Monitor Closely (1)dopexamine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. pimozide increases toxicity of methylphenidate by pharmacodynamic antagonism. amoxapine, methylphenidate. Use Caution/Monitor. Interaction more likely in certain predisposed pts. Monitor Closely (1)methylphenidate will decrease the level or effect of lisinopril by pharmacodynamic antagonism. Methylphenidate may diminish antihypertensive effects. Use Caution/Monitor. Interaction more likely in certain predisposed pts. hydralazine, methylphenidate. Additive vasospasm; risk of hypertension. Methylphenidate may diminish antihypertensive effects. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. desipramine, methylphenidate. Risk of acute hypertensive episode. Use Caution/Monitor. Contraindicated. Risk of acute hypertensive episode. Use Caution/Monitor. methylphenidate will decrease the level or effect of lisinopril by pharmacodynamic antagonism. Other (see comment). Monitor BP. Serious - Use Alternative (1)ergotamine, methylphenidate. Use Caution/Monitor. Serious - Use Alternative (1)methylergonovine, methylphenidate. Use Caution/Monitor. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Monitor BP. Risk of acute hypertensive episode. Interaction more likely in certain predisposed pts. Use Caution/Monitor. Use Caution/Monitor. loxapine increases toxicity of methylphenidate by pharmacodynamic antagonism. Monitor BP. The recommended dose of CONCERTA for patients who are currently taking methylphenidate twice daily or three times daily at doses of 10 to 60 mg/day is provided in Table 2. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. Monitor BP. Potential for additive CNS stimulation. Potential for additive CNS stimulation. Use Caution/Monitor. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Modify Therapy/Monitor Closely. protriptyline, methylphenidate. Methylphenidate may diminish antihypertensive effects. Methylphenidate may diminish antihypertensive effects. Other (see comment). Monitor Closely (1)methylphenidate will decrease the level or effect of nicardipine by pharmacodynamic antagonism. Amifampridine. Modify Therapy/Monitor Closely. Use Caution/Monitor. Monitor Closely (1)methylphenidate will decrease the level or effect of telmisartan by pharmacodynamic antagonism. Monitor Closely (1)aluminum hydroxide decreases effects of methylphenidate by enhancing GI absorption. only. Use Caution/Monitor. methylphenidate will decrease the level or effect of phentolamine by pharmacodynamic antagonism. Applies only to oral form of both agents. Mechanism: pharmacodynamic synergism. Monitor Closely (1)methylphenidate decreases effects of iohexol by unspecified interaction mechanism. Use Caution/Monitor. Potential for additive CNS stimulation. Risk of acute hypertensive episode. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. Risk of acute hypertensive episode. Mechanism: unknown. Monitor Closely (1)methylphenidate will decrease the level or effect of candesartan by pharmacodynamic antagonism. However, Ritalin is a short-acting stimulant that boosts focus and attention quickly. Methylphenidate may diminish antihypertensive effects. Avoid or Use Alternate Drug. Use Caution/Monitor. amitriptyline, methylphenidate. Monitor BP. Contraindicated. Use Caution/Monitor. Serious - Use Alternative (1)yohimbe, methylphenidate. Most Monitor Closely (1)risperidone increases toxicity of methylphenidate by pharmacodynamic antagonism. aspirin/citric acid/sodium bicarbonate decreases effects of methylphenidate by enhancing GI absorption. Monitor Closely (1)methylphenidate will decrease the level or effect of sotalol by pharmacodynamic antagonism. Potential for additive CNS stimulation. Monitor Closely (1)methylphenidate will decrease the level or effect of phentolamine by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Either increases effects of the other by pharmacodynamic synergism. Risk of acute hypertensive episode. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Medscape Education. Applies only to oral form of both agents. Mechanism: pharmacodynamic synergism. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. Either increases effects of the other by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Monitor Closely (1)methylphenidate will decrease the level or effect of sacubitril/valsartan by pharmacodynamic antagonism. Interaction more likely in certain predisposed pts. Use Caution/Monitor. Your doctor may adjust your dose as needed. Monitor Closely (1)bromocriptine, methylphenidate. Use Caution/Monitor. Serious - Use Alternative (1)lofepramine, methylphenidate. Monitor Closely (1)promazine, methylphenidate. Interaction more likely in certain predisposed pts. Comment: Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Tranylcypromine. Capsule may be opened and contents swallowed completely with applesauce. Use Caution/Monitor. cariprazine increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. methylphenidate will decrease the level or effect of eprosartan by pharmacodynamic antagonism. olanzapine increases toxicity of methylphenidate by pharmacodynamic antagonism. