Patient handout
Methylphenidate (Concerta, Ritalin)
You have been prescribed methylphenidate. This page explains what it is, what to expect, and when to call.
What it is
Methylphenidate is a stimulant for ADHD and the active ingredient in Ritalin, Concerta, Focalin, and others. It raises dopamine and norepinephrine where the brain manages attention and impulse control. Immediate-release tablets last three to four hours; extended-release forms such as Concerta last about ten to twelve hours. It is a controlled substance.
How to take it
- Take it in the morning. Immediate-release may be repeated at midday per your label; extended-release is once a day. Avoid doses after early afternoon.
- Swallow extended-release tablets whole. Concerta's shell may appear in the stool; that is normal.
- Eat breakfast before or with it, since appetite drops once it takes effect.
- If you miss a morning dose, take it only if it is still early. Otherwise skip it. Do not double up.
What to expect, and when
- Day 1: it works within thirty to sixty minutes. Focus and task start are usually noticed first.
- Week 1 to 2: appetite, sleep, and heart rate are watched while the dose is adjusted.
- Week 2 to 4: the right dose and form are found. If it wears off too early or too late in the day, the form can be changed.
- Follow-ups are more frequent at first, then spaced out once the dose is stable.
Common side effects
Reduced appetite, trouble falling asleep, dry mouth, headache, stomach upset, faster heartbeat, and a small rise in blood pressure. Some people feel irritable or flat as the dose wears off in the evening. Most effects ease over the first weeks or with a timing or dose change.
Call the office the same day if
- Chest pain, fainting, shortness of breath, or a racing or irregular heartbeat (call 911 for chest pain)
- Seeing or hearing things that are not there, severe agitation, or new paranoia
- A sharp rise in blood pressure, severe headache, or vision changes
- Numb, painful, or color-changing fingers or toes, or unexplained sores on them
- New or worsening depression, or thoughts of hurting yourself
Stopping
Stimulants can be paused and restarted, and some people skip days off work by plan. Stopping suddenly after daily use can bring a few days of fatigue, low mood, and extra sleep. Tell us before you stop so we can plan it.
Good to know
- This is a controlled substance. Keep it in a safe place, never share it, and know that early refills generally cannot be issued. Visits are required for each new prescription.
- Tell us about any heart condition, high blood pressure, glaucoma, or history of substance use before starting, and tell other prescribers and your pharmacist you take it.
- Caffeine, decongestants, and cannabis add to the heart-rate and blood-pressure effects. Keep caffeine modest and be honest with us about cannabis.
Questions about this medication?
Alice Tran Psychiatric Care · 3060 Williams Drive, Suite 300, Fairfax, VA 22031
Call: (703) 791-9099 · Text: (703) 791-9031 · info@alicetrannp.com · alicetrannp.com
This handout is for education and is not a substitute for the instructions you received at your visit. Follow the dose on your prescription label. If anything here differs from what you were told, call the office. In an emergency, call 911. If you are in crisis, call or text 988.