Methylphenidate Side Effects

Medically reviewed by Drugs.com. Last updated on Apr 30, 2024.

Applies to methylphenidate: transdermal patch extended release.

Other dosage forms:

• oral capsule extended release, oral capsule extended release biphasic 30/70, oral capsule extended release biphasic 40/60, oral capsule extended release biphasic 50/50, oral powder for suspension extended release, oral solution, oral tablet, oral tablet chewable, oral tablet extended release, oral tablet extended release chewable, oral tablet extended release disintegrating

Precautions

Your doctor should check your progress at regular visits to make sure this medicine is working properly and to decide if you should continue to use it. Blood tests may be needed to check for unwanted effects.

You will need to have your blood pressure measured before starting this medicine and while you are using it. If you notice any change to your recommended blood pressure, call your doctor right away.

Do not use this medicine if you used a medicine for depression called an MAO inhibitor (MAOI), such as Eldepryl®, Marplan®, Nardil®, or Parnate®, within the past 14 days.

Methylphenidate may cause serious heart or blood vessel problems. This may be more likely in patients who have a family history of heart disease. Check with your doctor right away if you have chest pain, trouble breathing, or fainting while using this medicine.

If you have any redness, itching, swelling, or blistering where the patch has been, call your doctor right away.

Tell your doctor right away if you notice any unusual changes in behavior, such as an increase in aggression, hostility, agitation, irritability, or suicidal thinking or behaviors. Check with your doctor if you have hallucinations or any unusual thoughts, especially if they are new or getting worse quickly.

This medicine may cause a condition called Raynaud phenomenon. Check with your doctor right away if you have tingling or pain in the fingers or toes when exposed to cold, paleness or a cold feeling in the fingertips and toes, or a skin color change of your fingers while using this medicine.

This medicine may cause slow growth. If your child is using this medicine, the doctor will need to keep track of your child's height and weight.

Symptoms of an overdose include: agitation, blurred vision, change in consciousness, chest pain or discomfort, confusion, dark urine, diarrhea, dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position, fast, pounding, or irregular heartbeat or pulse, fever, headache, inability to speak, loss of consciousness, muscle cramps, spasms, pain, or stiffness, nausea, nervousness, overactive reflexes, pain or discomfort in the arms, jaw, back, or neck, pale, clammy skin, palpitations, pounding in the ears, seeing, hearing, or feeling things that are not there, seizures, shivering, slow or fast heartbeat, slurred speech, sweating, talking or acting with excitement you cannot control, temporary blindness, thirst, trembling or shaking, trouble breathing, unusual tiredness or weakness, vomiting, or weakness in the arm or leg on one side of the body, sudden and severe. Call your doctor right away if you notice these symptoms.

If you have a prolonged or painful erection of the penis for more than 4 hours, check with your doctor right away.

Using this medicine may cause loss of skin color where the patch is applied or on other areas of the skin. This usually occurs more often if you have a personal or family history of vitiligo. Call your doctor right away if you notice changes in skin color while using this medicine.

Methylphenidate may cause dizziness, drowsiness, or changes in vision. Do not drive a car, ride a bicycle, operate machinery, or do other things that might be dangerous until you know how this medicine affects you.

Avoid putting this medicine near external sources of direct heat, such as hair dyers, heating pads, electric blankets, heated water beds, or hot tubs.

Check with your doctor immediately if blurred vision, change in vision, eye pain, or loss of vision occurs during or after treatment. Your doctor may want you or your child to have your eyes checked by an ophthalmologist (eye doctor).

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements, and medicine for appetite control, asthma, colds, cough, hayfever, or sinus problems.

