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S1759 LEAFLET Concerta 18mg 20150825


Rare (may affect up to 1 in 1,000 people)

What Concerta XL contains

The active substance is methylphenidate hydrochloride. Each tablet
contains 18mg of methylphenidate hydrochloride.

feeling disorientated or confused

trouble seeing or double vision

swelling of the breasts in men

excessive sweating, redness of the skin, red raised skin rash.

The other ingredients are:

Very rare (may affect up to 1 in 10,000 people)

muscle cramps

small red marks on the skin

abnormal liver function including liver failure and coma

changes in test results – including liver and blood tests

abnormal thinking, lack of feeling or emotion, doing things over
and over again, being obsessed with one thing

fingers and toes feeling numb, tingling and changing colour
(from white to blue, then red) when cold (‘Raynaud’s

Not known (frequency cannot be estimated from the available

Contents of the pack and other information

butylhydroxytoluene (E321), cellulose acetate 398-10,
hypromellose 3cp, phosphoric acid concentrated, poloxamer
188, polyethylene oxides 200k MW and 7000k MW, povidone
K29-32, sodium chloride, stearic acid, succinic acid, iron oxide
black (E172), iron oxide yellow (E172)

S1759 LEAFLET Concerta 18mg 20150825

Concerta XL 18 mg Prolonged Release Tablets
(methylphenidate hydrochloride)

The name of your medicine is Concerta XL 18 mg Prolonged
Release Tablets, but will be referred to as Concerta XL throughout
the following leaflet.
The active substance is ‘methylphenidate hydrochloride'. The name
‘methylphenidate' will also be used in this leaflet.
Please note that other strengths (36 and 54mg) are also available
for Concerta XL Prolonged Release Tablets.

Film coat: hypromellose 15cp, lactose monohydrate, titanium
dioxide (E171), triacetin, iron oxide yellow (E172) and stearic

Clear coat: carnauba wax, hypromellose 6cp, macrogol 400.

Important things you need to know about your medicine

Printing Ink: iron oxide black (E172), hypromellose 6cp,
isopropyl alcohol, propylene glycol and purified water.

This medicine is used to treat ADHD

What Concerta XL looks like and contents of the pack
Capsule-shaped yellow tablet with 'alza 18' printed on one side in
black ink.
Concerta XL tablets are available in bottle packs of 30 tablets.

The full name for ADHD is ‘Attention Deficit Hyperactivity

The medicine helps with your brain activity. It can help improve
your attention, help you concentrate, and make you less

You need to have other treatments for ADHD as well as this
Read Section 1 for more information.


Product Licence holder

dilated pupils

very high fever

Before you take this medicine, talk to your doctor if:

slow, fast or extra heart beats

Procured from within the EU and repackaged by the Product
Licence holder: S&M Medical Ltd, Chemilines House,
Alperton Lane, Wembley, HA0 1DX.

a major fit (‘grand mal convulsions’)

You have heart, circulation, or mental health problems – you
may not be able to take this medicine.


believing things that are not true

You are taking any other medicines - this is because
methylphenidate can affect how other medicines work.

severe stomach pain, often with feeling and being sick

This product is manufactured by Janssen Pharmaceutica NV,
Turnhoutseweg 30, 2340, Beerse, Belgium.

Read Section 2 for more information.

Effects on growth
When used for more than a year, methylphenidate may cause
reduced growth in some children. This affects less than 1 in 10

there may be lack of weight gain or height growth.

your doctor will carefully watch your height and weight, as well
as how well you are eating.

if you are not growing as expected, then your treatment with
methylphenidate may be stopped for a short time.



PL 19488/1759

Leaflet revision date: 25 August 2015
Concerta is a registered trademark of Alza Corporation.
S1759 LEAFLET Concerta 18mg 20150825

While taking this medicine:

See your doctor regularly. This is because your doctor will want
to check how the medicine is working.

Do not stop taking the medicine without first talking to your

Your doctor may stop your medicine to see if it is still needed, if
you take it for more than a year.

The most common side effects are feeling nervous, not being
able to sleep or having a headache.
Read Sections 3 and 4 for more information.

it is used in children and young people between the ages of 6
and 18.

it is used only after trying treatments which do not involve
medicines. Such as counselling and behavioural therapy.

Concerta XL is not for use as a treatment for ADHD in children
under 6 years of age or for the initiation of treatment in adults.
When treatment was started at a younger age, it might be
appropriate to continue taking Concerta XL when you become an
adult. Your doctor will advise you about this.
How it works
Concerta XL improves the activity of certain parts of the brain which
are under-active.
The medicine can help improve attention (attention span),
concentration and reduce impulsive behaviour.
The medicine is given as part of a treatment programme, which
usually includes:


educational and

social therapy.

