methylphenidate 10mg tab (oral)

Methylphenidate hydrochloride tablet and capsuleTrade nameRitalin ® 10mg tablet, Ritalin ® LA 20mg capsuleDrug classCentral Nervous System Stimulant (Amphetamine related)PresentationRitalin 10mg - Scored white, round tabs imprinted with CG on one side and A/Bon the reverse.Ritalin ® LA 20mg – White opaque gelatin capsulesCost RM 2.70 /10mg tab RM 5.00 / 20mg LA capSchool going children: FOC for 10mg tab only.PrescriberSpecialists from Child and Adolescent Psychiatry Dept and ConsultantPediatricians (including Dr Mary Marret)IndicationTreatment of Attention-Deficit / Hyperactive-Disorder (ADHD),Symptomatic treatment of narcolepsyDoseStart at low dose, with increments at weekly intervals. Daily doses > 60mg notrecommended. If symptoms do not improve after dosage titration over a month,the drug should be discontinued.Children (6 years and above):Tablets: 5mg once or twice daily (after breakfast & lunch) with weekly incrementsof 5mg to 10mg. Total daily dose should be administered in divided dosesLA capsules: 1 cap in the morning after foodLocationAdministrationInpatient pharmacy, Outpatient pharmacy (10mg tab) Cawangan PharmUMMC(20mg LA cap)Tablets: To avoid insomnia, the last dose of the day should be taken before 6pmLA Capsules: Must be swallowed whole; never crushed or chewed. Contents ofcap may be sprinkled on cooled soft food and consumed immediately.In ADHD, time of administration should coincide with periods of greatestacademic, behavorial and social stress.Special precautions • Chronic abuse can lead to marked tolerance and psychological dependencewith varying degrees of abnormal behavior.• Use with caution in patients with epilepsy, as it may increase seizurefrequency. If this happens, consider discontinuing Ritalin.• Monitor height & weight since moderately reduced weight gain and slightgrowth retardation have been reported with long-term use

• Monitor periodically for blood pressure, complete & differential bloodcounts.• Careful supervision is required during drug withdrawal, since this mayunmask depression as well as the effects of chronic overactivity.Special notes • Methylphenindate may be abused. Ensure guidelines for prescribing andsupply are adhered.• Drug and Therapeutics Subcommittee on 24.10.2006 (Bil 4/2006) hadapproved 50 children to receive subsidised treatment for Ritalin LA andConcerta. Subsidy cards will be given to A.Prof Aili Hashim.• All other patients to pay full charge for LA capsules.Patient information • Nervousness and insomnia are common at the beginning of treatment• Decreased appetite, abdominal pain, nausea and vomiting are common & maybe alleviated by concomitant food intake• Other common side effects: headache, dizziness, rash or palpitations• Inform the doctor immediately if symptoms such as allergy, changes in vision,chest pain/SOB, convulsions/tremors, irregular heartbeat, fever/chills/rigors,sore throat, body aches, lightheadedness, fainting, unusual behavior,mood/mental changes, confusion, hallucinations, or uncontrolled musclemovements/twitching occurPrepared/checked byDate compiled/editionKong Sing Teang / PDS / PL9 May 2007, 1 st edition