Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Use Caution/Monitor. Caffeine is a CNS-stimulant and additive effects may be seen when coadministered with other CNS stimulants. Potential for additive CNS stimulation. Other (see comment). Risk of acute hypertensive episode. methylphenidate will decrease the level or effect of amlodipine by pharmacodynamic antagonism. Use Caution/Monitor. only.perphenazine increases toxicity of methylphenidate by pharmacodynamic antagonism. Minor/Significance Unknown. Applies only to oral form of both agents. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Risk of acute hypertensive episode. Serious - Use Alternative (1)ergotamine, methylphenidate. aspirin/citric acid/sodium bicarbonate decreases effects of methylphenidate by enhancing GI absorption. Interaction more likely in certain predisposed pts. Monitor Closely (1)levalbuterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. Contraindicated. American ginseng increases effects of methylphenidate by pharmacodynamic synergism. Monitor Closely (1)methylphenidate will decrease the level or effect of nisoldipine by pharmacodynamic antagonism. Use Caution/Monitor. Indication: attention-deficit/hyperactivity disorder (ADHD). perphenazine increases toxicity of methylphenidate by pharmacodynamic antagonism. only.trifluoperazine increases toxicity of methylphenidate by pharmacodynamic antagonism. Applies only to oral form of both agents. Use Caution/Monitor. Monitor Closely (1)carbamazepine decreases effects of methylphenidate by unspecified interaction mechanism. perphenazine, methylphenidate. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Caffeine should be avoided or used cautiously. 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. Mechanism: unknown. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. clomipramine, methylphenidate. Use Caution/Monitor. Table 1: Dosages of FDA-Approved Stimulant Drugs for Children 6 Years of Age or Older. Mechanism: unknown. Methylphenidate may diminish antihypertensive effects. Use Caution/Monitor. Monitor Closely (1)nortriptyline, methylphenidate. Either increases effects of the other by pharmacodynamic synergism. Compared to Concerta, the newer. 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. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. Risk of acute hypertensive episode. Interaction more likely in certain predisposed pts. Modify Therapy/Monitor Closely. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode. Methylphenidate may diminish antihypertensive effects. doxepin, methylphenidate. Use Caution/Monitor. Monitor for hypertension with concomitant use. The generic drug name of Concerta is methylphenidate. Use Caution/Monitor. Serious - Use Alternative (1)lofepramine, methylphenidate. Monitor Closely (1)methylphenidate, epinephrine inhaled. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Use Caution/Monitor. Monitor BP. dobutamine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Mechanism: unknown. Mechanism: pharmacodynamic synergism. Methylphenidate may diminish antihypertensive effects. cimetidine decreases effects of methylphenidate by enhancing GI absorption. Please confirm that you would like to log out of Medscape. Modify Therapy/Monitor Closely. Monitor BP. Share cases and questions with Physicians on Medscape consult. Use Caution/Monitor. lansoprazole decreases effects of methylphenidate by enhancing GI absorption. Risk of acute hypertensive episode. Monitor Closely (1)protriptyline, methylphenidate. Modify Therapy/Monitor Closely. Risk of acute hypertensive episode. Minor/Significance Unknown. arformoterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Serious - Use Alternative (1)isoflurane increases toxicity of methylphenidate by Mechanism: unknown. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Monitor BP. Monitor BP. Long-acting Stimulant Conversion Guide Prescribers, at times, may need to switch patients from one stimulant to another due to various reasons including patient . Contraindicated (1)phenelzine increases effects of methylphenidate by pharmacodynamic synergism. The above information is provided for general Use Caution/Monitor. 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. Methylphenidate may diminish antihypertensive effects. desipramine, methylphenidate. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Modify Therapy/Monitor Closely. Contraindicated. Monitor for hypertension with concomitant use. Use Caution/Monitor. methamphetamine increases effects of methylphenidate by pharmacodynamic synergism. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. norepinephrine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. methylphenidate and solriamfetol both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Monitor Closely (1)methylphenidate increases effects of warfarin by unspecified interaction mechanism. Optimal doses appear to be 1.2 mg/kg daily, given once daily or in two divided doses. Additive vasospasm; risk of hypertension. Modify Therapy/Monitor Closely. Mechanism: pharmacodynamic synergism. Risk of acute hypertensive episode. 