Interaction more likely in certain predisposed pts. Modify Therapy/Monitor Closely. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. Monitor Closely (2)perphenazine, methylphenidate. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. isocarboxazid increases effects of methylphenidate by pharmacodynamic synergism. Monitor Closely (1)methylphenidate will decrease the level or effect of eprosartan by pharmacodynamic antagonism. Risk of acute hypertensive episode. Risk of acute hypertensive episode. armodafinil increases effects of methylphenidate by pharmacodynamic synergism. Monitor for increased serum concentrations/toxicity of phenytoin if methylphenidate is initiated/dose increased, or decreased concentrations/effects if methylphenidate is discontinued/dose decreased. Increased pH may enhance the release of the drug from delayed release formulations. Individual plans may vary Use Caution/Monitor. Use Caution/Monitor. phentermine increases effects of methylphenidate by pharmacodynamic synergism. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Contraindicated. amitriptyline, methylphenidate. Monitor Closely (1)dopexamine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. These cannot be substituted on a milligram-per-milligram basis. Monitor BP. ergoloid mesylates, methylphenidate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. levalbuterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Minor/Significance Unknown. Monitor BP. Monitor BP. Contraindicated. Monitor for increased serum concentrations/toxicity of phenytoin if methylphenidate is initiated/dose increased, or decreased concentrations/effects if methylphenidate is discontinued/dose decreased. only. prochlorperazine, methylphenidate. Modify Therapy/Monitor Closely. Monitor Closely (1)promethazine, methylphenidate. Monitor Closely (1)methylphenidate will decrease the level or effect of telmisartan by pharmacodynamic antagonism. Use Caution/Monitor. Other (see comment). Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. nortriptyline, methylphenidate. Use Caution/Monitor. Serious - Use Alternative (1)desflurane increases toxicity of methylphenidate by Mechanism: unknown. Methylphenidate may diminish antihypertensive effects. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. sevoflurane increases toxicity of methylphenidate by Mechanism: unknown. methylphenidate will increase the level or effect of phenytoin by unknown mechanism. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Minor/Significance Unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Serious - Use Alternative (1)methylphenidate decreases effects of iobenguane I 123 by Other (see comment). Methylphenidate may diminish antihypertensive effects. Contraindicated (1)isocarboxazid increases effects of methylphenidate by pharmacodynamic synergism. Monitor Closely (1)methylphenidate will decrease the level or effect of captopril by pharmacodynamic antagonism. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. Interaction more likely in certain predisposed pts. Use Caution/Monitor. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Use Caution/Monitor. epinephrine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Applies only to extended release formulationnizatidine decreases effects of methylphenidate by enhancing GI absorption. maprotiline, methylphenidate. Monitor Closely (1)methylphenidate will decrease the level or effect of candesartan by pharmacodynamic antagonism. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)methylphenidate will decrease the level or effect of irbesartan by pharmacodynamic antagonism. Use Caution/Monitor. Use Caution/Monitor. methylphenidate will decrease the level or effect of losartan by pharmacodynamic antagonism. molindone increases toxicity of methylphenidate by pharmacodynamic antagonism. Risk of acute hypertensive episode. Potential for additive CNS stimulation. Use Caution/Monitor. Monitor Closely (1)albuterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Monitor Closely (1)aspirin/citric acid/sodium bicarbonate decreases effects of methylphenidate by enhancing GI absorption. Interaction more likely in certain predisposed pts. Caffeine should be avoided or used cautiously. Use Caution/Monitor. Monitor Closely (1)methylphenidate will decrease the level or effect of penbutolol by pharmacodynamic antagonism. Applies only to oral form of both agents. tranylcypromine increases effects of methylphenidate by pharmacodynamic synergism. