Methylphenidate (Ritalin) Interactions
In This Article
What is Methylphenidate (Ritalin) Used For?
Methylphenidate is the drug name for Ritalin. Other brand names include Concerta®, Quillivant®, Quillichew ER®, and Daytrana® (transdermal patch).
This prescription drug is a central nervous system (CNS) stimulant. It increases alertness, focus, energy, and physical activity. The drug’s effect on the body is similar to amphetamines.
Ritalin is available in different forms:
- Immediate-release tablet
- Chewable tablets
- Liquid solution
- Extended-release tablet (Ritalin-SR)
- Extended-release capsule (Ritalin-LA)
Who Gets Prescribed Methylphenidate?
This medication is most commonly prescribed for children and adults with attention-deficit/hyperactivity disorder (ADHD).
People with narcolepsy may also take Ritalin under a doctor’s supervision.
Who Should Not Take Methylphenidate?
If you or your family has the following conditions, you shouldn't take methylphenidate:
- Motor tics
- Tourette's syndome
- Heart disease
- Hyperthyroidism (overactive thyroid)
- Seizure disorder
Like any other CNS stimulant, Ritalin has a high potential for misuse and dependence. This risk is higher for individuals with a history of substance or alcohol abuse.
In severe cases, Ritalin misuse can result in overdose or death.
Side Effects of Ritalin
Methylphenidate has a series of common side effects, including:
- 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
- Abnormal liver function, such as severe hepatic injury
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Methylphenidate Interactions
Individuals should consult their medical specialist before taking these drugs with Ritalin:
Monoamine oxidase inhibitor (MAOI)
This is a type of antidepressant prescribed for people with depression.
Examples include:
- Linezolid
- Methylene blue
- Phenelzine
- Tranylcypromine
- Selegiline
Ritalin can interact with these drugs up to two weeks after taking Ritalin. This can cause aortic dissection, seizures during pregnancy, fluid in the lungs, renal failure, heart attack, and death.
Antihypertensive drugs
Ritalin may decrease antihypertensive drug efficacy.
Halogenated anesthetics
Mixing these anesthetics and Ritalin can cause a sudden increase in blood pressure and heart rate during surgery.
Antacids or acid blockers
These can make it more difficult to absorb long-acting stimulants. Drug absorption depends on the amount of acid in the stomach.
CNS stimulants
Taking additional stimulants can cause high blood pressure, stroke, heart attack, and even sudden death.
Alcohol
The effects of taking a stimulant and a depressant are unpredictable and dangerous.
Alcohol can increase side effects from methylphenidate. It can also cause extended-release methylphenidate to get released into your bloodstream too quickly.
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.
Caffeine increases your risk of:
- Anxiety
- Nervousness
- Nausea
- Muscle twitching/palpitations
- Trouble sleeping
- Rapid heartbeat
- Other CNS stimulant side effects
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 individual 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
Symptoms of Ritalin abuse (misuse) may include:
- Increased heart and respiratory rate
- High blood pressure
- Dilated pupils
- Loss of coordination
- Loss of appetite
- Aggression
In the most severe cases, individuals who combine Ritalin with other substances may overdose or even result in death.
The number of Americans to misuse prescription stimulants in 2017 was more than one million.
National Institute on Drug Abuse
Methylphenidate Addiction Treatment
Methylphenidate has a high risk for addiction and abuse.
In order to recover from a methylphenidate dependency, most people will taper off the medication.
If you or someone you know is suffering from methylphenidate addiction, speak with an addiction specialist. They can help you review your options and choose a treatment program that is tailored to your needs.
Common treatment programs for methylphenidate addiction include:
- Outpatient treatment
- Partial hospitalization programs (for more severe cases)
- Inpatient treatment (for the most severe cases, or co-occurring disorders)
What's Next?
Resources
- Melamed, Isaac, and Melinda Heffron. “Attention Deficit Disorder and Allergic Rhinitis: Are They Related?.” Journal of immunology research vol. 2016 : 1596828. doi:10.1155/2016/1596828, https://www.hindawi.com/journals/jir/2016/1596828/
- “Methylphenidate.” Medications, University of Minnesota Student Mental Health, www.mentalhealth.umn.edu/medication/pdf/methylphenidate.pdf.
- National Institute on Drug Abuse. “How Can Prescription Drug Addiction Be Treated?” National Institute on Drug Abuse, 3 June 2020, www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/how-can-prescription-drug-addiction-be-treated.
- National Institute on Drug Abuse. “What Is the Scope of Prescription Drug Misuse?” National Institute on Drug Abuse, 13 Apr. 2020, www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/what-scope-prescription-drug-misuse.
- Novartis Pharmaceuticals A-Z. Novartis US, www.novartis.us/product-list/products?title=ritalin.