It is prescribed only by doctors who have experience in children or
young people's behaviour problems. Although there is no cure for
ADHD, it can be managed using treatment programmes.
About ADHD
Children and young people with ADHD find it:

hard to sit still and

hard to concentrate.

It is not their fault that they cannot do these things.
Many children and young people struggle to do these things.
However, with ADHD they can cause problems with everyday life.
Children and young people with ADHD may have difficulty learning
and doing homework. They find it hard to behave well at home, at
school or in other places.
ADHD does not affect the intelligence of a child or young person.

What you need to know before you take Concerta XL

Do not take Concerta XL if:

you have a thyroid problem

you have increased pressure in your eye (glaucoma)

you have a tumour of your adrenal gland (phaeochromocytoma)

you have an eating problem when you do not feel hungry or
want to eat - such as ‘anorexia nervosa’

you have very high blood pressure or narrowing of the blood
vessels, which can cause pain in the arms and legs

you have ever had heart problems - such as a heart attack,
uneven heartbeat, pain and discomfort in the chest, heart
failure, heart disease or were born with a heart problem

you have had a problem with the blood vessels in your brain such as a stroke, swelling and weakening of part of a blood
vessel (aneurysm), narrow or blocked blood vessels, or
inflammation of the blood vessels (vasculitis)

you are currently taking or have taken within the last 14 days an
antidepressant (known as a monoamine oxidase inhibitor)- see
‘Other medicines and Concerta XL’ .

The leaflet has been written in sections:

you have mental health problems such as:
- a ‘psychopathic’ or ‘borderline personality’ problem



Talk to your doctor straight away if any of the following


How to store Concerta XL

The rest of this leaflet includes more detail and other important
information on the safe and effective use of this medicine.


Keep this leaflet. You may need to read it again.

Do not store above 30°C. Keep the bottle tightly closed in order
to protect from moisture.

If you have any further questions, ask your doctor or

Do not use this medicine after the expiry date which is stated on
the label. The expiry date refers to the last day of that month.

The pack contains one or two silica gel pouches. These
pouches are used to keep the tablets dry and should not be

This medicine has been prescribed for you only. Do not pass it
on to others. It may harm them, even if their signs of illness are
the same as yours.

If you get any side effects, talk to your doctor or pharmacist.
This includes any possible side effects not listed in this leaflet.
See section 4.

Your mood and how you feel changes.

 You feel any problems with your heart.
Read Section 4 for more information.

If the medicine becomes discoloured or shows any other signs
of deterioration, you should seek the advice of your pharmacist
who will tell you what to do.
Medicines should not be disposed of via wastewater or
household waste. Ask your pharmacist how to dispose of
medicines no longer required. These measures will help to
protect the environment

Concerta XL is used to treat ‘attention deficit hyperactivity disorder’

you are allergic to methylphenidate or any of the other
ingredients of this medicine (listed in section 6)

If you get any side effects talk to your doctor, pharmacist or nurse.
This includes any possible side effects not listed in this leaflet. You
can also report side effects directly via the Yellow Card Scheme at:
By reporting side effects, you can help provide more information on
the safety of this medicine.

What Concerta XL is and what it is used for

What it is used for

Reporting of side effects



Sections 1 to 6 are for parents and carers (sometimes called
‘your guardians’).
The last section is a special section for a child or young person
to read.



What Concerta XL is and what it is used for


What you need to know before you take Concerta XL


How to take Concerta XL


Possible side effects


How to store Concerta XL


Contents of the packet and other information

signs of a severe mood problem like:

However, all sections are written as though the child or young
person taking the medicine is reading them.
The sections are:

abnormal thoughts or visions or an illness called
feeling like killing yourself
severe depression, where you feel very sad, worthless
and hopeless


mania, where you feel unusually excitable, over-active,
and un-inhibited.
Do not take methylphenidate if any of the above apply to you. If you
are not sure, talk to your doctor or pharmacist before you take
methylphenidate. This is because methylphenidate can make these
problems worse.

Information for children and young people
Now read the rest of this leaflet before you start taking this
medicine because it contains important information for you.

Other things to remember

Who should I ask if there is anything I don’t understand?

make sure you keep your medicine in a safe place, so that no
one else takes it, especially younger brothers or sisters.