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. Monitor Closely (3)serdexmethylphenidate/dexmethylphenidate increases effects of methylphenidate by pharmacodynamic synergism. Monitor BP. Risk of acute hypertensive episode. Risk of acute hypertensive episode. only. Other (see comment). Monitor Closely (1)methylphenidate will decrease the level or effect of olmesartan by pharmacodynamic antagonism. Use Caution/Monitor. Use Caution/Monitor. guarana increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. ropinirole, methylphenidate. Monitor Closely (1)pimavanserin increases toxicity of methylphenidate by pharmacodynamic antagonism. Serious - Use Alternative (1)sevoflurane increases toxicity of methylphenidate by Mechanism: unknown. paliperidone increases toxicity of methylphenidate by pharmacodynamic antagonism. Minor/Significance Unknown. Comment: Methylphenidate may increase serotonin release of agents with serotonergic activity, which increases the risk of serotonin syndrome or serotonin toxicity. Use Caution/Monitor. Monitor BP. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Use Caution/Monitor. Minor/Significance Unknown. Monitor Closely (1)pimozide increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Risk of acute hypertensive episode. Monitor Closely (1)ropinirole, methylphenidate. Methylphenidate may diminish antihypertensive effects. Caffeine should be avoided or used cautiously. Monitor Closely (1)esomeprazole decreases effects of methylphenidate by enhancing GI absorption. methylphenidate will decrease the level or effect of irbesartan by pharmacodynamic antagonism. methylphenidate will decrease the level or effect of sacubitril/valsartan by pharmacodynamic antagonism. Monitor BP. Use Caution/Monitor. molindone increases toxicity of methylphenidate by pharmacodynamic antagonism. Risk of acute hypertensive episode. Use Caution/Monitor. ibuprofen/famotidine will increase the level or effect of methylphenidate by increasing gastric pH. Methylphenidate may diminish antihypertensive effects. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Use Caution/Monitor. iloperidone increases toxicity of methylphenidate by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Potential for additive CNS stimulation. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. Use Caution/Monitor. imipramine, methylphenidate. Risk of acute hypertensive episode. 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. Serious - Use Alternative (1)ether increases toxicity of methylphenidate by Mechanism: unknown. Use Caution/Monitor. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. Use Caution/Monitor. Monitor BP. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. The recipient will receive more details and instructions to access this offer. Use Caution/Monitor. Monitor BP. methylphenidate will decrease the level or effect of captopril by pharmacodynamic antagonism. Use Caution/Monitor. Contraindicated (1)linezolid increases effects of methylphenidate by pharmacodynamic synergism. Additive vasospasm; risk of hypertension. Use Caution/Monitor. Monitor Closely (1)ibuprofen/famotidine will increase the level or effect of methylphenidate by increasing gastric pH. Additive vasospasm; risk of hypertension. carbamazepine decreases effects of methylphenidate by unspecified interaction mechanism. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. Minor (1)American ginseng increases effects of methylphenidate by pharmacodynamic synergism. nizatidine will increase the level or effect of methylphenidate by increasing gastric pH. Methylphenidate may diminish antihypertensive effects. Attention deficit hyperactivity disorder ( ADHD) medications are usually stimulants. Methylphenidate may diminish antihypertensive effects. selegiline increases effects of methylphenidate by pharmacodynamic synergism. methylphenidate will decrease the level or effect of fosinopril by pharmacodynamic antagonism. Use Caution/Monitor. Mechanism: unknown. Use Caution/Monitor. Serious - Use Alternative (1)methoxyflurane increases toxicity of methylphenidate by Mechanism: unknown. Monitor Closely (1)methylphenidate will decrease the level or effect of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. Use Caution/Monitor. Risk of V tach, HTN. Risk of acute hypertensive episode. Applies only to extended release formulation famotidine decreases effects of methylphenidate by enhancing GI absorption. Use Caution/Monitor. Monitor BP. 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. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Applies only to oral form of both agents. Dosing recommendations are based on current dose regimen and clinical judgment. amantadine, methylphenidate. Use Caution/Monitor. Monitor Closely (1)green tea, methylphenidate. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. cabergoline, 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. Mechanism: unknown. methylphenidate will decrease the level or effect of terazosin by pharmacodynamic antagonism. Risk of acute hypertensive episode. Monitor BP. sodium zirconium cyclosilicate will increase the level or effect of methylphenidate by increasing gastric pH. Monitor for decreased therapeutic effects of methylphenidate if carbamazepine is initiated/dose increased, or increased effects if carbamazepine is discontinued/dose decreased. Use Caution/Monitor. olanzapine increases toxicity of methylphenidate by pharmacodynamic antagonism. Monitor Closely (1)promazine, methylphenidate. Monitor Closely (1)cariprazine increases toxicity of methylphenidate by pharmacodynamic antagonism. Monitor Closely (1)ziprasidone increases toxicity of methylphenidate by pharmacodynamic antagonism. Monitor Closely (1)prochlorperazine, methylphenidate. Modify Therapy/Monitor Closely. only. 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. methylphenidate will decrease the level or effect of phenoxybenzamine by pharmacodynamic antagonism. Applies only to oral form of both agents. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Monitor Closely (1)bromocriptine, methylphenidate. Monitor BP. Monitor BP. Potential for additive CNS stimulation. Serious - Use Alternative (1)dihydroergotamine, methylphenidate. Contraindicated. Use Caution/Monitor. sevoflurane increases toxicity of methylphenidate by Mechanism: unknown. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. 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. ergoloid mesylates, methylphenidate. Monitor BP. Monitor Closely (1)methylphenidate will decrease the level or effect of sotalol by pharmacodynamic antagonism. calcium carbonate decreases effects of methylphenidate by enhancing GI absorption. Monitor BP. Avoid or Use Alternate Drug. Use Caution/Monitor. Risk of acute hypertensive episode. Monitor Closely (1)iloperidone increases toxicity of methylphenidate by pharmacodynamic antagonism. Monitor Closely (1)methylphenidate will decrease the level or effect of amlodipine by pharmacodynamic antagonism. Use Caution/Monitor. protriptyline, methylphenidate. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. Monitor Closely (2)trifluoperazine, 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. Use Caution/Monitor. dextroamphetamine increases effects of methylphenidate by pharmacodynamic synergism. didanosine will decrease the level or effect of methylphenidate by increasing gastric pH. . Use Caution/Monitor. lurasidone, methylphenidate. Modify Therapy/Monitor Closely. 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 BP. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. cariprazine increases toxicity of methylphenidate by pharmacodynamic antagonism. Monitor BP. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Modify Therapy/Monitor Closely. Monitor BP. maprotiline, methylphenidate. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Monitor Closely (1)sufentanil SL, methylphenidate. Are Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder Significantly Linked to Childhood Allergies? Use Caution/Monitor. Use Caution/Monitor. Contraindicated. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Use Caution/Monitor. 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. bromocriptine, methylphenidate. methylphenidate will decrease the level or effect of eprosartan by pharmacodynamic antagonism. Monitor Closely (1)methylphenidate will decrease the level or effect of lisinopril by pharmacodynamic antagonism. Either increases effects of the other by pharmacodynamic synergism. Monitor BP. Minor/Significance Unknown. Dosage Conversions of Various Methylphenidate Formulations QD = once daily, BID=twice daily, TID=three times daily, QAM=every morning Adapted from product labeling Click Here to Return to Article Methylphenidate may diminish antihypertensive effects. Table 2. Use Caution/Monitor. ozanimod increases toxicity of methylphenidate by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. informational and educational purposes only. Use Caution/Monitor. Other (see comment). Modify Therapy/Monitor Closely. Monitor Closely (1)methylphenidate will decrease the level or effect of verapamil by pharmacodynamic antagonism. Either increases effects of the other by serotonin levels. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Contraindicated. Use Caution/Monitor. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Use Caution/Monitor. Use Caution/Monitor. Risk of acute hypertensive episode. Risk of acute hypertensive episode. Ritalin LA Metadate CD Concerta . Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. 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. commonly, these are "non-preferred" brand drugs. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Use Caution/Monitor.serdexmethylphenidate/dexmethylphenidate increases effects of methylphenidate by pharmacodynamic synergism. Mechanism: pharmacodynamic synergism. Monitor Closely (1)hydrocodone, methylphenidate. Use Caution/Monitor. Risk of acute hypertensive episode. Contraindicated. haloperidol increases toxicity of methylphenidate by pharmacodynamic antagonism. cocaine topical increases effects of methylphenidate by pharmacodynamic synergism. Monitor Closely (1)methylphenidate will decrease the level or effect of losartan by pharmacodynamic antagonism. Use Caution/Monitor. Use Caution/Monitor. methylphenidate will decrease the level or effect of nifedipine by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Use Caution/Monitor. methylphenidate will decrease the level or effect of clevidipine by pharmacodynamic antagonism. 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. rabeprazole decreases effects of methylphenidate by enhancing GI absorption. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Monitor BP. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. Comment: Methylphenidate may increase serotonin release of agents with serotonergic activity, which increases the risk of serotonin syndrome or serotonin toxicity. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. isoproterenol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. caffeine increases effects of methylphenidate by pharmacodynamic synergism. Additive pressor effect. Monitor Closely (1)dopexamine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. ) ibuprofen/famotidine will increase the level or effect of amlodipine by pharmacodynamic antagonism risk serotonin. 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