![]() ![]() ![]() If such symptoms occur, consider discontinuing Ritalin and Ritalin-SR. Prior to initiating treatment, screen patients for risk factors for developing a manic episode (e.g., comorbid or history of depressive symptoms or a family history of suicide, bipolar disorder, or depression).ĬNS stimulants, at recommended doses, may cause psychotic or manic symptoms (e.g., hallucinations, delusional thinking, or mania) in patients without a prior history of psychotic illness or mania. Induction of a Manic Episode in Patients with Bipolar DisorderĬNS stimulants may induce a manic or mixed mood episode in patients. Periodically reevaluate the long-term use of Ritalin and Ritalin-SR, and adjust dosage as needed.ĬNS stimulants may exacerbate symptoms of behavior disturbance and thought disorder in patients with a preexisting psychotic disorder. Pharmacological treatment of ADHD may be needed for extended periods. Ritalin-SR tablets must be swallowed whole and never crushed or chewed. Therefore, Ritalin-SR tablets may be used in place of Ritalin tablets when the 8-hour dosage of Ritalin-SR corresponds to the titrated 8-hour dosage of Ritalin. Ritalin-SR tablets have a duration of action of approximately 8 hours. Patients who are unable to sleep if medication is taken late in the day should take the last dose before 6 p.m. Administer orally in divided doses 2 or 3 times daily, preferably 30 to 45 minutes before meals. Daily dosage above 60 mg is not recommended.Īdults: Average dosage is 20 to 30 mg daily. Increase dosage gradually, in increments of 5-to 10-mg weekly. Pediatric Patients 6 years and Older: Start with 5 mg orally twice daily (before breakfast and lunch). Long-Term Suppression of Growth: Monitor height and weight at appropriate intervals in pediatric patients.Careful observation for digital changes is necessary during treatment with ADHD stimulants. Peripheral Vasculopathy, Including Raynaud’s Phenomenon: Stimulants used to treat ADHD are associated with peripheral vasculopathy, including Raynaud’s phenomenon.Immediate medical attention should be sought if signs or symptoms of prolonged penile erections or priapism are observed. Priapism: Cases of painful and prolonged penile erections, and priapism have been reported with methylphenidate products.Evaluate for preexisting psychotic or bipolar disorder prior to Ritalin and Ritalin-SR use. Psychiatric Adverse Reactions: Use of stimulants may cause psychotic or manic symptoms in patients with no prior history or exacerbation of symptoms in patients with preexisting psychiatric illness. ![]() Consider the benefits and risk in patients for whom an increase in blood pressure or heart rate would be problematic. ![]()
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