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Updated on December 10, 2022
5 min read

Methylphenidate (Ritalin) Interactions

What is Methylphenidate (Ritalin) Used For?

Methylphenidate is the drug name for Ritalin. Other brand names include:

  • Concerta®
  • Quillivant®
  • Quillichew ER®
  • Daytrana® (transdermal patch)

This prescription drug is a central nervous system (CNS) stimulant. It helps increase alertness, focus, energy, and physical activity.

Healthcare providers commonly prescribe Ritalin for children (6 years and above) and adults with ADHD. People with narcolepsy may take Ritalin under a doctor's supervision.

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Before Taking This Medicine

Methylphenidate can produce adverse effects depending on a person’s condition. Consult your doctor before taking methylphenidate to avoid dangerous drug interactions.

If you or your family has the following conditions, you shouldn't take methylphenidate:

  • Methylphenidate allergy
  • High blood pressure
  • Anxiety
  • Motor tics
  • Tourette's syndrome
  • Heart disease
  • Hyperthyroidism (overactive thyroid)
  • Seizure disorder

Side Effects of Ritalin

Methylphenidate may cause some unwanted side effects. When these occur, you may need medical attention.

Common side effects include:

  • Increase in blood pressure (hypertension) and heart rate (tachycardia)
  • Nervousness 
  • Insomnia 
  • Agitation
  • Dizziness
  • Nausea or vomiting
  • Decrease in appetite
  • Weight loss
  • Diarrhea
  • Stomach Pain
  • Restlessness
  • Heavy sweating
  • Decreased libido 
  • Dry Mouth
  • Changes in vision
  • Abnormal liver function, such as severe hepatic injury 

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Methylphenidate Interactions

Drug interactions can change how your medications work, increasing the risk of severe side effects. Keep a list of all medications, including any supplements you are taking, and share it with your healthcare provider.

Do not start, stop, or change the dosage of any medicines without your doctor's approval. 

It is especially important to consult a healthcare professionalt before taking these drugs with Ritalin:

1. Monoamine oxidase inhibitor (MAOI)

Monoamine oxidase inhibitors (MAOIs) were the first type of antidepressant developed. MAOIs release monoamine oxidase to help elevate mood and increase the level of certain chemicals.

MAO inhibitors are used to treat depression and help slow down the progression of Parkinson's disease.

Methylphenidate can be dangerous if you’ve used an MAO inhibitor in the past 14 days. Ritalin can interact with the following drugs for up to two weeks:

  • Linezolid
  • Methylene blue
  • Phenelzine
  • Tranylcypromine
  • Selegiline

This drug interaction can cause a variety of adverse effects. These effects include:

  • Aortic dissection
  • Seizures during pregnancy
  • Lung fluid
  • Renal failure
  • Heart attack
  • Death

2. Antidepressants

Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) treat depression and anxiety. However, methylphenidate can block the effects of these drugs.

Not properly metabolizing these drugs can lead to the following:

  • Sleep issues
  • Anxiety
  • Nausea 

3. Seizure medications

Methylphenidate can cause higher levels of seizure medication and lead to a higher risk of side effects. These side effects include:

  • Dizziness 
  • Fatigue
  • Drowsiness

Seizure medications that interact with methylphenidate include:

  • Phenobarbital 
  • Phenytoin (Dilantin, Phenytek) 
  • Primidone (Mysoline). 

4. Antihypertensive drugs

Antihypertensive drugs help many people who have high blood pressure. However, Ritalin may decrease antihypertensive drug efficacy.

Examples of antihypertensive drugs include:

  • Acebutolol
  • Hydrochlorothiazide
  • Furosemide 

5. Halogenated anesthetics 

Mixing these anesthetics and Ritalin can cause a sudden increase in blood pressure and heart rate during surgery.

Examples include:

  • Halothane
  • Isoflurane
  • Enflurane
  • Desflurane
  • Sevoflurane

6. Antacids or acid blockers 

Drug absorption depends on the amount of acid in the stomach. Methylphenidate can make it harder for the body to absorb antacids or acid blockers.

