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Concerta (methylphenidate) Disease Interactions

There are 14 disease interactions with Concerta (methylphenidate):

Major

Cns Stimulants (Includes Concerta) ↔ Agitation

Severe Potential Hazard, High plausibility

Applies to: Anxiety/Stress, Neurosis, Psychosis

The use of central nervous system (CNS) stimulants is contraindicated in patients with marked agitation and/or anxiety, since these symptoms may be aggravated. CNS stimulants may also exacerbate symptoms of behavior disturbance and thought disorder in psychotic patients, particularly children. Therapy with CNS stimulants should be administered cautiously in patients with a history of psychosis or a predisposition to agitated states.

References

  1. "Product Information. Tenuate (diethylpropion)" Aventis Pharmaceuticals, Swiftwater, PA.
  2. "Product Information. Adderall (amphetamine-dextroamphetamine)" Shire Richwood Pharmaceutical Company, Florence, KY.
  3. "Product Information. Prelu-2 (phendimetrazine)" Boehringer-Ingelheim, Ridgefield, CT.
View all 11 references
Major

Cns Stimulants (Includes Concerta) ↔ Cardiac Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Heart Disease, Pheochromocytoma, Hyperthyroidism

The use of CNS stimulants is contraindicated in patients with significant cardiovascular impairment such as uncompensated heart failure, severe coronary disease, severe hypertension (including that associated with hyperthyroidism or pheochromocytoma), cardiac structural abnormalities, serious arrhythmias, etc. Sudden death has been reported in adults and children taking CNS stimulant treatment. Additionally, stroke, myocardial infarction, chest pain, syncope, arrhythmias and other symptoms have been reported in adults under treatment. A careful assessment of the cardiovascular status should be done in patients being considered for treatment. This includes family history, physical exam and further cardiac evaluation (EKG and echocardiogram). Patients who develop symptoms should have a detailed cardiac evaluation and if needed, treatment should be suspended.

References

  1. "Product Information. Dopram (doxapram)." Whitehall-Robbins, Madison, NJ.
Major

Cns Stimulants (Includes Concerta) ↔ Glaucoma

Severe Potential Hazard, Moderate plausibility

Applies to: Glaucoma/Intraocular Hypertension, Glaucoma (Narrow Angle)

The use of some CNS stimulants is contraindicated in patients with glaucoma, as these agents exhibit sympathomimetic activity and may induce mydriasis provoking an increase in intraocular pressure.

References

  1. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals, East Hanover, NJ.
  2. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc, Atlanta, GA.
Major

Cns Stimulants (Includes Concerta) ↔ Hypertension

Severe Potential Hazard, Moderate plausibility

Applies to: Hypertension

CNS stimulant medications have shown to increase blood pressure and their use is contraindicated in patients with severe hypertension. Caution should be used when administering to patients with preexisting high blood pressure and other cardiovascular conditions. All patients under treatment should be regularly monitored for changes in blood pressure and heart rate.

References

  1. "Product Information. Dopram (doxapram)." Whitehall-Robbins, Madison, NJ.
Major

Cns Stimulants (Includes Concerta) ↔ Liver Disease

Severe Potential Hazard, Moderate plausibility

Applies to: Liver Disease

In general, CNS stimulants are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with CNS stimulants should be administered cautiously in patients with moderate to severe liver disease, and the dosage should be adjusted accordingly. Additionally, postmarketing reports have shown that atomoxetine can cause severe liver injury. Laboratory testing should be done at the first sign or symptom of liver dysfunction (jaundice, dark urine, upper quadrant tenderness) and treatment should be discontinued in patients with evidence of liver injury.

References

  1. "Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
Major

Cns Stimulants (Includes Concerta) ↔ Seizure Disorders

Severe Potential Hazard, Moderate plausibility

Applies to: Seizures

Due to general central nervous system stimulation, therapy with CNS stimulant drugs may cause seizures. These drugs may lower the convulsive threshold in patients with prior history of seizures or EEG abnormalities, and very rarely in patients with no previous history of seizures. Therapy with CNS stimulants should be used with caution in patients with or predisposed to seizures. If seizures appear, therapy should be discontinued.

References

  1. American Medical Association, Division of Drugs and Toxicology "Drug evaluations annual 1994." Chicago, IL: American Medical Association; (1994):
Major

Cns Stimulants (Includes Concerta) ↔ Substance Abuse

Severe Potential Hazard, High plausibility

Applies to: Alcoholism, Drug Abuse/Dependence

Central nervous system (CNS) stimulants, especially amphetamines, have significant potential for habituation and abuse. Tolerance, psychological dependence and severe social dysfunction can develop after prolonged use. Frank psychotic episodes may also occur in association with chronic intoxication. Therapy with CNS stimulants should be administered cautiously, if at all, in patients with a history of alcohol or substance abuse. The use of amphetamines is considered by manufacturers to be contraindicated in such patients.

