Drug interaction -summary

Methylphenidate +

Guanethidine-                                                                                                                   hypotensive effects of guanethidine  Arrhythmias reported.

Guanethidine -  antihypertensive effect of guanethidine may be decreased

Monoamine oxidase (MAO) inhibitors- pharmacological effect of methylphenidate may be increased by concurrent use Headache,GI symptoms and hypertension may occur ,which may last several weeks after discontinuation of MAO inhibitors.
If hypertension occurs, administer phenolamine

 

LIST OF DRUGS DURING 2004

Approved by (DCI) Drug Controller  GENERAL -  India  For Marketing                                                                                   (Ref- IDMA Publication)

Behavour syndrome in children, Narcolepsy


 

Skin rash, urticaria, fever, arthalgia, exfolitive dermatitis.
Dizziness, headache,
Dyskinesia, drowsiness.
Blood pressure and pulse changes,
Cardiac arrhythmias.
 Nervousness, insomnia.

 

Marked anxiety,tension and agitation. Patients with motor tics or Tourettes syndrome

Special precautions:
Perform periodic CBC and platelet counts.
Not indicated for patients associated with acute stress syndrome

 

Indications:

Behavour syndrome in children, Narcolepsy

Dosage:
Adults- individualise dosage- average dose 20 to 30mg/day in 2 or 3 divided doses preferably 30 to 45 minutes before meals.

 

METHYLPHENIDATE HCL-

1. Take last daily dose early in the evening (prior to 6 pm) to avoid insomnia. Although it is often
    recommended that methylphenidate be taken  30 to 45 minutes before meals, meals do not
    significantly affect the pharmacokinetics or therapeutic eeffects. It may be taken without
    regards  to meals.

2. Use caution while driving or performing tasks requiring alertness

3. Allergies-
   Tell your doctor if you have ever had any unusual or allergic reaction to methylphenidate.
   Also tell your doctor if you are allergic to any other substances, such as foods, presrvatives or dyes.
 
4.Pregnancy -
     studies on effects in pregnancy have not  been done in either humans or animals   

5.Breast feeding-
  It is not known whether methylphenidate  passes into breast milk.

6 Children -
   Loss of appetite , trouble in sleeping, and weight loss may be especially likely to occur  in children
    who are more sensitive  than adults to the effects of methylphenidate. Also there have been reports
     of children growth rate being slowed  when methylphenidate  was used to  for a long time.
     Some doctors  recommend  drug-free  periods during treatment with methylphenidate
 
7. Elderly-  
    Many medicines have not been  studied  specially  in older people. Therefore,  it may not be known
     whether  they  work exactly in the same way  as they do  in younger adults  or if they cause  different
     side efects  or problems in older people.. No specific comparing  use of  methylphenidate  in the
      elderly  with use in other age groups.
    
8. Other medicines -

    Let your doctor know what other medicines you are taking, so that he can advice you accordingly.
   
    Amanatadine or
    Amphetamines or     
    Appetite supressants or
    Caffeine or
    Chlorphedianol or
    Cocaine or
    Medicine  for asthma  or other  breathing problems  or
    Medicine  for colds, sinus  problems, hay fever or other  alergies  including nose drops or sprays or
    Nabilone  or
    Pemoline  - using these medicines  with methylphenidate  may cause severe  nervousness, irritability
    , trouble in  sleeping  or possibly irregular heart beats  or seizures

    Monomaine oxidase inhibitors MAOI- taking  methylphenidate or within  2  weeks  of taking MAOI  
     may cause sudden extremely high blood pressure and severe convulsions. At least 14 days
     should be allowed between  treatment with the other        

    Pimozide - cause of tics may be masked

9. Other medical problems -

   Tell your doctor if you have any other medical problems especially -

    Alcohol abuse or
    Drug abuse or dependence - dependence  on methylphenidate may occur
    
    Epilepsy - risk of convulsions  may be increased
   
    Gilles  de la  Tourettes  disorder  or
    Glaucoma or
    High blodd pressure or
    Psychosis or
    Severe anxiety, agitation, tension, or depression  or
   
    Tics- methylphenidate  may make the condition worse      
    

10. Missed dose -
     If you miss a dose of this medicine, take it as soon as possible. however, if it is almost time
     for the next dose, skip the missed dose. Do not double doses.

11. Storage -
     Keep out of reach of children. Store away from heat or direct sunlight. Do not store
      the capsule in bathroom, near the kitchen sink, or in other damp places.

12. Outdated medicines -
     Do not keep outdated medicine or medicine no longer needed. Be sure that any
     discarded medicine is out of reach of children.


 

Not significant

Pregnancy:
Use when clearly needed.

Lactation:
Safety for use in nursing mother not established