Serious side effects of methylphenidate

Along with its needed effects, methylphenidate may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking methylphenidate:

Get emergency help immediately if any of the following symptoms of overdose occur while taking methylphenidate:

Symptoms of overdose

• agitation
• blurred vision
• change in consciousness
• chest pain or discomfort
• confusion
• dark urine
• diarrhea
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fast, slow, or irregular heartbeat
• fever
• headache
• inability to speak
• loss of consciousness
• muscle cramps, spasms, pain, or stiffness
• nausea
• nervousness
• overactive reflexes
• pain or discomfort in the arms, jaw, back, or neck
• pale, clammy skin
• palpitations
• pounding in the ears
• seeing, hearing, or feeling things that are not there
• seizures
• shivering
• slow or fast heartbeat
• slurred speech
• sweating
• talking or acting with excitement you cannot control
• temporary blindness
• thirst
• tremor
• trouble breathing
• unusual tiredness or weakness
• vomiting
• weakness in the arm or leg on one side of the body, sudden and severe

Other side effects of methylphenidate

Some side effects of methylphenidate may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to methylphenidate: oral capsule extended release, oral powder for reconstitution extended release, oral solution, oral tablet, oral tablet chewable, oral tablet chewable extended release, oral tablet disintegrating extended release, oral tablet extended release, transdermal film extended release.

General adverse events

The more commonly reported adverse reactions have included decreased appetite, abdominal pain, nausea, vomiting, dyspepsia, insomnia, weight loss, anxiety, dizziness, irritability, affect lability, tachycardia, and increased blood pressure.^[Ref]

Other

• Common (1% to 10%): Lethargy, ear infection, pyrexia, fatigue, ear and labyrinth disorders, asthenia, injury/poisoning/procedural complications
• Postmarketing reports: Hyperpyrexia^[Ref]

Psychiatric

• Very common (10% or more): Psychiatric disorders (27.9%), insomnia (13.3%), irritability (11%)
• Common (1% to 10%): Anxiety, restlessness, sleep disorder, agitation, affect lability, aggression, depression, depressed mood, abnormal behavior, bruxism, confusional state, initial insomnia, decreased libido, nervousness, emotional poverty, tension, panic attack
• Uncommon (0.1% to 1%): Psychotic disorders, hallucinations (auditory, visual, tactile), anger, suicidal ideation, altered mood, mood swings, tearfulness, tics, worsening of pre-existing tics or Tourette's syndrome, hypervigilance
• Rare (less than 0.1%): Mania, disorientation, libido disorder
• Very rare (less than 0.01%): Suicidal attempt/completed suicide, transient depressed mood, abnormal thinking, apathy, repetitive behaviors, over-focusing
• Frequency not reported: Delusions, thought disturbances, confessional state, logorrhea^[Ref]

Metabolic

• Very common (10% or more): Decreased appetite (27.1%), metabolism and nutrition disorders (11.5%)
• Common (1% to 10%): Anorexia, decreased weight, thirst^[Ref]

Gastrointestinal

• Very common (10% or more): Gastrointestinal disorders (23.5%), dry mouth (21.5%), nausea (12.2%), vomiting (10.2%)
• Common (1% to 10%): Abdominal pain (upper and general), diarrhea, dyspepsia, toothache, stomach discomfort
• Uncommon (0.1% to 1%): Constipation^[Ref]

Nervous system

• Very common (10% or more): Nervous system disorders (23.5%), headache (23.2%)
• Common (1% to 10%): Dizziness, dyskinesia, tremor, drowsiness, feeling jittery, psychomotor hyperactivity, somnolence, vertigo, paresthesia, motion sickness, tension headache
• Uncommon (0.1% to 1%): Sedation, tremor
• Very rare (less than 0.01%): Convulsions, choreoathetoid movements, reversible ischemic neurological deficit, cerebrovascular disorders (vasculitis, cerebral hemorrhages, cerebrovascular accidents, cerebral arteritis, cerebral occlusion), neuroleptic malignant syndrome (NMS)
• Frequency not reported: Grand mal convulsions, migraine, sedation, serotonin syndrome (in combination with serotonergic drugs)^[Ref]

Endocrine

• Common (1% to 10%): Reproductive system and breast disorders
• Rare (less than 0.1%): Gynecomastia