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Methylphenidate may diminish antihypertensive effects. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Dosing recommendations are based on current dose regimen and clinical judgment. Risk of acute hypertensive episode. Monitor BP. Use Caution/Monitor. carbamazepine decreases effects of methylphenidate by unspecified interaction mechanism. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI. methylphenidate will decrease the level or effect of phenoxybenzamine by pharmacodynamic antagonism. methylphenidate increases toxicity of trazodone by Other (see comment). Use Caution/Monitor. Use Caution/Monitor. iloperidone increases toxicity of methylphenidate by pharmacodynamic antagonism. aripiprazole increases toxicity of methylphenidate by pharmacodynamic antagonism. Methylphenidate may diminish antihypertensive effects. Contraindicated. Capsule with multilayer beads; 40% of dose in the immediate-release layer and 60% in the extended-release layer (2nd peak at 7-8 hrs) 12 hours. Avoid or Use Alternate Drug. Use Caution/Monitor. Monitor Closely (1)cocaine topical increases effects of methylphenidate by pharmacodynamic synergism. Methylphenidate may diminish antihypertensive effects. Minor/Significance Unknown. Methylphenidate may diminish antihypertensive effects. Use Caution/Monitor. apomorphine, methylphenidate. Monitor BP. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination. Monitor Closely (1)methylphenidate increases toxicity of trazodone by Other (see comment). Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Monitor Closely (1)modafinil increases effects of methylphenidate by pharmacodynamic synergism. only. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose. Risk of V tach, HTN. Contraindicated. Interaction more likely in certain predisposed pts. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Contraindicated (1)selegiline increases effects of methylphenidate by pharmacodynamic synergism. Other (see comment). Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Contraindicated. Methylphenidate may diminish antihypertensive effects. Monitor BP. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. Use Caution/Monitor. Monitor Closely (1)dopamine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron. ziprasidone increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Monitor Closely (1)molindone increases toxicity of methylphenidate by pharmacodynamic antagonism. safinamide increases effects of methylphenidate by pharmacodynamic synergism. Methylphenidate may diminish antihypertensive effects. Avoid or Use Alternate Drug. methylphenidate will decrease the level or effect of prazosin by pharmacodynamic antagonism. methylphenidate will decrease the level or effect of terazosin by pharmacodynamic antagonism. Interaction more likely in certain predisposed pts. Use Caution/Monitor. Blood and lymphatic system disorders: Pancytopenia, thrombocytopenia, thrombocytopenic purpura, Cardiac disorders: Angina pectoris, bradycardia, extrasystole, supraventricular tachycardia, ventricular extrasystole, hypertension, Eye disorders: Diplopia, mydriasis, visual impairment, General Disorders: Chest pain, chest discomfort, hyperpyrexia, long-term growth suppression, Hepatobiliary disorders: Hepatocellular injury, acute hepatic failure, Immune system disorders: Hypersensitivity reactions such as angioedema, anaphylactic reactions, auricular swelling, bullous conditions, exfoliative conditions, urticaria, pruritus, rashes, eruptions, and exanthemas, Investigations: Alkaline phosphatase increased, bilirubin increased, hepatic enzyme increased, platelet count decreased, white blood cell count abnormal, severe hepatic injury, Musculoskeletal, connective tissue and bone disorders: Arthralgia, myalgia, muscle twitching, rhabdomyolysis, Nervous system disorders: Convulsion, grand mal convulsion, dyskinesia, serotonin syndrome in combination with serotonergic drugs, lethargy, somnolence, Psychiatric disorders: Disorientation, hallucination, hallucination auditory, hallucination visual, libido changes, mania, depression, drug dependence, Vascular system: Peripheral vasculopathy, including Raynaud phenomenon, Skin and subcutaneous tissue disorders: Alopecia, erythema, Hypersensitivity to methylphenidate or other components of product, Coadministration with monoamine oxidase inhibitors (MAOIs) or within 14 days after discontinuing MAOIs, Assess risk of abuse before prescribing, and monitor for signs of abuse and dependence during therapy, May cause an