Ritalin/Ritalin LA

Ritalin/Ritalin LA

methylphenidate

Manufacturer:

Novartis

Distributor:

Zuellig
/
Four Star
Concise Prescribing Info
Contents
Methylphenidate HCl
Indications/Uses
ADHD in childn ≥6 yr. Ritalin Narcolepsy. Ritalin LA ADHD in adults.
Dosage/Direction for Use
ADHD Adult Ritalin LA Patient currently not taking methylphenidate: Initially 20 mg. Patients currently taking methylphenidate: Dosage should be equal to the total daily dose of the immediate-release formulation. Max daily dose: 80 mg. Dosage may be adjusted at wkly intervals in 20 mg increments. Childn ≥6 yr Ritalin Initially 5 mg once daily or bd, increase in increments of 5-10 mg wkly. Ritalin LA Patient currently not taking methylphenidate: Initially 20 mg. May begin treatment w/ 10 mg if necessary. Patients currently taking methylphenidate: Dosage should be equal to the total daily dose of the immediate-release formulation. Max daily dose: 60 mg. Dosage may be adjusted at wkly intervals in 10 mg increments. Narcolepsy Adult Ritalin Usual daily dose: 20-30 mg. Max daily dose: 60 mg.
Administration
May be taken with or without food: May be taken w/ meals to reduce GI discomfort. LA cap: Swallow whole, do not chew/crush/divide. Alternatively, open cap & sprinkle contents in a small amount of soft food. The food should not be warm. Do not chew/crush the contents of the cap.
Contraindications
Hypersensitivity. Anxiety & tension states, agitation, family history or diagnosis of Tourette's syndrome, glaucoma, hyperthyroidism, pre-existing CV disorders including uncontrolled HTN, angina pectoris, arterial occlusive disease especially coronary arteries; heart failure, haemodynamically significant congenital heart disease, cardiomyopathies, MI, cardiac arrhythmia & channelopathies, treatment w/ MAOIs, & also w/in a min of 14 days following discontinuation of a MAOI (hypertensive crises may result), phaeochromocytoma, known drug dependence or alcohol abuse; severe depression, anorexia nervosa, psychotic symptoms or suicidal tendency, since Ritalin might worsen these conditions.
Special Precautions
Not indicated in all cases of ADHD. Consider treatment only after detailed history taking & evaluation of the patient. Not to be used in patients w/ structural cardiac abnormalities or other serious cardiac disorders. Assess pre-existing CV disorders, family history of sudden death & ventricular arrhythmia & pre-existing psychiatric disorders & family history of psychiatric disorders before initiating treatment. Caution in patients w/ pre-existing HTN. Monitor BP during treatment. Patients w/ pre-existing cerebrovascular abnormalities should not be treated w/ Ritalin. Patients w/ additional risk factors (history of CV disease, concomitant medications that elevate BP) should be assessed regularly for neurological/psychiatric signs & symptoms. Do not initiate treatment in patients w/ acute psychosis, acute mania or acute suicidality. Emergent psychiatric symptoms or exacerbation of pre-existing psychiatric symptoms. Family history should be assessed & clinical evaluation for tics or Tourette's syndrome in childn should precede ADHD treatment. Monitor regularly for emergence or worsening of tics during initiating treatment. Monitor growth during treatment as clinically necessary. Caution in epileptic patients. Priapism. Chronic abuse can lead to marked tolerance & psychological dependence. Caution in emotionally unstable patients. Careful supervision during w/drawal. Patients requiring long-term therapy should be carefully monitored. Hematological disorders. Prolonged & painful erections. Concomitant use w/ serotonergic drugs. Do not take on the day of a planned surgery. May induce false +ve laboratory test for amphetamines. Refrain from driving & using machinery if dizziness, drowsiness, blurred vision, hallucination or other CNS side effects occur. Pregnancy & lactation. Childn <6 yr.
Adverse Reactions
Nasopharyngitis, decreased appetite, nervousness, insomnia, nausea, dry mouth, irritability. Anxiety, restlessness, sleep disorder, agitation, tremor, dyskinesia, headache, drowsiness, dizziness, tachycardia, palpitation, arrhythmias, changes in BP & heart rate (usually an increase), cough, abdominal pain, vomiting, dyspepsia, toothache, rash, pruritus, urticaria, fever, scalp hair loss, hyperhidrosis, arthralgia, feeling jittery, wt decreased.
Drug Interactions
Hypertensive crisis may result when co-administered w/ MAOIs (or w/in the preceding 2 wk). Caution when used concomitantly w/ drugs that elevate BP, coumarin anticoagulants, anticonvulsants, centrally acting α-2 agonists (eg, clonidine), direct & indirect dopaminergic drugs (eg, TCAs, DOPA, antipsychotics), phenylbutazone. Abstain from alcohol during treatment. Risk of serotonin syndrome w/ serotonergic drugs.
MIMS Class
Other CNS Drugs & Agents for ADHD
ATC Classification
N06BA04 - methylphenidate ; Belongs to the class of centrally-acting sympathomimetics. Used as CNS stimulant.
Presentation/Packing
Form
Ritalin LA cap 20 mg
Packing/Price
30's
Form
Ritalin LA cap 30 mg
Packing/Price
30's
Form
Ritalin LA cap 10 mg
Packing/Price
30's
Form
Ritalin tab 10 mg
Packing/Price
200's
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