methylphenidate hydrochloride at a glance
Medicine class
Central nervous system stimulant and Schedule 2 controlled drug.
Main licensed use
ADHD in children aged 6 years and over; selected products are also licensed for adults.
Formulations differ
Standard, modified-release, prolonged-release and chewable products have different release patterns and administration instructions.
Do not switch casually
Changing modified-release products can alter symptom control or adverse effects; check the prescribed product and instructions.
What is methylphenidate hydrochloride used for?
Licensing depends on the particular formulation and age group.
ADHD in children aged 6 years and over when non-medicine measures alone are insufficient, as part of a comprehensive treatment programme.
ADHD in adults is licensed for selected products, including selected immediate-release, capsule and prolonged-release tablet products.
Methylphenidate is sometimes used for narcolepsy, but narcolepsy is not an indication in the selected product licences.
How does methylphenidate hydrochloride work?
Methylphenidate inhibits dopamine and noradrenaline reuptake, increasing their availability between nerve cells. Its full mechanism in ADHD is not completely understood, but these effects increase activity in brain networks involved in attention and behavioural control.
methylphenidate hydrochloride preparations and strengths
Capsule
Route: Oral
Strengths: 5 mg, 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg
How to take methylphenidate hydrochloride
Follow the instructions for the exact product supplied because food and swallowing requirements differ.
Swallow Xaggitin XL tablets whole with liquid; do not break, divide, chew or crush them.
Tuzulby tablets must be chewed rather than swallowed whole or crushed and may be taken with or without food.
Equasym XL is taken before breakfast. Its capsules may be opened onto a small amount of apple sauce and swallowed immediately without chewing the contents.
Ambinet XL must be taken with or after food. Capsules may be opened onto apple sauce or yoghurt and swallowed immediately without chewing or crushing the contents.
Ritalin standard tablets may be taken with or without food; food may reduce stomach upset.
methylphenidate hydrochloride side effects
Common or expected effects
- Reduced appetite or weight loss
- Difficulty sleeping
- Headache
- Stomach pain, nausea or vomiting
- Dry mouth
- Nervousness, anxiety or irritability
- Small increases in heart rate or blood pressure
Get urgent medical advice
- Chest pain, fainting or significant palpitations
- Seizures or stroke-like symptoms
- Hallucinations, mania, severe aggression or suicidal thoughts
- Severe allergic reaction
- Prolonged or painful erection
- New or worsening tics
methylphenidate hydrochloride in pregnancy
Information in pregnancy remains limited. Specialist or prescriber review is important before conception or promptly after pregnancy is recognised; treatment should not be stopped without advice because the risks of untreated illness and medicine exposure must be considered together.
methylphenidate hydrochloride while breastfeeding
Available evidence suggests only tiny amounts enter breast milk, and methylphenidate can sometimes be used while breastfeeding a healthy baby. Seek professional advice and monitor feeding, weight gain, sleep, irritability, vomiting, diarrhoea or rash.
methylphenidate hydrochloride interactions
Tell the prescriber and pharmacist about all medicines, supplements and planned surgery.
Monoamine oxidase inhibitors
Combined use, or recent MAOI use, is contraindicated because of the risk of a hypertensive crisis.
Antihypertensives
Methylphenidate may reduce their blood-pressure-lowering effect.
Medicines that raise blood pressure
Combined use may further increase blood pressure and requires caution and monitoring.
Coumarin anticoagulants
Common questions about methylphenidate hydrochloride
Answers are fully visible for fast scanning and source review.
Is methylphenidate hydrochloride a controlled drug?
Yes. It is a Schedule 2 controlled drug, so prescription, collection, storage and travel requirements are stricter than for many medicines.
Can methylphenidate hydrochloride brands be switched directly?
Not always. Modified-release brands differ in release pattern and food instructions, so a switch should be clinically planned and its effect reviewed.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.