Methylphenidate controlled-release belongs to the family of medications known as stimulants. It is used to treat attention deficit hyperactivity disorder (ADHD). It is used for children 6 years of age and older, adolescents, and adults who have been diagnosed with ADHD to help increase attention and decrease restlessness.

Other measures (e.g., psychological, educational, and social therapies) are used along with methylphenidate controlled-release as part of an overall treatment program for ADHD.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The dose of methylphenidate controlled release is determined according to the needs of the person taking the medication. The dose is usually started low and increased gradually at 5 to 7 day intervals.

For people who are not already taking methylphenidate, the usual starting dose is 25 mg, once daily, in the morning.

For people already taking methylphenidate, the starting dose depends on the dose being taken. The maximum daily dose is 70 mg for children and adolescents and 100 mg for adults.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones above, do not change the way that you are taking the medication without consulting your doctor.

Methylphenidate may be taken with or without food. Swallow this medication whole with water or other liquids. Do not crush or chew the capsules. This medication is designed to be released into the body over time. When the contents of the capsule are crushed, the medication is released into the body faster than it should be and may cause serious side effects.

If desired, the capsule may be opened and the contents of the capsule (the medication) may be sprinkled onto a tablespoon of apple sauce, ice cream, or yogurt. The entire mixture should be consumed within 10 minutes without chewing. Rinse your mouth with water and swallow the water immediately.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Avoid taking this medication late in the day, as it may cause difficulty sleeping. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from moisture, and keep it out of the reach of children.

25 mg
Each blue capsule, imprinted with "MLR-02" and "25 mg" in black ink, contains 25 mg of methylphenidate. Nonmedicinal ingredients: ammonio methacrylate copolymer dispersion (type B), anionic copolymer (consisting of methyl acrylate, methyl methacrylate and methacrylic acid), glyceryl monostearate, hypromellose, polyethylene glycol, polysorbate, silicon dioxide, sodium hydroxide, sodium lauryl sulfate, sorbic acid, sugar spheres, triethyl citrate, and FD&C Blue No. 1.

35 mg
Each orange capsule, imprinted with "MLR-02" and "35 mg" in black ink, contains 35 mg of methylphenidate. Nonmedicinal ingredients: ammonio methacrylate copolymer dispersion (type B), anionic copolymer (consisting of methyl acrylate, methyl methacrylate and methacrylic acid), glyceryl monostearate, hypromellose, polyethylene glycol, polysorbate, silicon dioxide, sodium hydroxide, sodium lauryl sulfate, sorbic acid, sugar spheres, triethyl citrate, Yellow No. 6, and titanium dioxide.

45 mg
Each yellow capsule, imprinted with "MLR-02" and "45 mg" in black ink, contains 45 mg of methylphenidate. Nonmedicinal ingredients: ammonio methacrylate copolymer dispersion (type B), anionic copolymer (consisting of methyl acrylate, methyl methacrylate and methacrylic acid), glyceryl monostearate, hypromellose, polyethylene glycol, polysorbate, silicon dioxide, sodium hydroxide, sodium lauryl sulfate, sorbic acid, sugar spheres, triethyl citrate, Yellow No. 5, and titanium dioxide.

55 mg
Each light green capsule, imprinted with "MLR-02" and "55 mg" in black ink, contains 55 mg of methylphenidate. Nonmedicinal ingredients: ammonio methacrylate copolymer dispersion (type B), anionic copolymer (consisting of methyl acrylate, methyl methacrylate and methacrylic acid), glyceryl monostearate, hypromellose, polyethylene glycol, polysorbate, silicon dioxide, sodium hydroxide, sodium lauryl sulfate, sorbic acid, sugar spheres, triethyl citrate, Blue No. 1, yellow iron oxide, and titanium dioxide.

70 mg
Each light green capsule, imprinted with "MLR-02" and "70 mg" in black ink, contains 70 mg of methylphenidate. Nonmedicinal ingredients: ammonio methacrylate copolymer dispersion (type B), anionic copolymer (consisting of methyl acrylate, methyl methacrylate and methacrylic acid), glyceryl monostearate, hypromellose, polyethylene glycol, polysorbate, silicon dioxide, sodium hydroxide, sodium lauryl sulfate, sorbic acid, sugar spheres, triethyl citrate, black iron oxide, and titanium dioxide.

85 mg
Each white capsule, imprinted with "MLR-02" and "85 mg" in black ink, contains 85 mg of methylphenidate. Nonmedicinal ingredients: ammonio methacrylate copolymer dispersion (type B), anionic copolymer (consisting of methyl acrylate, methyl methacrylate and methacrylic acid), glyceryl monostearate, hypromellose, polyethylene glycol, polysorbate, silicon dioxide, sodium hydroxide, sodium lauryl sulfate, sorbic acid, sugar spheres, triethyl citrate, and titanium dioxide.

100 mg
Each cream-coloured capsule, imprinted with "MLR-02" and "100 mg" in black ink, contains 100 mg of methylphenidate. Nonmedicinal ingredients: ammonio methacrylate copolymer dispersion (type B), anionic copolymer (consisting of methyl acrylate, methyl methacrylate and methacrylic acid), glyceryl monostearate, hypromellose, polyethylene glycol, polysorbate, silicon dioxide, sodium hydroxide, sodium lauryl sulfate, sorbic acid, sugar spheres, triethyl citrate, Blue No. 1, yellow iron oxide, red iron oxide, and titanium dioxide.

Do not take methylphenidate controlled-release if you:

• are allergic to methylphenidate or any ingredients of the medication
• are taking a monoamine oxidase (MAO) inhibitor (e.g., phenelzine, tranylcypromine) or have taken one in the last 14 days
• have advanced hardening of the arteries (arteriosclerosis)
• have anxiety, tension, or agitation
• have glaucoma (increased pressure in the eye)
• have heart disease
• have moderate-to-severe high blood pressure
• have motor tics, Tourette's syndrome, or a family history of Tourette's syndrome
• have an overactive thyroid gland
• have a history of drug abuse

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• agitation, nervousness, or anxiety
• diarrhea
• dizziness
• drowsiness
• dry mouth
• headache
• loss of appetite
• nausea
• stomach pain
• trouble sleeping
• weight changes (increase or decrease)
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abnormal thoughts or behaviour
• aggressive or hostile behavior
• breast swelling in men and boys
• blurred vision
• confusion
• difficulty controlling impulses
• difficulty opening mouth
• hallucinations (hearing, seeing, or feeling things that are not actually there)
• increased blood pressure
• increased heart rate
• increased sweating
• loss of bladder control
• muscle twitching or tics
• swollen hands or feet
• symptoms of Raynaud's Phenomenon (e.g., discolouration of the fingers and toes, pain, sensation of cold and/or numbness)
• symptoms of bladder infection (e.g., increased need to urinate, pain with urination, blood in the urine)
• symptoms of depression (e.g., losing interest in your usual activities, feeling sad, having thoughts of suicide)
• symptoms of mania (e.g., decreased need for sleep, elevated or irritable mood, racing thoughts)
• symptoms of muscle breakdown (e.g., weakness, muscle pain or spasms, red-brown coloured urine)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• convulsions (seizures)
• long-lasting, painful erection (4 hours or longer)
• signs of a serious allergic reaction (difficulty breathing; hives; swelling of the face, lips, eyes, mouth, or throat)
• signs of stroke (e.g., sudden or severe headache; sudden loss of coordination; vision changes; sudden slurring of speech; or unexplained weakness, numbness, or pain in arm or leg)
• signs of Tourette's Syndrome (e.g., repetitive motor (movement) tics or verbal tics)
• sudden signs of heart problems (e.g., fast heartbeat, palpitations, chest pain, shortness of breath, fainting)
• suicidal thoughts or behaviour
• symptoms of serotonin toxicity (e.g., confusion, fast heartbeat, hallucinations, restlessness, shaking, shivering, sudden jerking of muscles, sweating)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol use: Drinking alcohol while taking methylphenidate may increase the risk of nervous system side effects. Avoid combining alcohol with this medication.

Behaviour or mood changes: There have been reports of agitation, aggression, hallucinations, and symptoms of depression in people taking this medication. If you experience these side effects or notice them in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.

Blood pressure: This medication can increase blood pressure. If you have high blood pressure, or heart problems, talk to your doctor before taking this medication.

