This article describes possible interactions with methylphenidate oral tablet. Interactions can cause a drug to have a different effect on the body than expected. Interactions can occur due to medications, alcohol, or certain health conditions.
Methylphenidate comes as oral tablets that you swallow. It’s also available in the following forms:
- extended-release* film that’s applied to the skin
- extended-release* oral capsule
- extended-release* oral tablet
- oral solution
*”Extended-release” means the drug is slowly released into your body over time.
Interactions of methylphenidate may vary depending on the form of methylphenidate you’re prescribed.
Boxed warning: Risk of misuse and addiction
Methylphenidate has a boxed warning for the risk of misuse and addiction. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).
See the end of this article for more information about this warning.
Other drugs and methylphenidate
The drugs in the list below may interact with methylphenidate oral tablet. This article doesn’t include all drugs that may interact with methylphenidate.
Drug classes or drugs that may interact with methylphenidate oral tablet include:
- angiotensin-converting-enzyme (ACE) inhibitors
- drug examples: lisinopril (Zestril), ramipril (Altace)
- what might happen: can make the ACE inhibitor less effective
- angiotensin II receptor blockers (ARBs)
- drug examples: valsartan (Diovan), olmesartan (Benicar)
- what might happen: can make the ARB less effective
- beta-blockers
- drug examples: metoprolol (Lopressor, Toprol XL), carvedilol (Coreg)
- what might happen: can make the beta-blocker less effective
- certain anesthetics used before surgery
- drug examples: sevoflurane (Sojourn, Ultane), isoflurane (Forane)
- what might happen: can increase the risk of severe side effects during surgery
- certain diuretics (water pills)
- certain drugs for treating pulmonary hypertension (high blood pressure in your lungs)
- drug examples: riociguat (Adempas), selexipag (Uptravi)
- what might happen: can make the pulmonary hypertension drug less effective
- monoamine oxidase inhibitors (MAOIs)
- drug examples: isocarboxazid (Marplan), selegiline (Emsam)
- what might happen: can increase the risk for severe side effects caused by methylphenidate and the MAOI drug
- other stimulant drugs
- drug examples: modafinil (Provigil), Adderall (dextroamphetamine/amphetamine mixed salts)
- what might happen: can increase the risk of side effects of methylphenidate and the other stimulant drug (methylphenidate is a stimulant drug)
- esketamine (Spravato)
- what might happen: can increase the risk of side effects of methylphenidate and esketamine
- risperidone (Risperdal, others)
- what might happen: can increase the risk of side effects of risperidone
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When to avoid methylphenidate
Certain health conditions or other factors could increase some risks with methylphenidate oral tablet. Because of this, doctors may not prescribe methylphenidate in these cases. These health conditions or other factors are called contraindications.
Here’s a list of contraindications for methylphenidate oral tablet:
- Taking a monoamine oxidase inhibitor (MAOI) drug or have used one in the past 14 days: If you take or have recently taken an MAOI drug, taking methylphenidate oral tablet may cause dangerously high blood pressure as a side effect.
- Past allergic reaction to methylphenidate: If you’ve ever had an allergic reaction to methylphenidate oral tablet, taking it again may cause another allergic reaction.
Before you start taking methylphenidate, tell your doctor if anything listed above relates to you. They can recommend whether you should use methylphenidate.
Alcohol and methylphenidate
Methylphenidate oral tablet is known to interact with alcohol. Alcohol doesn’t directly affect how methylphenidate works. But consuming alcohol can make it seem as if methylphenidate isn’t working or isn’t working as well. Alcohol can affect cognition, which can make it harder to think and make decisions, among other effects.
Also, taking methylphenidate oral tablet and drinking alcohol may worsen certain side effects methylphenidate can cause, including delusions (false beliefs) or hallucinations.
If you drink alcohol, talk with your doctor about whether it’s safe to consume it while taking methylphenidate oral tablet. They can provide more information about methylphenidate interactions with alcohol.
Other interactions and methylphenidate
Interactions can occur with supplements, foods, vaccines, and some lab tests. Below you can learn whether methylphenidate oral tablet has these interactions.
The information below doesn’t include all other interactions possible with methylphenidate. Talk with your doctor to learn more about what not to take with methylphenidate.
