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, muscle tics, or a history of Tourette syndrome.

How to Use This Medicine:
Patch

• Your doctor will tell you how many patches to use, where to apply them, and how often to apply them. Do not use more patches or apply them more often than your doctor tells you to.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• The patch is usually placed on your hip. When you put on a new patch, do not put it on the same place you wore the last one.
• Open the medicine pouch carefully. Do not cut or tear the patch itself. Do not use a patch that is cut or torn.
• Do not touch the sticky side, because you will get medicine on your skin.
• Wash your hands with soap and water before and after applying a patch.
• Do not put the patch over burns, cuts, or irritated skin. Make sure the skin area is clean, dry, cool, and free of powder, oil, or lotion before you apply the patch. Press down on the patch for 30 seconds to make sure it sticks.
• If a patch comes off, put on a new one in a different spot on the same hip. Remove the new patch at the same time that you would have removed the old one.
• Never wear 2 patches at the same time.
• Do not wear patches for longer than 9 hours a day total. If you put on a new patch because one fell off, the total time for both patches should still be less than 9 hours. Use the chart that comes with the patient instructions to help you keep track of how long to wear the patch. Take the patch off by slowly peeling it back. Use mineral oil or petroleum jelly if needed to make the patch less sticky.
• The patch might come off if you go swimming or take a bath or shower.
• Missed dose: If you forget to apply the patch at the usual time, you may apply it later in the day. Remove it at the time you normally would, so you do not have side effects later than usual (such as trouble sleeping that night).
• Store the patches at room temperature in a closed container, away from heat, moisture, and direct light. Do not store in the refrigerator or freezer.
• Ask your pharmacist about the best way to dispose of used or leftover patches. Fold used or leftover patches in half with the sticky sides together. Then wash your hands with soap and water. When you stop treatment or the patches expire, take each patch out of its pouch, fold it in half, and dispose as directed.
• There is still enough medicine in a used patch to make a child or pet sick, so be sure they cannot come in contact with the patches.

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) in the past 14 days.
• Some foods and medicines can affect how methylphenidate works. Tell your doctor if you are also using any of the following:
  
  • Blood pressure medicine
  • Blood thinner (including warfarin)
  • Cold or allergy medicine
  • Medicine for seizures (including phenobarbital, phenytoin, primidone)
  • Medicine to treat depression (including clomipramine, desipramine, imipramine)

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have heart disease, heart rhythm problems, blood vessel or circulation problems, high blood pressure, history of vitiligo (a skin problem), or seizures. Tell your doctor if you have depression, anxiety, agitation, bipolar disorder, mental illness, or a history of drug or alcohol dependence. Also tell your doctor if you or anyone in your family has tried to commit suicide or talked about suicide.
• This medicine may cause the following problems:
  
  • Sudden death in people who already have serious heart problems
  • Heart or blood vessel problems, including heart attack or stroke in adults
  • Slow growth in children
  • Blood circulation problem in the fingers or toes, such as Raynaud phenomenon
  • Loss of skin color, usually where the patch is applied
• 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 drowsy or cause trouble seeing. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• Do not expose the patch to direct heat, such as a hair dryer, heating pad, electric blanket, water bed, or hot tub.
• 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
• Areas of lighter skin color, at the application site or on skin that is farther away from the site
• Blurred vision or vision changes
• Chest pain that may spread to your arms, jaw, back, or neck, trouble breathing, nausea, unusual sweating
• Erection of the penis that is painful or lasts longer than 4 hours
• Extreme energy, mood or mental changes, confusion, restlessness, trouble sleeping, unusual thoughts or behavior
• Fast, slow, pounding, or uneven heartbeat
• Seeing, hearing, or feeling things that are not there
• Seizures, tremors, twitching
• Severe skin redness, swelling, itching, or blistering where the patch is worn
• Sores, coldness, numbness, or color changes on your fingers or toes

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

• Mild trouble sleeping, feeling irritable
• Mild nausea, vomiting, stomach pain, loss of appetite, weight loss
• Mild redness or itching where a patch was applied

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