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Methylphenidate (Ritalin, Ritalin SR)

Category:

  • CNS Stimulant

Description:

  • Cerebral stimulant: DEA Schedule II

Indications:

  • Attention deficit disorders

  • Narcolepsy

  • Depression in elderly, cancer, and post-stroke victims (non FDA approved)

Contraindications:

  • Marked anxiety, tension and agitation

  • Glaucoma, Tourette’s syndrome or motor tics, prevention of normal fatigue

Precautions:

  • Pregnancy category C

  • Severe depression, seizure disorders, hypertension, history of drug abuse

  • Children <6 years, symptoms associated with acute stress reactions

Adverse Reactions (Side Effects):

  • CNS: akathisia, dizziness, dyskinesia, fever, headache, hyperactivity, insomnia, restlessness, talkativeness, Tourette’s syndrome (rare)

  • CV: angina, blood pressure changes, dysrhythmias, palpitations, tachycardia

  • GI: abdominal pain, anorexia, dry mouth, nausea, weight loss

  • GU: uremia

  • HEME: anemia, leukopenia

  • METAB: growth retardation

  • MS: arthralgia

  • SKIN: erythema-multiforme, exfoliative dermatitis, rash, scalp hair loss, urticaria

 

 

 

Dosage:

Administered orally

  • Adult:            

    • Narcolepsy: PO 10mg 2-3 times daily 30 to 45 minutes before meals; may increase up to 40-60mg daily

  • Child > or =6 years: 

    • Attention deficit disorder: PO 0.3 mg/kg/dose or 2.5-5 mg/dose given before breakfast and lunch; increase by 0.1 mg/kg/dose or 5-10mg daily at weekly intervals; usual dose 0.5-1 mg/kg/day, max 2 mg/kg/day or 60mg daily; sustained release may be used when the 8 hour dose of sustained release corresponds to the titrated 8 hour dose of immediate-release tablets

Drug interactions:

  • Labs: false positive urine amphetamine

  • MAOIs: hypertensive reactions

  • Guanethidine: inhibition of guanethidine antihypertensive effect

Special considerations:

  • Overdosage may cause vomiting, agitation, tremor, muscle twitching, seizures, confusion, tachycardia, hypertension, arrythmias

  • Take last daily dose prior to 1800 to avoid insomnia

  • Do not chew or crush sustained release formulation

 

The information contained here is an abbreviated summary. For more detailed and complete information, consult the manufacturer's product information sheets or standard textbooks. Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300

OB-GYN 101: Introductory Obstetrics & Gynecology
© 2003, 2004, 2005, 2008 Medical Education Division, Brookside Associates, Ltd.
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