Methylphenidate and supplements
Before taking methylphenidate oral tablet, tell your doctor and pharmacist about any herbs you take, as well as vitamins and supplements. Doing so may help you avoid interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Methylphenidate interactions with herbs
Methylphenidate oral tablet may interact with St. John’s wort. This herb is often used for helping mood and easing symptoms of depression.
Taking methylphenidate and St. John’s wort may increase your risk of serotonin syndrome as a side effect.
Because of this, ask your doctor or pharmacist before taking any herbs while taking methylphenidate oral tablet.
Methylphenidate interactions with vitamins
Methylphenidate oral tablet isn’t known to interact with any vitamins. But this doesn’t mean interactions with vitamins can’t happen or won’t be identified later.
Because of this, ask your doctor or pharmacist before taking any vitamins while taking methylphenidate oral tablet.
Methylphenidate and food
Methylphenidate can interact with foods that contain caffeine. Examples include coffee, green tea, and chocolate.
Using methylphenidate and consuming caffeine can increase your risk of side effects and increase the effect of methylphenidate.
Because of this, talk with your doctor or pharmacist about what foods you should avoid while taking methylphenidate oral tablet. They can provide more information about methylphenidate interactions with caffeine and how to avoid them.
Methylphenidate and vaccines
Methylphenidate oral tablet isn’t known to interact with any vaccines. But this doesn’t mean interactions with vaccines can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before receiving any vaccines while taking methylphenidate oral tablet.
Methylphenidate and lab tests
Methylphenidate oral tablet isn’t known to interact with lab tests. But this doesn’t mean interactions with lab tests can’t happen or won’t be identified later.
Because of this, talk with your doctor or pharmacist before having any lab tests performed while taking methylphenidate oral tablet.
Methylphenidate and cannabis or CBD
Studies of cannabis (commonly called marijuana) and cannabis products have been shown to interact with methylphenidate.
Taking methylphenidate and using cannabis or cannabis products may cause methylphenidate to not work as well. It may also increase your risks of side effects.
Before you take methylphenidate, tell your doctor and pharmacist if you use cannabis. Doing so may help prevent possible methylphenidate interactions with cannabis.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Health factors and methylphenidate
Certain medical conditions or other health factors may increase the risk of interactions with methylphenidate oral tablet. Keep in mind that interactions could lead to side effects or affect how well the drug works. Before taking methylphenidate, tell your doctor about your health history. They’ll determine whether methylphenidate is right for you.
These health conditions or other factors might interact with methylphenidate oral tablet:
Suicide prevention
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Preventing methylphenidate interactions
You may be able to help avoid certain interactions with methylphenidate oral tablet. Before taking this drug, you may want to discuss possible interactions with your doctor and pharmacist.
Things to consider include:
- Whether you drink alcohol or use cannabis.
- Other medications and herbs you take, as well as vitamins and supplements. Your doctor or pharmacist can help you fill out a medication list.
- What to do if you’re prescribed a new drug while taking methylphenidate oral tablet.
Taking methylphenidate exactly as prescribed can also help prevent interactions.
What to ask your doctor
If you have questions about methylphenidate and possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Does methylphenidate have similar interactions as Adderall?
- Could I still take methylphenidate even if it interacts with a health condition I have?
- Should dosages of other medications I take be adjusted due to interactions if I start taking methylphenidate?
- If methylphenidate interacts with another medication I need to take, how will I be monitored for side effects during treatment?
Boxed warning
Methylphenidate oral tablet has a boxed warning for the risk of misuse and addiction. A boxed warning is the most serious warning from the FDA.
Like with other stimulant drugs, treatment with methylphenidate carries a risk of misuse and addiction. “Misuse” refers to taking a drug in a manner other than how it’s prescribed by a doctor. An example of misuse is taking a drug to feel “high”. Addiction happens when you continue using a drug or substance despite it causing harm.
Due to these risks, methylphenidate is a Schedule II controlled substance. This means methylphenidate has approved medical uses, but also has a high risk of misuse and addiction. There are special regulations in place regarding how controlled substances are prescribed and dispensed from a pharmacy. These rules are in place to help prevent misuse and addiction.
If your doctor prescribes methylphenidate, they’ll monitor you closely for signs of misuse or addiction. Because of these risks, your doctor may choose to prescribe a treatment other than methylphenidate oral tablet if you have or have had a substance use disorder, such as alcohol use disorder.
To learn more, talk with your doctor.
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