Examples of antacids include:

  • Pepto-Bismol
  • Calcium carbonate (Alka-Seltzer, Tums)
  • Aluminum hydroxide gel 
  • Maalox

Examples of acid blockers include:

  • Lansoprazole
  • Omeprazole
  • Esomeprazole 
  • Cimetidine

7. CNS stimulants

Taking additional stimulants can cause high blood pressure, stroke, heart attack, and even sudden death.

Examples of CNS stimulants include:

  • Amphetamines
  • Armodafinil
  • Atomoxetine
  • Cocaine

8. Warfarin

Anticoagulants, or “blood thinners”, like warfarin, are used to prevent or treat blood clots. However, methylphenidate can increase the levels of warfarin in the body by blocking its metabolism.

This increases the chance of bleeding, bruising, and internal bleeding. Take a blood test to make sure you’re not experiencing abnormal bleeding.

9. Caffeine

Limit your intake of foods and beverages that contain caffeine. These include coffee, tea, sodas, chocolate, and dietary supplements.

Caffeine is also a CNS stimulant and can cause additive side effects. It increases your risk of:

  • Anxiety
  • Nervousness
  • Nausea
  • Muscle twitching/palpitations
  • Trouble sleeping
  • Rapid heartbeat
  • Other CNS stimulant side effects

10. Alcohol

The effects of taking a stimulant and a depressant are unpredictable and dangerous. Alcohol can increase the side effects of methylphenidate.

It can also cause extended-release methylphenidate to get released into your bloodstream too quickly.

Can You Take Antihistamines With Methylphenidate?

There are no known interactions between antihistamines and methylphenidate. Antihistamines like Benadryl (diphenhydramine) do not pose a high risk of problematic side effects

Each person has specific health needs. Consult a healthcare provider before taking other drugs with Ritalin. A doctor will be able to prescribe the most suitable drug combination treatment. 

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Ritalin Abuse & Addiction

Like any other CNS stimulant, Ritalin has a high potential for misuse and dependence. The drug’s effect on the body is similar to amphetamines.

The number of Americans to misuse prescription stimulants in 2017 was more than one million.

National Institute on Drug Abuse

In severe cases, Ritalin misuse can result in overdose or death. This risk is higher for people with a history of substance or alcohol abuse. 

Symptoms of Ritalin abuse (misuse) may include:

  • Increased heart and respiratory rate
  • High blood pressure
  • Dilated pupils
  • Loss of coordination 
  • Loss of appetite
  • Aggression

Methylphenidate Addiction Treatment

Methylphenidate has a high risk for addiction and abuse. To recover from a methylphenidate dependency, most people will taper off the medication.

If you or someone you know suffers from methylphenidate addiction, speak with an addiction specialist. They can help you review your options and choose a treatment program tailored to your needs.

Standard treatment programs for methylphenidate addiction include:

Inpatient treatment (for the most severe cases or co-occurring disorders)

Call to find out how much your insurance will cover
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Updated on December 10, 2022
9 sources cited
Updated on December 10, 2022
  1. Melamed, Isaac, and Melinda Heffron. “Attention Deficit Disorder and Allergic Rhinitis: Are They Related?.” Journal of Immunology Research, 2016. 
  2. Methylphenidate.” Medications, University of Minnesota Student Mental Health
  3. How Can Prescription Drug Addiction Be Treated?” National Institute on Drug Abuse, 2020.
  4. What Is the Scope of Prescription Drug Misuse?” National Institute on Drug Abuse, 2020.
  5. Novartis Pharmaceuticals A-Z.” Novartis US.
  6. Methylphenidate” MedlinePlus, National Library of Medicine, 2022.
  7. Israel et al. “Combining stimulants and monoamine oxidase inhibitors: A reexamination of the literature and a report of a new treatment combination.” The Primary Care Companion for CNS Disorders, 2015.
  8. Subbarao et al. “Seizure Medications.” Treasure Island (FL): StatPearls Publishing, 2022.
  9. Omidi et al. “Effects of methylphenidate on blood pressure, QT-interval, and cardiac output in ADHD diagnosed children: A three months' follow-up study.” International Journal of Cardiology Heart & Vasculature, 2021.

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