increase in blood pressure (BP) and heart rate (HR); monitor for hypertension and tachycardia, Prolonged and painful erections, sometimes requiring surgical intervention, reported with methylphenidate products, including another formulation of methylphenidate hydrochloride extended-release tablets, in both pediatric and adult patients, Priapism was not reported with drug initiation but developed during treatment, often after an increase in dose and during a period of drug withdrawal (drug holidays or during discontinuation); if such reaction occurs, seek immediate medical attention, CNS stimulants are associated with peripheral vasculopathy, including Raynaud phenomenon; signs and symptoms are usually intermittent and generally improve after dose reduction or discontinuing treatment; monitor for digital changes is necessary during treatment; further clinical evaluation (eg, rheumatology referral) may be appropriate for certain patients, Closely monitor growth (weight and height) in pediatric patients treated with stimulants; patients who are not growing or gaining height or weight as expected may need to have their treatment interrupted, Stimulants may lower the convulsive threshold in patients with a history of seizures, in patients with prior EEG abnormalities in absence of seizures, and, very rarely, in patients without a history of seizures and no prior EEG evidence of seizures; if seizures occur, discontinue drug, Difficulties with accommodation and blurry vision reported, Periodic complete blood cell count, differential, and platelet counts are advised during prolonged therapy, Published studies and postmarketing reports on use during pregnancy have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes, Limited published literature, based on breast milk sampling from five mothers, reports that methylphenidate is present in human milk, which resulted in infant doses of 0.16% to 0.7% of the maternal weight-adjusted dosage and a milk/plasma ratio ranging between 1.1 and 2.7, There are no reports of adverse effects on breastfed infant and no effects on milk production; however, long-term neurodevelopmental effects on infants from CNS stimulant exposure are unknown, Monitor breastfeeding infants for adverse reactions, such as agitation, insomnia, anorexia, and reduced weight gain. Use Caution/Monitor. Use Caution/Monitor. commonly, these are "preferred" (on formulary) brand drugs. Applies only to oral form of both agents. Monitor Closely (1)omeprazole decreases effects of methylphenidate by enhancing GI absorption. Monitor BP. Monitor Closely (1)aluminum hydroxide decreases effects of methylphenidate by enhancing GI absorption. Monitor BP. atomoxetine (strattera ) Drug Category: Selective Norepinephrine Reuptake Inhibitor. Table 3. Mechanism: unknown. Use Caution/Monitor. Contraindicated. Attention deficit hyperactivity disorder ( ADHD) medications are usually stimulants. only. methylphenidate will decrease the level or effect of sacubitril/valsartan by pharmacodynamic antagonism. Monitor BP. Methylphenidate may diminish antihypertensive effects. A: Generally acceptable. protriptyline, methylphenidate. Use Caution/Monitor. Monitor Closely (1)chlorpromazine, methylphenidate. Monitor BP. Use Caution/Monitor. phenelzine increases effects of methylphenidate by pharmacodynamic synergism. Contraindicated. fenfluramine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. aspirin/citric acid/sodium bicarbonate decreases effects of methylphenidate by enhancing GI absorption. This means that you only need to take. Methylphenidate may diminish antihypertensive effects. Monitor BP. Monitor BP. Modify Therapy/Monitor Closely. Applies only to oral form of both agents. dihydroergotamine, methylphenidate. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided. Use Caution/Monitor. Monitor Closely (1)trimipramine, methylphenidate. Use Caution/Monitor. Avoid or Use Alternate Drug. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. 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Either concerta ritalin conversion chart dosimetry or an antipsychotic when using these drugs in combination strattera drug! Toxicity of methylphenidate by enhancing GI absorption level or effect of candesartan by pharmacodynamic antagonism initiated/dose increased, or concentrations/effects! Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined additional. Selegiline increases effects of methylphenidate by pharmacodynamic antagonism level or effect of phenytoin by unknown Mechanism of by.