Your mum, dad, carer, doctor, nurse or pharmacist will be able to
help you.

the medicine is special for you - do not let anyone else have
it. It may help you, but it could hurt someone else.

if you forget to take your medicine don’t take two tablets the
next time. Just take one tablet at the next normal time.

if you do take too much medicine, tell your mum, dad or carer
right away.

it is important not to take too much medicine or you will get ill.

don’t stop taking your medicine until your doctor says it’s OK.

Information for children and young people
This info is to help you learn the main things about your medicine
called Concerta XL.

Why have I been given this medicine?
This medicine can help children and young people with ‘ADHD’.

If you don’t enjoy reading, someone like your mum, dad or carer
(sometimes called ‘your guardian’) can read it to you and answer
any questions.
It may help if you read small bits at a time.

ADHD can make you:
- run about too much

not be able to pay attention


act quickly without thinking about what will happen next

It affects learning, making friends and how you think about
yourself. It is not your fault.

Warnings and precautions
Talk to your doctor before taking Concerta XL if:

you have liver or kidney problems

you have a problem with swallowing or swallowing whole

you have a narrowing or blockage of your gut or food-pipe

you have had fits (seizures, convulsions, epilepsy) or any
abnormal brain scans (EEGs)

you have ever abused or been dependent on alcohol,
prescription medicines or street drugs

you are a girl and have started your periods (see the
‘Pregnancy, breast-feeding and contraception’ section below)

you have hard-to-control, repeated twitching of any parts of the
body or you repeat sounds and words

Please tell you doctor or pharmacist if you are taking or have
recently taken any other medicines, including medicines obtained
without a prescription.

Signs of overdose may include: being sick, feeling agitated,
shaking, increased uncontrolled movements, muscle twitching, fits
(may be followed by coma), feeling very happy, being confused,
seeing, feeling or hearing things that are not real (hallucinations),
sweating, flushing, headache, high fever, changes in heart beat
(slow, fast or uneven), high blood pressure, dilated pupils and dry
nose and mouth.

Having an operation
Tell your doctor if you are going to have an operation. You should
not take methylphenidate on the day of your surgery if a certain
type of anaesthetic is used. This is because there is a chance of a
sudden rise in blood pressure during the operation.
Drug testing

Concerta XL with alcohol

you have a mental health problem which is not in the ‘Do not
take’ section above.
Other mental health problems include:

Do not drink alcohol while taking this medicine. Alcohol may make
the side effects of this medicine worse. Remember that some foods
and medicines contain alcohol.

- mood swings (from being manic to being depressed - called
‘bipolar disorder’)

Pregnancy, breast-feeding and contraception

Your doctor will do some tests

If you are pregnant or breast-feeding, think you may be pregnant or
are planning to have a baby, ask your doctor for advice before
taking this medicine.

before you start - to make sure that Concerta XL is safe and will
be of benefit.

after you start - they will be done at least every 6 months, but
possibly more often. They will also be done when the dose is

It is not known if methylphenidate will affect an unborn baby. Tell
your doctor or pharmacist before using methylphenidate if you are:

having sex. Your doctor will discuss contraception with you

- feeling agitated, anxious or tense

pregnant or think you may be pregnant. Your doctor will decide
whether you should take methylphenidate.

Checks that your doctor will make before you start taking
Concerta XL
These checks are to decide if methylphenidate is the correct
medicine for you. Your doctor will talk to you about:

any other medicines you are taking

whether there is any family history of sudden unexplained death

any other medical problems (such as heart problems) you or
your family may have

how you are feeling, such as feeling high or low, having strange
thoughts or if you have had any of these feelings in the past
whether there is a family history of ‘tics’ (hard-to-control,
repeated twitching of any parts of the body or repeating sounds
and words)
any mental health or behaviour problems you or other family
members have ever had. Your doctor will discuss whether you
are at risk of having mood swings (from being manic to being
depressed - called ‘bipolar disorder’). They will check your
mental health history, and check if any of your family have a
history of suicide, bipolar disorder or depression.

It is important that you provide as much information as you can.
This will help your doctor decide if methylphenidate is the correct
medicine for you. Your doctor may decide that other medical tests
are needed before you start taking this medicine.
Other medicines and Concerta XL
Tell your doctor if you are taking, have recently taken or might take
any other medicines.

are taking a medicine called a ‘monoamine oxidase inhibitor’
(MAOI) used for depression, or have taken an MAOI in the last
14 days. Taking an MAOI with methylphenidate may cause a
sudden increase in your blood pressure.
If you are taking other medicines, methylphenidate may affect how
well they work or may cause side effects. If you are taking any of
the following medicines, check with your doctor or pharmacist
before taking methylphenidate:

other medicines for depression

medicines for severe mental health problems

medicines for epilepsy

medicines used to reduce or increase blood pressure

some cough and cold remedies which contain medicines that
can affect blood pressure. It is important to check with your
pharmacist when you buy any of these products

breast-feeding or planning to breast-feed. It is possible that
methylphenidate is passed into human breast milk. Therefore,
your doctor will decide whether you should breast-feed while
taking methylphenidate.

these tests will include:

checking your appetite

measuring height and weight

measuring blood pressure and heart rate

checking whether you have any problems with your mood,
state of mind or any other unusual feelings. Or if these have
got worse while taking Concerta XL.

