When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to methylphenidate, or if you have glaucoma, an overactive thyroid, muscle tics, or a history of Tourette syndrome.

How to Use This Medicine:
Long Acting Capsule, Liquid, Tablet, Chewable Tablet, Long Acting Tablet, Long Acting Chewable Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Chewable tablet: Drink at least 8 ounces of water or other liquid when you take the tablet.
• Chewable tablet, immediate-release tablet, or oral liquid: Take the medicine 30 to 45 minutes before meals. Take the last dose of the day before 6 PM if you have problems falling asleep.
• Extended-release capsule: Take your medicine in the morning before breakfast. Swallow it whole with water or other liquid. If you cannot swallow the capsule whole, you may open it and mix the medicine with a tablespoon of applesauce. Swallow this mixture right away, and then drink some water.
• Extended-release tablet: Take the medicine in the morning. Swallow it whole with water or other liquid. Do not crush, break, or chew it.
• Extended-release chewable tablet: Take this medicine in the morning. If the tablet is scored, you may cut it in half if you need to. Do not break a tablet that is not scored.
• Extended-release suspension: Take the medicine in the morning. Shake the bottle well for at least 10 seconds before you measure each dose. Measure the dose with the dispenser that comes with the medicine.
• Oral liquid: Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
• If you take the extended-release tablet, part of the tablet may pass into your stools. This is normal and is nothing to worry about.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Throw away any unused extended-release suspension after 4 months.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine if you have used an MAO inhibitor (MAOI) within the past 14 days.
• Some foods and medicines can affect how methylphenidate works. The specific medicines and foods of concern are different for different brands of methylphenidate. Tell your doctor if you are using any of the following:
  
  • Guanethidine, phenylbutazone
  • Antacid or other stomach medicine
  • Blood pressure medicine
  • Blood thinner (including warfarin)
  • Medicine to treat depression (including clomipramine, desipramine, imipramine)
  • Medicine to treat seizures (including phenobarbital, phenytoin, primidone)
  • Alcohol

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have heart or blood vessel disease, heart rhythm problems, high blood pressure, phenylketonuria, thyroid problems, or a history of seizures, heart attack, or stroke. Tell your doctor if you or anyone in your family has a history of depression, mental health problems, or drug or alcohol abuse.
• This medicine may cause the following problems:
  
  • Serious heart or blood vessel problems, including heart attack and stroke (especially in people who already have heart problems)
  • Peripheral vasculopathy (a blood circulation problem)
  • Slow growth in children
• This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
• This medicine may make you dizzy or cause blurred vision. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• If you need surgery, tell the doctor who treats you that you are using this medicine. Medicines used during surgery can increase your blood pressure when used with this medicine.
• Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blurred vision or vision changes
• Chest pain that may spread, trouble breathing, nausea, unusual sweating
• Extreme energy or restlessness, confusion, agitation, unusual moods or behaviors
• Fast, slow, pounding, or uneven heartbeat
• Lightheadedness, dizziness, fainting
• Numb, cold, pale, or painful fingers or toes
• Painful erection or an erection that lasts longer than 4 hours
• Seeing, hearing, or feeling things that are not there
• Seizures

If you notice these less serious side effects, talk with your doctor:

• Dry mouth, nausea, stomach pain
• Loss of appetite, weight loss
• Trouble sleeping

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088