Maois
Contraindicated
Database
Hypertensive crisis
Do not use within 14 days of an MAOI
Source: Kimi deep-research + Cla
Drug reference
Methylphenidate
CNS stimulant (dopamine/noradrenaline reuptake inhibitor) · Attention-Deficit/Hyperactivity Disorder (ADHD) agent, Narcolepsy agent
Also known as Ritalin, Concerta, Methylin, Metadate CD, Daytrana, Quillivant XR
START
Children IR 5 mg once–twice daily titrated weekly; adults 5–10 mg BID–TID or ER once daily
TYPICAL MAX
~60 mg/day (up to 100 mg/day specialist, product-dependent)
STOP IF
Serious cardiovascular event, psychosis/mania, priapism, marked growth suppression
WATCH
Baseline + periodic HR/BP, cardiac history screen, growth in children, mood/psychiatric, misuse
CDSCO approvedSchedule XATC N06BA04
KDIGO 2024 + manufacturer label
- ONSET
- 30min · IR onset
- PEAK
- 1.5h · IR Cmax
- t½
- 2.5h · plasma t½
- DURATION
- 4h · IR effect
EXCRETION
Esterase metabolism; ~80% renal ritalinic acid
route + CYP
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Use only if clearly needed — possible small cardiac malformation signal; weigh risk/benefit
FDA category + note
Top interactionssee all 12 →
- MaoisContraindicatedDatabaseKimi deep-research + Cla
- BupropionSevereDatabaseDDInter
- EsketamineSevereDatabaseDDInter
- IohexolSevereDatabaseDDInter
Available in India
23 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Blocks dopamine and noradrenaline reuptake transporters, increasing synaptic catecholamines in prefrontal/striatal circuits — improves attention, impulse control and arousal.
Indications
Attention-deficit/hyperactivity disorder (children ≥6 years, adolescents, adults)Narcolepsy
Dosing
- Adult
- IR: 5–10 mg BID–TID, titrate (max ~60 mg/day, up to 100 mg specialist). ER formulations once daily (e.g. OROS 18–72 mg/day). Children start 5 mg once–twice daily, titrate weekly.
- Pediatric
- ≥6 years: IR 5 mg BID titrated; ER per product (specialist).
- Renal adjustment
- No specific adjustment (extensively metabolised).
- Hepatic adjustment
- No specific adjustment; monitor.
- Geriatric
- Not generally established; cautious use.
- Max dose
- ~60 mg/day (commonly; up to 100 mg/day specialist for some products)
Pharmacokinetics
Onset
IR ~20–60 min
Peak effect
IR 1–2 h; ER 6–8 h
Duration
IR 3–4 h; ER 8–12 h
Half-life
~2–3 h (IR)
Bioavailability
~11–52% (high first-pass; enantioselective)
Protein binding
~15%
Metabolism
Carboxylesterase CES1A1 → inactive ritalinic acid (non-CYP)
Excretion
Renal (~80% as ritalinic acid)
Contraindications
- MAOI use within 14 days
- Severe symptomatic cardiovascular disease (structural cardiac, serious arrhythmia, advanced atherosclerosis)
- Severe anxiety/agitation, motor tics/Tourette (relative), phaeochromocytoma, hyperthyroidism
- Hypersensitivity to methylphenidate
Side effects
Common
Decreased appetite, weight lossInsomniaHeadacheIncreased heart rate/blood pressureIrritability/anxiety, abdominal pain
Serious
- Sudden cardiac death in structural heart disease; serious CV events
- Psychosis/mania, aggression, suicidal ideation
- Growth suppression (children — monitor)
- Priapism; peripheral vasculopathy (Raynaud); seizures
- Dependence/misuse (controlled drug)
Pregnancy & lactation
Pregnancy
Use only if clearly needed — possible small cardiac malformation signal; weigh risk/benefit
Lactation
Small amounts in milk; monitor infant (irritability, poor feeding) — caution
Drug interactions
Bupropion
Severe
Database
Drug interaction classified as: synergy.
Source: DDInter
Esketamine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Iohexol
Severe
Database
Clinical effect not specified
Source: DDInter
Iopamidol
Severe
Database
Clinical effect not specified
Source: DDInter
Isocarboxazid
Severe
Database
Clinical effect not specified
Source: DDInter
Linezolid
Severe
Database
Clinical effect not specified
Source: DDInter
Methylene Blue
Severe
Database
Clinical effect not specified
Source: DDInter
Ozanimod
Severe
Database
Clinical effect not specified
Source: DDInter
Phenelzine
Severe
Database
Clinical effect not specified
Source: DDInter
Pimozide
Severe
Database
Clinical effect not specified
Source: DDInter
Procarbazine
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Ask House about Methylphenidate
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, Harrison 22e, Katzung, BNF·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19