Methylphenidate Hydrochloride tablet is used for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy.

Methylphenidate (MPH) acts as a norepinephrine and dopamine reuptake inhibitor (NDRI), increasing the levels of these neurotransmitters in the synaptic space and prolonging their action. Its effects are dose-dependent: higher doses increase norepinephrine (NE) and dopamine (DA) activity throughout the brain, which may lead to impaired cognition and increased locomotor activity. At low doses, it selectively enhances NE and DA transmission in the prefrontal cortex, a brain region involved in ADHD, thereby improving attention, reducing impulsivity, and enhancing cognitive performance such as working memory. Low therapeutic doses do not produce locomotor stimulation. Its effect on sustained attention is also linked to alpha-1 adrenergic receptor activity.

Genetic studies suggest that patients with ADHD may have abnormalities in dopamine transporter (DAT1), dopamine receptor D4 (DRD4), and D2 receptor genes. Methylphenidate Hydrochloride may partially correct these dopaminergic dysfunctions, explaining its clinical effectiveness.

Child: Over 6 years, initially 5 mg 1–2 times daily, increased if necessary at weekly intervals by 5–10 mg daily to max. 60 mg daily in divided doses; discontinue if no response after one month also suspend periodically to assess child’s condition (usually finally discontinued during or after puberty); Child under 6 years not recommended.

Adult: 10–15 mg daily in divided doses (2–3 times daily). Average dosage is 20–30 mg daily. Some patients may require 40–60 mg daily. Patients who are unable to sleep if medication is taken late in the day should take the last dose before 6 pm.

Should be taken on an empty stomach. Take 30–45 min before meals. May be taken with or without food. Swallow whole, do not divide/chew/crush.

Methylphenidate Hydrochloride slows the elimination of phenytoin. It may also increase the anticoagulant effect of coumarin. It can increase the serum concentration of imipramine and desipramine.

Methylphenidate is contraindicated in alcoholics, emotionally unstable patients, drug abusers, hypertension, cardiac arrhythmias, psychoses, epilepsy, thyrotoxicosis, glaucoma, marked anxiety, severe depression, and known hypersensitivity to methylphenidate.

Sleep disturbances, restlessness, dizziness, headache, tremor, convulsion, rash, pruritus, urticaria, fever, arthralgia, alopecia, exfoliative dermatitis, erythema multiforme, thrombocytopenic purpura, thrombocytopenia, leucopenia, urinary disorders, and very rarely liver damage.

The use of methylphenidate in pregnancy and lactation has not been established.

Use with caution in mild hypertension (contraindicated in moderate or severe hypertension) and monitor blood pressure. Caution in patients with epilepsy, tics, Tourette syndrome. May cause cystic ovarian swellings in premenopausal women, hypercalcemia in bony metastases, increased risk of thromboembolic events when used with cytotoxics, breast feeding concerns, endometrial changes, and porphyria.

CNS stimulant drugs

Store in a cool (below 25°C), dry place, away from light. Keep out of reach of children.