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. Monitor Closely (1)green tea, methylphenidate. Use Caution/Monitor. Monitor Closely (1)dexfenfluramine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Risk of V tach, HTN. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Dosing recommendations are based on current dose regimen and clinical judgment. Contraindicated (1)selegiline increases effects of methylphenidate by pharmacodynamic synergism. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Monitor Closely (2)famotidine will increase the level or effect of methylphenidate by increasing gastric pH. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. and formulary information changes. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Use Caution/Monitor. clomipramine, methylphenidate. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. Monitor BP. Controlled studies in pregnant women show no evidence of fetal risk. Additive vasospasm; risk of hypertension. Potential for additive CNS stimulation. Mechanism: unknown. Use Caution/Monitor. Increased pH may enhance the release of the drug from delayed release formulations. Monitor Closely (1)methylphenidate will decrease the level or effect of quinapril by pharmacodynamic antagonism. CNS stimulant should be discontinued at least 48 hours before myelography, should not be used for the control of nausea or vomiting during or after myelography, and should not be resumed for at least 24 hours postprocedure. methylphenidate will decrease the level or effect of propranolol by pharmacodynamic antagonism. quetiapine increases toxicity of methylphenidate by pharmacodynamic antagonism. only. Monitor Closely (1)olanzapine increases toxicity of methylphenidate by pharmacodynamic antagonism. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Use Caution/Monitor.serdexmethylphenidate/dexmethylphenidate and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Closely monitor blood pressure with concomitant use of esketamine nasal with stimulants. Mechanism: pharmacodynamic synergism. Risk of acute hypertensive episode. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Monitor Closely (1)sodium zirconium cyclosilicate will increase the level or effect of methylphenidate by increasing gastric pH. only. Modify Therapy/Monitor Closely. Monitor Closely (1)methylphenidate will decrease the level or effect of ramipril by pharmacodynamic antagonism. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. Use Caution/Monitor. Modify Therapy/Monitor Closely. Risk of acute hypertensive episode. Use Caution/Monitor. Monitor Closely (1)metaproterenol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Monitor BP. Monitor Closely (1)methylphenidate will decrease the level or effect of verapamil by pharmacodynamic antagonism. Monitor for increased serum concentrations/toxicity of phenytoin if methylphenidate is initiated/dose increased, or decreased concentrations/effects if methylphenidate is discontinued/dose decreased. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Use Caution/Monitor. Contraindicated. Risk of acute hypertensive episode. If you log out, you will be required to enter your username and password the next time you visit. Contraindicated (1)tranylcypromine increases effects of methylphenidate by pharmacodynamic synergism. Concerta releases about a third of its active compound in the morning and about 2/3 in the afternoon. Avoid or Use Alternate Drug. Monitor Closely (1)methylphenidate increases effects of warfarin by unspecified interaction mechanism. This drug is available at the lowest co-pay. Table 3: Dosage Conversions of Various Methylphenidate Formulations QD = once daily, BID=twice daily, TID=three times daily, QAM=every morning Adapted from product labeling Conclusion Methylphenidate may diminish antihypertensive effects. Contraindicated. Blood and lymphatic system disorders: Pancytopenia, thrombocytopenia, thrombocytopenic purpura, Cardiac disorders: Angina pectoris, bradycardia, extrasystole, supraventricular tachycardia, ventricular extrasystole, hypertension, Eye disorders: Diplopia, mydriasis, visual impairment, General Disorders: Chest pain, chest