You may feel dizzy, have problems focussing or have blurred vision
when taking methylphenidate. If these happen it may be dangerous
to do things such as drive, use machines, ride a bike or horse or
climb trees.
This medicine can affect your ability to drive. Do not drive whilst
taking this medicine until you know how this medicine affects you. It
may be an offence to drive if your ability to drive safely is affected.
There is further information for patients who are intending to drive in
Great Britain – go to

unexplained fainting, chest pain, shortness of breath (these can
be signs of heart problems)

paralysis or problems with movement and vision, difficulties in
speech (these can be signs of problems with the blood vessels
in your brain)

If you have any of the side effects above, see a doctor straight

Concerta XL contains lactose
This medicine contains lactose (a type of sugar). If you have been
told by your doctor that you cannot tolerate or digest some sugars,
talk to your doctor before taking this medicine.

How to take Concerta XL

Other side effects include the following, if they get serious,
please tell your doctor or pharmacist:
Very common (may affect more than 1 in 10 people)


feeling nervous

not being able to sleep.

Common (may affect up to 1 in 10 people)

joint pain

blurred vision

tension headache

dry mouth, thirst
high temperature (fever)
problems with sex drive

unusual hair loss or thinning

muscle tightness, muscle cramps

loss of appetite or decreased appetite

inability to develop or maintain an erection

itching, rash or raised red itchy rashes (hives)

feeling unusually sleepy or drowsy, feeling tired

clenching or grinding your teeth, feeling of panic

tingling feeling, prickling, or numbness of the skin

increased alanine aminotransferase (liver enzyme) level in your

cough, sore throat or nose and throat irritation; upper
respiratory tract infection; sinus infection

Possible side effects

Like all medicines, this medicine can cause side effects, although
not everybody gets them. Although some people get side effects,
most people find that methylphenidate helps them. Your doctor will
talk to you about these side effects.
Some side effects could be serious. If you have any of the side
effects below, see a doctor straight away:

How much to take

Common (may affect up to 1 in 10 people)

high blood pressure, fast heart beat (tachycardia)

Always take this medicine exactly as your doctor has told you.
Check with your doctor or pharmacist if you are not sure.

uneven heartbeat (palpitations)

mood changes or mood swings or changes in personality

dizziness (vertigo), feeling weak, movements which you cannot
control, being unusually active

feeling aggressive, agitated, anxious, depressed, irritable,
tense, jittery and abnormal behaviour

upset stomach or indigestion, stomach pain, diarrhoea, feeling
sick, stomach discomfort and being sick.

your doctor will usually start treatment with a low dose and
increase it gradually as required.

the maximum daily dose is 54 mg.

you should take Concerta XL once each day in the morning with
a glass of water. The tablet should be swallowed whole and not
chewed, broken, or crushed. The tablet may be taken with or
without food.

The tablet does not dissolve completely after all of the drug has
been released and sometimes the tablet shell may appear in your
stools. This is normal.

Uncommon (may affect up to 1 in 100 people)

thinking about or feeling like killing yourself

seeing, feeling, or hearing things that are not real, these are
signs of psychosis

Uncommon (may affect up to 1 in 100 people)

uncontrolled speech and body movements (Tourette’s)

dry eyes

signs of allergy such as rash, itching or hives on the skin,
swelling of the face, lips, tongue or other parts of the body,
shortness of breath, wheezing or trouble breathing


chest discomfort

blood in the urine

If you do not feel better after 1 month of treatment

Rare (may affect up to 1 in 1,000 people)


If you do not feel better, tell your doctor. They may decide you need
a different treatment.

shaking or trembling

increased need to pass urine

Very rare (may affect up to 1 in 10,000 people)

muscle pain, muscle twitching

heart attack

shortness of breath or chest pain

sudden death

feeling hot

suicidal attempt

increases in liver test results (seen in a blood test)

fits (seizures, convulsions epilepsy)

skin peeling or purplish red patches

anger, feeling restless or tearful, talking too much, excessive
awareness of surroundings, problems sleeping.

inflammation or blocked arteries in the brain

Not using Concerta XL properly
If Concerta XL is not used properly, this may cause abnormal
behaviour. It may also mean that you start to depend on the
medicine. Tell your doctor if you have ever abused or been
dependent on alcohol, prescription medicines or street drugs.
This medicine is only for you. Do not give this medicine to anyone
else, even if their symptoms seem similar.

feeling unusually excited, over-active and un-inhibited (mania)

S1759 LEAFLET Concerta 18mg 20150825

as well as taking this medicine you will also get help with ways
to cope with your ADHD such as talking to ADHD specialists.