Respiratory

• Very common (10% or more): Nasopharyngitis (19.1%), respiratory/thoracic/mediastinal disorders (10.6%)
• Common (1% to 10%): Upper respiratory tract infection, cough, oropharyngeal/pharyngolaryngeal pain, sinusitis, dyspnea^[Ref]

Musculoskeletal

• Very common (10% or more): Musculoskeletal and connective tissue disorders (14.4%),
• Common (1% to 10%): Joint sprain, arthralgia
• Uncommon (0.1% to 1%): Myalgia, muscle twitching, muscle tightness, muscle spasms
• Very rare (less than 0.01%): Muscle cramps
• Frequency not reported: Rhabdomyolysis, growth suppression, arthralgia^[Ref]

Among patients 7 to 10 years old, consistently medicated (i.e., receiving methylphenidate for 7 days per week) for over 14 months, as well as in naturalistic subgroups of newly methylphenidate-treated patients over 36 months (ages of 10 to 13 years), a temporary slowing in growth rate (on average, a total of about 2 cm less growth in height and 2.7 kg less growth in weight over 3 years), has been observed compared to non-medicated patients. This slowing in growth rate has been observed without evidence of growth rebound.^[Ref]

Local

• Very common (10% or more): Administration site and general disorders (12.9%)
• Postmarketing reports: Patch application site reactions^[Ref]

Cardiovascular

• Common (1% to 10%): Palpitations, tachycardia, cardiac disorders, vascular disorders, arrhythmias, hypertension, hot flush, changes in blood pressure and heart rate (usually an increase)
• Uncommon (0.1% to 1%): Cardiac murmur
• Rare (less than 0.1%): Angina pectoris
• Very rare (less than 0.01%): Cardiac arrest, myocardial infarction, peripheral coldness, Raynaud's phenomenon, sudden cardiac death
• Frequency not reported: Supraventricular tachycardia, bradycardia, ventricular extrasystoles, extrasystoles
• Postmarketing reports: Angina pectoris, bradycardia extrasystole, supraventricular tachycardia, ventricular extrasystole, chest pain, chest discomfort^[Ref]

Dermatologic

• Common (1% to 10%): Rash, pruritus, urticaria, fever, scalp hair loss/alopecia, dermatitis, excoriation hyperhidrosis, skin and subcutaneous tissue disorders
• Uncommon (0.1% to 1%): Angioneurotic edema, bullous conditions, exfoliative conditions
• Rare (less than 0.1%): Macular rash, erythema
• Very rare (less than 0.01%): Thrombocytopenic purpura, exfoliative dermatitis, erythema multiforme, fixed drug eruption^[Ref]

Immunologic

• Very common (10% or more): Infections and infestations (45.2%)
• Common (1% to 10%): Immune systems disorders, influenza^[Ref]

Ocular

• Common (1% to 10%): Eye disorders, eye pain
• Uncommon (0.1% to 1%): Diplopia, blurred vision
• Rare (less than 0.1%): Visual accommodation difficulties, mydriasis, visual disturbance
• Frequency not reported: Dry eye
• Postmarketing reports: Visual impairment, mydriasis, diplopia^[Ref]

Genitourinary

• Uncommon (0.1% to 1%): Hematuria, pollakiuria
• Frequency not reported: Increased erection, prolonged erection, priapism^[Ref]

Hepatic

• Uncommon (0.1% to 1%): Hepatic enzyme elevations
• Very rare (less than 0.01%): Abnormal liver function, hepatic coma, increased blood alkaline phosphatase, increased blood bilirubin
• Postmarketing reports: Hepatocellular injury, acute hepatic failure^[Ref]

Hypersensitivity

• Uncommon (0.1% to 1%): Hypersensitivity reactions (angioedema, anaphylaxis, auricular swelling, exanthemas)^[Ref]

Hematologic

• Very rare (less than 0.01%): Leukopenia, thrombocytopenia, anemia, decreased platelet count, abnormal white blood count
• Postmarketing reports: Pancytopenia, thrombocytopenia, thrombocytopenia purpura^[Ref]

See also:

Frequently asked questions

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Further information

Methylphenidate side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer