Methylphenidate is a stimulant medicine used to treat attention deficit hyperactivity disorder (ADHD).

Methylphenidate may also be used for purposes not listed in this medication guide.

Stimulants have caused stroke, heart attack, and sudden death in people with high blood pressure, heart disease, or a heart defect.

Methylphenidate may cause new or worsening psychosis (unusual thoughts or behavior), especially if you have a history of depression, mental illness, or bipolar disorder.

Call your doctor right away if you have: signs of heart problems--chest pain, feeling light-headed or short of breath; or signs of psychosis--paranoia, aggression, new behavior problems, seeing or hearing things that are not real.

Methylphenidate may be habit-forming. Tell your doctor if you have a history of drug or alcohol addiction. Keep the medication where others cannot get to it.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Methylphenidate may be habit-forming. Misuse can cause addiction, overdose, or death. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.

Apply the patch to a clean and dry area on your hip. The effects of this medicine may not be noticeable until 2 hours after applying the skin patch.

Wash your hands after applying a skin patch.

Remove the patch 9 hours after it was applied. Peel off slowly and fold the patch in half so it sticks together. Flush the folded patch down the toilet or place it into a waste can with a lid.

Apply each new patch to the opposite hip. Do not wear more than one patch at a time. Never cut a skin patch.

If a patch falls off, replace it with a new one. Do not wear a patch longer than 9 hours per day, even if you apply a new patch to replace one that has fallen off.

If you have loss of appetite or trouble sleeping, ask your doctor if you can remove the skin patch earlier in the day.

Children using this medicine should be warned never to remove the skin patch and place it onto another person. Serious side effects may result.

Over time, methylphenidate transdermal can cause your skin to lighten around areas where the patches are worn. This effect may be permanent. Tell your doctor if you see new areas of lighter color under or around a skin patch, or if skin lightens on other areas of your body.

Your doctor will need to check your progress on a regular basis. Your heart rate, blood pressure, height and weight may also need to be checked often.

Store at room temperature. Do not refrigerate or freeze. Keep each patch in its sealed pouch until you are ready to use it. Throw away unused patches if it has been more than 2 months since you opened the original package.

Keep your medicine in a place where no one can use it improperly.

If you discontinue using methylphenidate transdermal, fold together and flush any unused patches at that time.

You should not use methylphenidate if you are allergic to methylphenidate (Ritalin, Concerta, Metadate, and others), or if you have:

• glaucoma;

• tics (muscle twitches);

• a personal or family history of Tourette's syndrome;

• severe anxiety, tension, or agitation; or

• if you have ever had a skin reaction to a methylphenidate skin patch.

Stimulants have caused stroke, heart attack, and sudden death in certain people. Tell your doctor if you have:

• heart problems or a congenital heart defect;

• high blood pressure; or

• a family history of heart disease or sudden death.

Do not use methylphenidate if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, and tranylcypromine.

Tell your doctor if you also use opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with methylphenidate could cause a serious condition called serotonin syndrome.

Tell your doctor if you have ever had:

• a skin disorder (such as eczema, psoriasis), skin sensitivity to soaps, lotions, cosmetics, or glues;

• vitiligo (loss of skin color in patches) in you or a family member;

• depression, mental illness, bipolar disorder, psychosis, or suicidal thoughts or actions;

• blood circulation problems in your hands or feet;

• a seizure;

• an abnormal brain wave test (EEG); or

• drug or alcohol addiction.

Becoming dependent on this medicine during pregnancy can cause premature birth or low birth weight. Tell your doctor if you are pregnant or plan to become pregnant. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of methylphenidate on the baby.

Ask a doctor if it is safe to breastfeed while using this medicine. If you are breastfeeding, tell your doctor if you notice symptoms in the baby such as agitation, sleep problems, feeding problems, or reduced weight gain.

Not approved for use by anyone younger than 6 years old.

Apply a patch as soon as you remember, and do not wear it for longer than 9 hours. You may need to shorten the wearing time if you apply a patch later than usual. Do not wear two patches at the same time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Remove the patch right away and clean the skin area with soap and water. An overdose of methylphenidate can be fatal.

Overdose symptoms may include sweating, redness in your face, vomiting, shaking, confusion, agitation, hallucinations, and irregular heartbeat.

Do not expose the skin patch to heat while you are wearing it. This includes heat from a heating pad, hair dryer, electric blanket, or a heated water bed. Heat can cause the skin patch to release too much medicine at one time.

Avoid using any lotions or creams on skin where you will apply a patch. Avoid placing a patch on skin that will be rubbed by a waistband or tight clothing.

Avoid driving or hazardous activity until you know how methylphenidate will affect you. Your reactions could be impaired.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Methylphenidate may cause serious side effects. Stop using methylphenidate and call your doctor at once if you have:

• redness, swelling, blistering, or skin color changes where the skin patch was worn (may also spread to other areas);

• blurred vision;

• a seizure;

• signs of heart problems--chest pain, trouble breathing, feeling like you might pass out;

• signs of psychosis--hallucinations (seeing or hearing things that are not real), new behavior problems, aggression, hostility, paranoia;

• signs of circulation problems--numbness, pain, cold feeling, unexplained wounds, or skin color changes (pale, red, or blue appearance) in your fingers or toes; or

• penis erection that is painful or lasts 4 hours or longer.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Methylphenidate can affect growth in children. Your child's height and weight may need to be checked often. Tell your doctor if your child is not growing at a normal rate.

Common side effects of methylphenidate may include:

• dizziness, mood swings;

• tics;

• nausea, vomiting, stomach pain, loss of appetite, weight loss;

• sleep problems (insomnia); or

• skin redness, bumps, or itching where a patch was worn.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your other medicines, especially:

• an antidepressant;

• blood pressure medication;

• a blood thinner such as warfarin (Coumadin, Jantoven);

• a cold or allergy medicine that contains a decongestant such as pseudoephedrine or phenylephrine; or

• seizure medicine.

This list is not complete. Other drugs may affect methylphenidate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.