You cannot have this medicine if:

swallow your medicine with water.

you have a problem with your heart

this medicine should help you. But it does not cure ADHD.

you feel very unhappy, depressed or have a mental illness.

your doctor will tell you how many times a day you should take
your medicine

you will need to go to your doctor several times a year for check
ups. This is to make sure the medicine is working and that yo u
are growing and developing OK.

do not stop taking the medicine without talking to your doctor

if you are having sex, please talk to your doctor about
contraception. Girls must tell their doctor straight away if they
think they may be pregnant. We do not know how this medicine
affects unborn babies.

unwanted thoughts that keep coming back

Concerta XL does not need to be taken for ever. If you take
Concerta XL for more than a year, your doctor should stop
treatment for a short time, this may happen during a school holiday.
This will show if the medicine is still needed.
If you have any further questions on the use of this product, ask
your doctor or pharmacist.

How do I take my medicine?

do not drink alcohol. Alcohol may make the side effects of this
medicine worse.

Not known (frequency cannot be estimated from the available

trouble falling asleep

Some people cannot have this medicine

a sudden increase in body temperature, very high blood
pressure and severe convulsions (‘Neuroleptic Malignant
Syndrome’). It is not certain that this side effect is caused by
methylphenidate or other drugs that may be taken in
combination with methylphenidate.


medicines that thin the blood to prevent blood clots.

if you take the medicine for more than one year, your doctor
may stop your medicine to see if it is still needed. This will
probably happen in a school holiday.

While you are taking this medicine

decrease in number of blood cells (red cells, white cells and
platelets) which can make you more likely to get infections, and
make you bleed and bruise more easily

Long-term treatment

Driving and using machines

Do not take methylphenidate if you:

Things your doctor will do when you are on treatment

- feeling unusually suspicious (paranoia)

Tell your doctor or pharmacist if any of the above apply to you
before starting treatment. This is because methylphenidate can
make these problems worse. Your doctor will want to monitor how
the medicine affects you.

Do not take a double dose to make up for a forgotten dose. If you
forget a dose, wait until it is time for the next dose.

you have a heart problem which is not in the ‘Do not take’
section above

- feeling depressed or guilty.

muscle spasms which you cannot control affecting your eyes,
head, neck, body and nervous system -due to a temporary lack
of blood supply to the brain

If you forget to take Concerta XL

If you suddenly stop taking this medicine, the ADHD symptoms may
come back or unwanted effects such as depression may appear.
Your doctor may want to gradually reduce the amount of medicine
taken each day, before stopping it completely. Talk to your doctor
before stopping Concerta XL.

you have high blood pressure

If you take too much medicine, talk to a doctor or call an ambulance
straight away. Tell them how much has been taken.

If you stop taking Concerta XL

- seeing, hearing or feeling things that are not there
- believing things that are not true (delusions)

If you take more Concerta XL than you should

This medicine may give a positive result when testing for drug use.
This includes testing used in sport.

- starting to be aggressive or hostile, or your aggression gets

If you are in any doubt about whether any medicines you are taking
are included in the list above, ask your doctor or pharmacist before
taking methylphenidate.

Some people need to talk to their doctor before they start
having this medicine
You need to talk to your doctor if:

you have epilepsy (fits)

you are pregnant or breastfeeding

you are taking other medicines – your doctor needs to know
about all the medicines you are taking.

Possible side effects
Side effects are the unwanted things that can happen when you
take a medicine. If any of the following happen, tell an adult you
trust straight away. They can then talk to your doctor. The main
things that could affect you are:

feeling worried or nervous

feeling dizzy, or getting head aches

being very depressed and unhappy or wanting to hurt yourself

having different moods than usual, not being able to get to

skin rashes, bruising easily, getting out of breath

the medicine can also make you feel sleepy. If you feel sleepy,
it is important not to do outdoor sports like riding a horse or
bike, swimming or climbing trees. You could hurt yourself and

 your heart beating faster than usual.
If you feel unwell in any way while you are taking your
medicine please tell an adult you trust straight away.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. 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. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.