Before giving methylphenidate

Before giving methylphenidate to your child make sure your doctor knows:

• If your child has heart problems.
• If your child has blood circulation problems.
• If your child has ever had an eating disorder, anxiety, agitation, mood disorders, severe depression, or thoughts about suicide.
• If your child has a problem with drug or alcohol dependence.
• If your child has epilepsy.
• If your child has uncontrollable movements such as a nervous tic or Tourette's syndrome.
• If your child has high blood pressure.
• If your child has glaucoma (increased pressure in the eye).
• If your child has thyroid problems.
• If your child has phaeochromocytoma (a growth on the adrenal gland).
• If your child has ever had an allergic reaction to this or to any other medicine.
• If your child is taking any other medicines, including those available to buy without a prescription, herbal or complementary medicines.
• If your child could be pregnant.

How to take methylphenidate

• Before beginning treatment, read the manufacturer's information leaflet.
• Try to give methylphenidate at the same times each day to avoid missing any doses.
• The modified release forms of methylphenidate should be swallowed whole and must not be crushed or chewed. If you have been given modified release capsules (Equasym® XL or Medikinet® XL), the capsules can be opened and the contents sprinkled on to a tablespoon of apple sauce. This must then be swallowed straight away without chewing.
• If you forget a dose, give it as soon as you remember unless it is nearly time for the next dose, in which case leave out the missed dose. Do not give two doses together to make up for a missed dose.

Getting the most from this treatment

• Keep the regular appointments with your doctor. Your doctor will want to check your child's progress to ensure that the treatment is helping. Your doctor may also monitor your child's weight and height, and do blood tests.
• Do not stop methylphenidate without speaking with your doctor first. Your doctor may want to reduce the dose slowly to prevent the symptoms of ADHD from returning and to stop any side-effects.
• Your child must not drink alcohol while taking methylphenidate.
• Before buying any medicines for your child, check with your pharmacist which medicines are safe to take alongside methylphenidate.
• If your child is due to have any kind of surgery, including dental and emergency treatment, tell your doctor, dentist or surgeon that they are taking methylphenidate.
• Methylphenidate may give a positive result in drug testing which is sometimes used in competitive sports.

Can methylphenidate cause problems

Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as our bodies adjust to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

How to store methylphenidate

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.
• Never keep out-of-date or unwanted medicines. Take them to your local pharmacist who will dispose of unwanted medicines for you.

Important information about all medicines

References

• Manufacturer's PIL, Equasym® XL 10 mg, 20 mg or 30 mg Capsules, Shire Pharmaceuticals Limited, electronic Medicines Compendium. Accessed July 2010.
• Manufacturer's PIL, Concerta® XL 18 mg-36-54 mg Prolonged Release Tablets, Janssen-Cilag Ltd, electronic Medicines Compendium. Dated December 2009, accessed July 2010.
• Manufacturer's PIL, Ritalin®, Novartis Pharmaceuticals UK Ltd, electronic Medicines Compendium. Dated December 2009, accessed July 2010.
• British National Formulary; 60th Edition (September 2010) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)