Circulation problems: Like other stimulant medications, methylphenidate controlled-release may cause problems with blood circulation, particularly to the fingers and toes. If you notice unusual episodes of cold fingers or toes, or develop sores that aren't healing well, talk to your doctor.

Drowsiness/reduced alertness: Methylphenidate controlled-release may cause dizziness or vision changes, which could affect your ability to drive or operate machinery. Avoid activities requiring alertness until you have determined how this medication affects you.

Drug dependence: There does not appear to be an increased risk of dependence or addiction with the use of methylphenidate by children and adolescents. However, abuse of methylphenidate is possible by certain individuals. Regular, long-term abuse can lead to high levels of tolerance and psychological dependence, and a wide range of abnormal behaviours. If you have a history of drug or alcohol dependence, you should be closely monitored by your doctor while using this medication.

Drug holidays: It is sometimes helpful to stop methylphenidate to determine whether it is still needed to help the ADHD symptoms. Talk to your doctor about whether a drug holiday might be appropriate for you or your child. Do not stop this medication without discussing it with your doctor first.

Exercise: People participating in strenuous exercise or activities should consult their doctor before taking methylphenidate controlled-release. Strenuous exercise combined with the effects of methylphenidate on heart and blood pressure may increase the risk of sudden death.

Heart problems and blood pressure: This medication can increase heart rate and blood pressure. It may also increase the risk of sudden death for people with heart problems. This medication should generally not be used by people with known structural heart abnormalities (such as abnormal size, missing or poorly functioning heart valves, or problems with blood vessels connected to the heart), or a family history of sudden or cardiac death. People taking more than one stimulant medication for ADHD should be closely monitored by their doctor.

Misuse of methylphenidate may also be associated with sudden death and other serious heart-related effects.

Long-term use: If you will be using methylphenidate controlled-release for a long period of time, your doctor will want you to have regular heart checkups, blood pressure checks and lab tests to monitor your liver and blood.

Prolonged erections: Rarely, prolonged and painful erections (called priapism) have been reported by patients using methylphenidate. Priapism is a very rare condition that can affect children as well as adults. It may occur after increasing the dose or stopping the medication for a short period of time.

Patients who develop priapism should seek immediate medical attention to prevent potential long-term effects on the penis.

Psychiatric conditions: Methylphenidate may cause other mental health conditions to develop or become worse. Severe mood swings, unusual excitement, increased or new aggressive behavior, or other behavior changes may indicate changes in mental health. If you notice any change in thinking or behavior in yourself or family members, contact your doctor.

Seizures: There is some evidence that methylphenidate controlled-release may increase the risk of seizures, particularly for people who have had seizures in the past. If you have a history of epilepsy or medical conditions that increase the risk of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Serotonin toxicity: Severe reactions are possible when methylphenidate is combined with other medications that act on serotonin, such as tricyclic antidepressants and serotonin reuptake inhibitors, medications used to treat depression. These combinations must be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation. Coma and death are possible.

If you are taking antidepressants, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Stopping the medication: Check with your doctor before stopping this medication. Suddenly stopping the medication may cause mental conditions or hyperactivity to return.

Suicidal or agitated behaviour: People taking this medication may feel agitated (restless, anxious, aggressive, emotional, and feeling not like themselves), or they may want to hurt themselves or others. These symptoms may occur within several weeks after starting this medication. If you experience these side effects or notice them in a family member who is taking this medication, contact your doctor immediately. You should be closely monitored by your doctor for emotional and behaviour changes while taking this medication.

Suppression of growth: Growth suppression (i.e., less increase in height or weight than usual) has been reported for children using stimulants such as methylphenidate for long periods of time. It is not known if this medication causes growth suppression in children (i.e., less increase in height or weight than usual). Children who need long-term treatment should be carefully monitored for growth.

Tics: This medication may cause tics or worsening of motor or verbal tics. If you have Tourette's syndrome or develop tics while on this medication, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Vision: Rarely, people taking methylphenidate controlled-release have experienced vision changes. If you notice any changes in your vision, contact your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are breast-feeding and taking methylphenidate controlled-release, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication have not been established for and should not be used by children less than 6 years of age.

For a full list of interactions, use the Drug Interaction Checker available on the Drugs.com website.

If you are taking other medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.