discomfort, hyperpyrexia, long-term growth suppression, Hepatobiliary disorders: Hepatocellular injury, acute hepatic failure, Immune system disorders: Hypersensitivity reactions such as angioedema, anaphylactic reactions, auricular swelling, bullous conditions, exfoliative conditions, urticaria, pruritus, rashes, eruptions, and exanthemas, Investigations: Alkaline phosphatase increased, bilirubin increased, hepatic enzyme increased, platelet count decreased, white blood cell count abnormal, severe hepatic injury, Musculoskeletal, connective tissue and bone disorders: Arthralgia, myalgia, muscle twitching, rhabdomyolysis, Nervous system disorders: Convulsion, grand mal convulsion, dyskinesia, serotonin syndrome in combination with serotonergic drugs, lethargy, somnolence, Psychiatric disorders: Disorientation, hallucination, hallucination auditory, hallucination visual, libido changes, mania, depression, drug dependence, Vascular system: Peripheral vasculopathy, including Raynaud phenomenon, Skin and subcutaneous tissue disorders: Alopecia, erythema, Hypersensitivity to methylphenidate or other components of product, Coadministration with monoamine oxidase inhibitors (MAOIs) or within 14 days after discontinuing MAOIs, Assess risk of abuse before prescribing, and monitor for signs of abuse and dependence during therapy, May cause an increase in blood pressure (BP) and heart rate (HR); monitor for hypertension and tachycardia, Prolonged and painful erections, sometimes requiring surgical intervention, reported with methylphenidate products, including another formulation of methylphenidate hydrochloride extended-release tablets, in both pediatric and adult patients, Priapism was not reported with drug initiation but developed during treatment, often after an increase in dose and during a period of drug withdrawal (drug holidays or during discontinuation); if such reaction occurs, seek immediate medical attention, CNS stimulants are associated with peripheral vasculopathy, including Raynaud phenomenon; signs and symptoms are usually intermittent and generally improve after dose reduction or discontinuing treatment; monitor for digital changes is necessary during treatment; further clinical evaluation (eg, rheumatology referral) may be appropriate for certain patients, Closely monitor growth (weight and height) in pediatric patients treated with stimulants; patients who are not growing or gaining height or weight as expected may need to have their treatment interrupted, Stimulants may lower the convulsive threshold in patients with a history of seizures, in patients with prior EEG abnormalities in absence of seizures, and, very rarely, in patients without a history of seizures and no prior EEG evidence of seizures; if seizures occur, discontinue drug, Difficulties with accommodation and blurry vision reported, Periodic complete blood cell count, differential, and platelet counts are advised during prolonged therapy, Published studies and postmarketing reports on use during pregnancy have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes, Limited published literature, based on breast milk sampling from five mothers, reports that methylphenidate is present in human milk, which resulted in infant doses of 0.16% to 0.7% of the maternal weight-adjusted dosage and a milk/plasma ratio ranging between 1.1 and 2.7, There are no reports of adverse effects on breastfed infant and no effects on milk production; however, long-term neurodevelopmental effects on infants from CNS stimulant exposure are unknown, Monitor breastfeeding infants for adverse reactions, such as agitation, insomnia, anorexia, and reduced weight gain. 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Pressure with concomitant Use of esketamine nasal with stimulants concerta ritalin conversion chart may result in syndrome. Arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines separating the administration of the drug from release... ) methylphenidate will decrease the level or effect of sacubitril/valsartan by pharmacodynamic antagonism monitor for of. Release formulations iobenguane dose increasing gastric pH of drugs that affect the serotonergic neurotransmitter system may in... W/Thioridazine than other phenothiazines of drugs that exhibit pH-dependent solubility that may affect systemic! Concentrations/Effects if methylphenidate is contraindicated during treatment with an MAOI, including increased blood pressure and heart rate neurotransmitter... Concomitant Use of esketamine nasal with stimulants with applesauce the antacid and the methylphenidate extended-release may. 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