References

  1. "Product Information. Sanorex (mazindol)" Novartis Pharmaceuticals, East Hanover, NJ.
  2. "Product Information. Desoxyn (methamphetamine)" Abbott Pharmaceutical, Abbott Park, IL.
  3. "Product Information. Didrex (benzphetamine)" Pharmacia and Upjohn, Kalamazoo, MI.
View all 11 references
Major

Methylphenidate (Includes Concerta) ↔ Hypertension

Severe Potential Hazard, High plausibility

Applies to: Hypertension

Methylphenidate (racemic) and dexmethylphenidate (the more pharmacologically active d-enantiomer) exhibit sympathomimetic activity and may elevate blood pressure and pulse rate. Therapy with these agents should be administered cautiously in patients with hypertension. Blood pressure should be monitored periodically during therapy.

References

  1. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals, East Hanover, NJ.
  2. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc, Atlanta, GA.
Major

Methylphenidate (Includes Concerta) ↔ Seizures Disorders

Severe Potential Hazard, High plausibility

Applies to: Seizures

There is some clinical evidence that methylphenidate may lower the seizure threshold, occasionally even in patients without a history of seizures or prior EEG abnormalities. Therapy with methylphenidate (racemic) or dexmethylphenidate (the more pharmacologically active d-enantiomer) should be administered cautiously in patients with or predisposed to seizures. The medication should be discontinued if seizures occur during its use.

References

  1. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals, East Hanover, NJ.
  2. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc, Atlanta, GA.
Moderate

Cns Stimulants (Includes Concerta) ↔ Psychosis

Moderate Potential Hazard, Moderate plausibility

Applies to: Psychosis, Bipolar Disorder, Depression

The use of CNS stimulants can cause psychotic or maniac symptoms, suicidal ideation, aggression and can exacerbate symptoms of behavior disturbance and thought disorder. Psychiatric symptoms have been reported in patients with and without history of psychiatric disorders, and all patients should be monitored closely, specially during treatment initiation and at times of dose changes. Extreme caution should be exercised when CNS stimulants are given to patients with a history of psychosis, depression, mania, or bipolar disorder. If symptoms emerge or are exacerbated, treatment suspension should be considered. CNS stimulants are contraindicated in patients with marked agitation or anxiety.

References

  1. "Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
Moderate

Cns Stimulants (Includes Concerta) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Renal Dysfunction

Overall CNS stimulants should be administered with caution in patients with significantly impaired renal function as the reduction in the rate of elimination may alter the therapeutic response. The dosage should be adjusted accordingly.

References

  1. "Product Information. Provigil (modafinil)." Cephalon, Inc, West Chester, PA.
Moderate

Cns Stimulants (Includes Concerta) ↔ Tics

Moderate Potential Hazard, High plausibility

Applies to: Tic Disorder

Central nervous system (CNS) stimulants have been reported to exacerbate Tourette's syndrome and other motor and phonic tics. Therapy with CNS stimulants, if necessary, should be administered cautiously in patients with tic disorders or family history of Tourette's syndrome. The manufacturers of the CNS stimulants, methylphenidate (racemic) and dexmethylphenidate (the more pharmacologically active d-enantiomer), consider their use to be contraindicated in such patients.

References

  1. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals, East Hanover, NJ.
  2. "Product Information. Fastin (phentermine)." SmithKline Beecham, Philadelphia, PA.
  3. "Product Information. Sanorex (mazindol)" Novartis Pharmaceuticals, East Hanover, NJ.
View all 11 references
Moderate

Methylphenidate (Includes Concerta) ↔ Hematologic Toxicity

Moderate Potential Hazard, Low plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

Hematologic toxicity, including thrombocytopenia, easy bruisability, epistaxis, leukopenia, anemia and eosinophilia, has been reported rarely during use of methylphenidate. However, a causal relationship has not been established. Therapy with methylphenidate (racemic) or dexmethylphenidate (the more pharmacologically active d-enantiomer) should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Periodic hematologic monitoring may be appropriate in all patients during prolonged therapy.

References

  1. "Product Information. Focalin (dexmethylphenidate)." Mikart Inc, Atlanta, GA.
  2. "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals, East Hanover, NJ.
Moderate

Methylphenidate Er (Includes Concerta) ↔ Gi Narrowing

Moderate Potential Hazard, High plausibility

Applies to: Gastrointestinal Obstruction

The extended-release formulation of methylphenidate (Concerta) contains a non-deformable material. There have been rare reports of obstructive symptoms in patients with known strictures following the ingestion of similar sustained-release products. The extended-release formulation of methylphenidate should ordinarily not be administered in patients with preexisting severe gastrointestinal narrowing or obstruction, whether pathologic or iatrogenic (e.g., small bowel inflammatory disease, "short gut" syndrome due to adhesions or decreased transit time, past history of peritonitis, cystic fibrosis, chronic intestinal pseudo-obstruction, or Meckel's diverticulum). The medication should only be used in patients who are able to swallow the tablet whole.

References

  1. "Product Information. Concerta (methylphenidate)." Alza, Palo Alto, CA.

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There are 4 alcohol/food interactions with Concerta (methylphenidate)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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