unbranded plain tablet that contains neither lactose nor sucrose is available. Ask your pharmacist.

Ritalin® tablets contain wheat starch. This is still okay to take if you have coeliac disease, but not if you have wheat intolerance leading to chronic diarrhoea (fatty, loose poo).

Ritalin® tablets, Equasym XL® capsules and Medikinet XL® capsules contain gelatine.

If you need to avoid animal products such as gelatine, please note that this is often found in capsules but also in some tablet formulations. Ask your pharmacist if you have any questions about the ingredients.

Further information about practical considerations for medicines if you need to avoid animal products can be found on the Vegan Society website.

Taking methylphenidate may give you blurred vision, make you feel dizzy, or affect your focus when you start taking it.

It may be best to stop doing things like driving a car, riding a bike, or anything else that needs a lot of focus for the first few days until you know how it affects you.

Most people drive as normal while taking methylphenidate. If you are worried about this or have any concerns you would like to discuss, speak to your doctor or pharmacist.

You must tell DVLA if your ADHD or your ADHD medication affects your ability to drive safely. It is illegal to drive with medication in your body if it impairs your driving. You do not need to tell DVLA about your condition unless you think that it may affect your ability to drive safely. If you think you driving might be affected by your ADHD or your medication, don’t drive and speak to your doctor.

You may also have to prove that you have been given methylphenidate on prescription, so you should keep your repeat prescription slip or get a letter to explain it from your doctor.

Pregnancy

Taking methylphenidate in early pregnancy has been associated with an increased risk of miscarriage.

If you become pregnant while you are on methylphenidate, you should carry on taking it and make an appointment to see your doctor as soon as possible. They can discuss the benefits and risks of continuing methylphenidate and help you to make a decision that is best for you and your baby.

They may refer you to a specialist perinatal mental health team to support you with this decision.

You can find out more information about taking amitriptyline during pregnancy at Bumps (Best Use of Medicines in Pregnancy).

Any decisions about stopping or avoiding medication when you are pregnant need to be discussed carefully with your doctor. If you and your doctor agree that it is best for you to continue taking methylphenidate while pregnant, you should tell your midwife. If you are planning to get pregnant, it is recommended that you take folic acid while you are trying for a baby and during pregnancy. It is safe to take this together with methylphenidate.

Postnatal

Some newborn babies whose mothers take methylphenidate during pregnancy can get withdrawal symptoms at birth and soon after, like restlessness, feeding problems or being floppy.

Tell your midwife if you are taking methylphenidate, so that they can help if the baby has nay symptoms after birth.

Breastfeeding

Methylphenidate can be passed to the baby in breastmilk in very small or undetectable amounts.

If your baby was born early, then breastfeeding while you are taking methylphenidate may not be recommended. Talk to your midwife and doctor about feeding options.

If you breastfeed while taking methylphenidate, seek urgent medical advice if your baby becomes restless, very sleepy or develops feeding problems.

Please talk to your midwife, doctor or pharmacist if you want to breastfeed whilst taking methylphenidate. They can discuss feeding options with you and help you to weigh up the benefits and possible risks based on what we currently know so you can make a decision that is best for you and your baby.

Sex

Methylphenidate can have side effects that may affect your sex life. These include:

• having a lower sex drive or not wanting to have sex
• losing weight, which might impact your confidence
• mild hair loss, which can affect your body confidence

Some other uncommon or rare side effects include some breast growth or a long-lasting and painful erection (priapism), which needs to be treated in hospital.

Untreated ADHD can have a negative effect on your sex life, so if methylphenidate helps you then the positive effects can include improving your desire, experience and enjoyment of sex as your symptoms settle and you can concentrate on your relationships.

Fertility

There is currently no evidence to suggest that methylphenidate has any effect on fertility.

Talk to your doctor about your methylphenidate if you are trying to get pregnant or planning a family.

Methylphenidate is a banned substance in competitive sport. If you play sports to a high level, and you want to compete where testing will happen you need to inform regulators. You must not take methylphenidate during competitions. Discuss this with your doctor and they can recommend other treatment options for managing your ADHD during this time.

Most people play sports as normal while taking methylphenidate, but if methylphenidate affects your concentration or co-ordination, then you may want to wait to see if those effects go away before playing sports that need a lot of focus. If you have any concerns, discuss this with your doctor.

Taking methylphenidate may affect your concentration, give you blurred eyesight and make you feel dizzy or tired.

Ideally, it’s best not to take methylphenidate for the first time just before your exams.

It is not possible to predict how the medication will make you feel, and if you do get any side effects, these are more likely to occur when you first start taking methylphenidate.

You should talk to your doctor about any future exams if you are starting methylphenidate. You might decide together to delay starting it until you have done them.

If they are more than a month away, however, you might find that it is better to start methylphenidate to improve your sleep, motivation and ability to study.

Most people take exams as normal while taking methylphenidate, but if you have any concerns, discuss this with your doctor. give you blurred vision, make you feel dizzy, or affect your focus when you start taking it.