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Methylphenidate is a medication that needs to be used with caution due to its potential risks and side effects. Below are important safety and warning details for both patients and healthcare professionals to consider when using this medication.

• Misuse and Dependence: Methylphenidate can be habit-forming and has a risk of misuse, which involves using the drug in a manner not prescribed. This misuse can lead to severe side effects such as increased heart rate, high blood pressure, aggressive behavior, and self-harm thoughts. Individuals with a history of substance or alcohol use disorders should be particularly cautious. It is crucial not to exceed the prescribed dosage or abruptly stop the medication without consulting a healthcare provider.

• Cardiovascular Risks: The use of methylphenidate has been associated with serious heart issues, including sudden death, stroke, and heart attack, even at prescribed doses. It can also elevate blood pressure and heart rate. Patients with a history of heart problems should inform their healthcare provider before starting this medication. Immediate medical attention is necessary if symptoms like unexplained fainting, chest pain during physical activity, or irregular heartbeat occur.

• Mental Health Concerns: This medication may induce changes in behavior or thoughts, including hallucinations, abnormal thinking, and mania, and can exacerbate existing mood disorders. These effects can manifest even in those without a prior history of mental health issues. Patients experiencing such symptoms should contact their healthcare provider promptly.

• Prolonged Erection: Rarely, methylphenidate can cause prolonged and painful erections, which may require surgical intervention. If an erection lasts longer than four hours, discontinue the medication and seek immediate medical help.

• Circulation Issues: Methylphenidate may cause blood circulation problems, like Raynaud's phenomenon, leading to fingers and toes feeling cold, numb, or painful. Inform your healthcare provider if you notice these symptoms, as your dosage may need adjustment.

• Growth Effects in Children: Long-term use of methylphenidate in children can lead to slowed growth. Healthcare providers should monitor the child's growth and may modify the treatment plan if necessary.

• Serotonin Syndrome: Combining methylphenidate with other medications that affect serotonin can result in serotonin syndrome, a potentially life-threatening condition. Symptoms include rapid heart rate, muscle stiffness, high fever, and confusion. Seek immediate medical help if these symptoms occur.

• Drug Interactions: Methylphenidate can interact with various medications, particularly those used to manage blood pressure and MAOIs, leading to potentially severe health risks. Always discuss all current medications, including over-the-counter drugs and supplements, with your healthcare provider.

• Contraindications: Do not use methylphenidate if you have a severe allergy to its components, have used MAOIs in the past 14 days, or have certain digestive disorders. Specific brands like Relexxi should not be used by individuals with marked anxiety, glaucoma, or motor tics, including those with a family history of Tourette syndrome.

It is essential to follow prescribed instructions closely and maintain open communication with your healthcare provider to manage any risks effectively.

While using this medication, some people may experience common side effects such as headache, loss of appetite, stomach pain, trouble sleeping, dry mouth, nausea, vomiting, anxiety, irritability, dizziness, and sweating. These are generally mild, but if they persist or worsen, consulting a healthcare provider is advisable. Occasionally, an empty tablet shell may appear in your stool, which is harmless as the medication has already been absorbed.

More serious side effects, although rare, require prompt medical attention. These include signs of blood flow issues in the fingers or toes, such as coldness, numbness, pain, or skin color changes, as well as unusual wounds, fast or irregular heartbeat, mental or mood changes, uncontrolled muscle movements, and sudden outbursts. Vision changes like blurred vision, fainting, seizures, heart attack symptoms (chest, jaw, or left arm pain, shortness of breath, unusual sweating), and stroke symptoms (weakness on one side of the body, trouble speaking, sudden vision changes, confusion) are also critical.

For males, including young boys and teens, a painful or prolonged erection lasting four hours or more is a severe side effect that necessitates immediate medical help to prevent permanent damage. Additionally, very serious allergic reactions, though rare, may occur, characterized by rash, itching, swelling, severe dizziness, or trouble breathing.

If you notice any other effects not listed above, or if any listed side effects become severe, it is important to contact your healthcare provider for guidance.

When taking methylphenidate, it is important to be aware of potential drug interactions. Avoid using MAO inhibitors such as isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, and tranylcypromine while on this medication due to the risk of a serious, possibly fatal interaction. It is recommended not to use MAO inhibitors for two weeks before starting methylphenidate. Consult your doctor for specific guidance on when to begin or discontinue these medications.

Furthermore, methylphenidate should not be taken in combination with dexmethylphenidate, as they are very similar drugs. If you are prescribed both, your healthcare provider may need to adjust the dosage or treatment plan.

Inform your doctor and pharmacist about any other medications or supplements you are taking. This includes prescription drugs, over-the-counter medications, vitamins, and herbal supplements, as methylphenidate may have interactions with them.

Certain medications, such as amifampridine, bupropion, desflurane, donepezil, enflurane, halothane, iobenguane I 131, isoflurane, risperidone, sevoflurane, and carbamazepine, may require dose adjustments or special monitoring if used with methylphenidate due to potential side effects or interactions.

Lastly, this medication might interfere with some medical or laboratory tests, potentially leading to inaccurate results. Ensure that all healthcare providers and lab personnel are aware that you are taking methylphenidate.