A nurse is teaching a client who is to start taking methyldopa for the treatment of hypertension

Methylphenidate comes as an immediate-release tablet, a chewable tablet, a solution (liquid), a long-acting (extended-release) suspension (liquid), an intermediate-acting (extended-release) tablet, a long-acting (extended-release) capsule, a long-acting (extended-release) tablet, a long-acting (extended-release) chewable tablet, and a long-acting (extended-release) orally disintegrating tablet (tablet that dissolves quickly in the mouth). The long-acting tablet, orally disintegrating tablets, and capsules supply some medication right away and release the remaining amount as a steady dose of medication over a longer time. All of these forms of methylphenidate are taken by mouth. The regular tablets, chewable tablets (Methylin), and solution (Methylin) are usually taken two to three times a day by adults and twice a day by children, preferably 35 to 40 minutes before meals. Adults who are taking three doses should take the last dose before 6:00 pm, so that the medication will not cause difficulty in falling asleep or staying asleep. The intermediate-acting tablets are usually taken once or twice a day, in the morning and sometimes in the early afternoon 30 to 45 minutes before a meal. The long-acting capsule (Metadate CD) is usually taken once a day before breakfast; the long-acting tablet (Concerta), long-acting chewable tablet (Quillichew ER), long-acting suspension (Quillivant XR), and long-acting capsules (Aptensio XR, Ritalin LA) are usually taken once a day in the morning with or without food. The long-acting suspension (Quillivant XR) will begin to work sooner if it is taken with food. The long-acting orally disintegrating tablet (Cotempla XR-ODT) and the long-acting capsule (Adhansia XR) is usually taken once daily in the morning and should be taken consistently, either always with food or always without food. The long-acting capsule (Jornay PM) is usually taken once daily in the evening (between 6:30 pm and 9:30 pm),and should be taken consistently, at the same time every evening and either always with food or always without food.

Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take methylphenidate exactly as directed.

Do not try to push the extended-release orally disintegrating tablet (Cotempla XR-ODT) through the blister pack foil. Instead, use dry hands to peel back the foil packaging. Immediately take out the tablet and place it in your mouth. The tablet will quickly dissolve and can be swallowed with saliva; no water is needed to swallow the tablet.

You should thoroughly chew the immediate-release chewable tablets and then drink a full glass (at least 8 ounces [240 milliliters]) of water or other liquid. If you take the immediate-release chewable tablet without enough liquid, the tablet may swell and block your throat and may cause you to choke. If you have chest pain, vomiting, or trouble swallowing or breathing after taking the chewable tablet, you should call your doctor or get emergency medical treatment immediately.

Swallow the intermediate-acting and long-acting tablets and capsules whole; do not split, chew, or crush them. However, if you cannot swallow the long-acting capsules (Aptensio XR, Jornay PM, Metadate CD, Ritalin LA), you may carefully open the capsules and sprinkle the entire contents on a tablespoon of cool or room temperature applesauce, or for long-acting capsules (Adhansia XR), you may open the capsules and sprinkle the entire contents on a tablespoon of applesauce or yogurt. Swallow (without chewing) this mixture immediately after preparation (within 10 minutes if taking Adhansia XR) and then drink a glass of water to make sure you have swallowed all of the medicine. Do not store the mixture for future use.

If you are taking the long-acting chewable tablet (Quillichew ER) and your doctor has told you to take part of the tablet to get the correct amount of your dose, break the 20 mg or 30 mg long-acting chewable tablet carefully along the lines that have been scored into it. However, the 40 mg long-acting chewable tablet is not scored and cannot be divided or split.

If you are taking the long-acting suspension (Quillivant XR), follow these steps to measure the dose:

1. Remove the bottle of medication and dosing dispenser from the box. Check to be sure that the bottle contains liquid medication. Call your pharmacist and do not use the medication if the bottle contains powder or if there is no dosing dispenser in the box.
2. Shake the bottle up and down for at least 10 seconds to mix the medication evenly.
3. Remove the bottle cap. Check that the bottle adapter has been inserted into top of the bottle.
4. If the bottle adapter has not been inserted into the top of the bottle, insert it by placing the bottom of the adapter into the opening of the bottle and pressing down firmly on it with your thumb. Call your pharmacist if the box does not contain a bottle adapter. Do not remove the bottle adapter from the bottle once it is inserted.
5. Insert the tip of the dosing dispenser into the bottle adapter and push the plunger all the way down.
6. Turn the bottle upside down.
7. Pull the plunger back to withdraw the amount of oral suspension prescribed by your doctor. If you are not sure how to correctly measure the dose your doctor has prescribed, ask your doctor or pharmacist.
8. Remove the dosing dispenser and slowly squirt the oral suspension directly into your mouth or your child's mouth.
9. Replace the cap on the bottle and close tightly.
10. Clean the dosing dispenser after each use by placing it in the dishwasher or by rinsing with tap water.

Your doctor may start you on a low dose of methylphenidate and gradually increase your dose, not more often than once every week.

Your condition should improve during your treatment. Call your doctor if your symptoms worsen at any time during your treatment or do not improve after 1 month.

Your doctor may tell you to stop taking methylphenidate from time to time to see if the medication is still needed. Follow these directions carefully.

Some methylphenidate products may not be able to be substituted for another. Ask your pharmacist if you have any questions about the type of methylphenidate product your doctor has prescribed.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. 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.

Copyright 1996-2022 Cerner Multum, Inc. Version: 8.01. Revision date: 9/17/2018.