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RITALIN AND RITALIN-SR (METHYLPHENIDATE) TABLETS: ADVERSE REACTIONS / SIDE EFFECTS

Nervousness and insomnia are the most common adverse reactions but are usually controlled by reducing dosage and omitting the drug in the afternoon or evening. Other reactions include hypersensitivity (including skin rash, fever, urticaria, arthralgia, erythema multiforme with histopathological findings of necrotizing vasculitis, exfoliative dermatitis, thrombocytopenic purpura); nausea; anorexia; dizziness; headache; palpitations; dyskinesia; drowsiness; blood pressure and pulse changes, both up and down; angina; tachycardia; cardiac arrhythmia; abdominal pain; weight loss during prolonged therapy.

There have been rare reports of Tourette's syndrome. Toxic psychosis has been reported. Although a definite causal relationship has not been established, the following have been reported in patients taking this drug: instances of abnormal liver function, ranging from transaminase elevation to hepatic coma; isolated cases of cerebral arteritis and/or occlusion; leukopenia and/or anemia; transient depressed mood; aggressive behavior; a few instances of scalp hair loss. Very rare reports of neuroleptic malignant syndrome (NMS) have been received, and, in most of these, patients were concurrently receiving therapies associated with NMS.

In a single report, a ten-year-old boy who had been taking methylphenidate for approximately 18 months experienced an NMS-like event within 45 minutes of ingesting his first dose of venlafaxine. It is uncertain whether this case represented a drug-drug interaction, a response to either drug alone, or some other cause.

In children, loss of appetite, abdominal pain, weight loss during prolonged therapy, insomnia, and tachycardia may occur more frequently; however, any of the other adverse reactions listed above may also occur.



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