What side effects can methylphenidate have?
Below you will find the most important information about possible, known side effects of methylphenidate.
These side effects do not occur, but you can. Because every person reacts differently to medication. Please also note that the type and frequency of side effects may vary depending on the drug formulation (eg tablet, syringe, ointment).
Very common side effects:
Insomnia, nervousness, headache.
only in adults with narcolepsy:
Concentration deficiency, sensitivity to noise, sweating.
Common side effects:
nasopharyngitis, food restriction, decreased appetite, moderately decreased weight and height (prolonged use in children), mental imbalance, aggression, restlessness, anxiety, depression, irritability, abnormal behavior, dizziness, senseless movements, restlessness, drowsiness, cardiac arrhythmias, palpitations, palpitations, high blood pressure, coughing, throat pain, nausea and vomiting, stomach upset, dry mouth, hair loss, itching, rash, hives, joint pain, fever, changes in blood pressure and heartbeat (usually an increase), weight loss.
Occasional side effects:
Hypersensitivity reactions (such as facial swelling, ear swelling, blistering skin diseases, flaky skin diseases, hives, itching, rashes), psychotic disorders, delusions (images, sounds, feelings), anger, suicidal thoughts, Mood changes, mood swings, restlessness, tearfulness, tics, aggravation of preexisting tics or Tourette’s syndrome, insomnia, sleep disturbance, blunting, shaking, double vision, blurred vision, chest pain, shortness of breath, constipation, increase in liver enzymes in the blood, muscle pain, muscle twitching, blood in the urine, chest pain, fatigue, heart murmur, increased liver enzymes in the blood.
Rare side effects:
Exaggeration, disorientation, disturbance of the libido, problems with acuity, pupillary dilation, blurred vision, angina pectoris, increased sweating, blotchy rash, redness of the skin, breast swelling.
Very rare side effects:
White blood cell deficiency, platelet deficiency, anemia, subcutaneous hemorrhage, attempted suicide (including completed suicide), transient depressive mood, abnormal thinking, listlessness, pathological frequently repeated behaviors, obstinacy, seizures, heart failure Similar movements, temporary circulatory disorders of the brain, malignant neuroleptic syndrome (drug as cause unclear), cardiac arrest, heart attack, cerebral vascular obstruction, cold sensation in the arms and legs, circulatory disorders of fingers and toes (Raynaud’s phenomenon), impaired liver function (to coma), severe Skin reactions (erythema multiforme, exfoliative dermatitis), muscle spasms, sudden cardiac death.
Side effects of unknown frequency – lack of all blood cells, delusions, thought disorders, state of confusion, brain dysfunction (including blood vessel inflammation, cerebral hemorrhage, strokes, cerebral vascular occlusion), epileptic (grand mal) seizures, migraine, cardiac arrhythmias arising above the ventricle ( supraventricular tachycardia), slow heartbeat, extra heartbeats, menstrual disorders, chest pain, very high fever, increased alkaline phosphatase in the blood, increased bilirubin in the blood, reduced platelet count, abnormal white blood cell count.
In chronic improper use, methylphenidate may lose its effect (tolerance development) and lead to emotional dependence. When used as intended in the approved fields of application, there is practically no danger of dependency. However, the possibility of drug misuse or drug dependence in the patient’s environment must be considered.
Abdominal pain, diarrhea, nausea and vomiting and stomach discomfort usually occur at the beginning of treatment and can be relieved by taking a meal.
What interactions does methylphenidate show?
Please note that the interactions may vary depending on the drug formulation of a drug (eg tablet, syringe, ointment).
Methylphenidate influences high blood pressure. Therefore, on the one hand, it may affect the effectiveness of medicines for the treatment of high blood pressure. On the other hand, it can enhance the effect of blood pressure-increasing agents. The initial hypertensive effects of guanethidine (for lowering blood pressure) and amantadine (for influenza and Parkinson’s disease) may also be increased.
The active substance must not be used during or within 14 days after taking MAO-inhibitors (for depression).
Methylphenidate inhibits the reuptake of the neurotransmitter dopamine into the nerves. Therefore, it interferes with the action of all substances that affect dopamine. These include Parkinson’s drugs such as levodopa and methyldopa, but also tricyclic anticonvulsants and neuroleptics such as haloperidol. The concomitant use of methyldopa and neuroleptics should be avoided due to the opposite effects.
There may be interactions of methylphenidate with coumarin-type blood-thinning anticoagulants, anticonvulsants (such as phenobarbital, phenytoin, primidone), neuroleptics and tricyclic antidepressants (imipramine, desipramine) and phenylbutazone (non-steroidal anti-inflammatory drug). The dose of the active substances mentioned may need to be reduced by the doctor if given together with methylphenidate.
Co-administration of carbamazepine (antiepileptic) may decrease the efficacy of methylphenidate. The same applies to acid-inhibiting agents (antacids), as they impede the absorption of the active substance into the body.
Alcohol can increase the unwanted side effects of methylphenidate on the brain. It is therefore recommended not to drink alcohol during the treatment.
Methylphenidate can lead to false positive laboratory values for amphetamines (stimulants), especially if so-called immunoassay methods are used for their measurement.