RITALIN® LA
Methylphenidate Hydrochloride
20, 30 and 40mg capsules
What is in this leaflet
This leaflet answers some common questions about Ritalin LA (long-acting) capsules.
It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.
The information in this leaflet was last updated on the date listed on the final page. More recent information on the medicine may be available. You should ensure that you speak to your pharmacist or doctor to obtain the most up to date information on the medicine.
All medicines have risks and benefits. Your doctor has weighed the risks of you or your child taking this medicine against the benefits they expect it will provide.
If you have any concerns about this medicine, ask your doctor or pharmacist.
Keep this leaflet with the medicine. You may need to read it again.
What Ritalin LA is used for
Ritalin LA (long-acting) capsules are used to treat Attention Deficit Hyperactivity Disorder (ADHD).
About 3% of children suffer from ADHD. It makes them unable to sit still or concentrate on tasks for any length of time. They may have trouble learning and doing school work. They frequently become difficult to manage, both in school and at home.
Ritalin LA is a central nervous system stimulant. It is thought to work by regulating specific chemicals in the brain that affect behaviour. It helps to focus attention, shut out distraction and allows impulsive people to think before they act. If successful, it will enhance an inattentive person's natural ability.
This medicine is part of a treatment program that usually includes psychological, educational and social therapy.
Ask your doctor if you have any questions about why this medicine has been prescribed for you or your child.
Your doctor may have prescribed it for another purpose.
This medicine is only available with a doctor's prescription and your doctor has special permission to prescribe it.
There is not enough information to recommend its use in children under 6 years old.
Note: Ritalin LA is a 'Controlled Drug B2'. It should be kept in a secure place and under no circumstances should it be given to anyone else.
Before you take Ritalin LA
When you must not take it
Do not take Ritalin LA if you are allergic to methylphenidate (the active ingredient) or to any of the other ingredients listed at the end of this leaflet.
Some of the symptoms of an allergic reaction may include shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; rash, itching or hives on the skin.
Do not take Ritalin LA if you have any of the following medical conditions:
- periods of severe anxiety, tension or agitation
- tics (muscle twitching which is usually in the face or shoulders) or if your brothers or sisters have tics
- Tourettes's syndrome or you have a family history of this disorder
- glaucoma (increased pressure in the eye)
- an overactive thyroid
- an irregular heartbeat
- severe angina (chest pain)
- phaeochromocytoma (a rare tumour of the adrenal gland, which sits near the kidney)
If you are not sure whether any of the above medical conditions apply to you, check with your doctor.
Do not take Ritalin LA if you are taking a medicine called a monoamine oxidase inhibitor (MAOI) or have been taking it within the past 14 days.
Taking Ritalin LA together with MAOI medicines may cause a serious reaction with a sudden increase in body temperature, extremely high blood pressure and severe convulsions.
Ask your doctor or pharmacist if you are not sure if you have been taking one of these medicines.
Do not take this medicine after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering.
In that case, return it to your pharmacist.
Before you start to take it
Tell your doctor if you are allergic to any other medicines, foods, dyes or preservatives.
Your doctor will want to know if you are prone to allergies.
Tell your doctor if you have any of the following medical conditions:
- any heart defects (e.g. structural cardiac abnormality)
- a family history of sudden death or irregular heart beat
- hardening of the arteries
- any other current or previous heart problems
- any disorders of the blood vessels in the brain
- severe depression, bipolar disorder or other mental illness
- epilepsy (seizures or fits)
- high blood pressure
- alcoholism
- drug dependence
Your doctor may want to take special precautions if you have any of the above conditions.
Tell your doctor if you are pregnant or breast-feeding. Ask your doctor about the risks and benefits of taking Ritalin LA in this case.
This medicine may affect your developing baby if you take it while you are pregnant. It is not known if the active ingredient in Ritalin LA passes into the breast milk. Breast-feeding is not recommended while taking this medicine.
Taking other medicines
Tell your doctor if you are taking any other medicines, including medicines that you buy without a prescription from a pharmacy, supermarket or health food shop.
Some medicines and Ritalin LA may interfere with each other. These include:
- medicines that increase blood pressure
- warfarin, a medicine used to prevent blood clots
- medicines for epilepsy (fits)
- medicines for depression, such as tricyclic antidepressants and MAO inhibitors
- phenylbutazone
- guanethidine
- clonidine
You may need to take different amounts of your medicines or you may need to take different medicines.Your doctor and pharmacist have more information.
If you have not told your doctor about any of these things, tell him/her before you start taking this medicine.
How to take Ritalin LA
Follow all directions given to you by your doctor and pharmacist carefully.
They may differ from the information contained in this leaflet.
If you do not understand the instructions on the label, ask your doctor or pharmacist for help.
How much to take
Ritalin LA is available in long-acting capsules containing 20 mg, 30 mg or 40 mg of methylphenidate hydrochloride as the active ingredient.
Your doctor will usually start with a low dose and, if necessary, increase it gradually at weekly intervals up to 20 mg to 40 mg each day. The maximum dose is 60 mg each day.
How to take it
Swallow the capsules whole as a single dose in the morning with a full glass of water. Do not crush or chew the capsules.
If you have trouble swallowing the capsules, you can carefully open them and sprinkle the contents (little beads) over a small amount of applesauce.
If the capsules upset your stomach, you can take them with food, but always take them in the same way (e.g. always with food or always without food).
That way the effect will always be the same.
How long to take it
Continue taking Ritalin LA for as long as your doctor tells you.
This medicine helps to control your symptoms but does not cure your condition. Your doctor will check your progress to make sure the medicine is working and will discuss with you how long your treatment should continue.
During treatment for ADHD, your doctor may stop Ritalin LA every so often (e.g. over weekends or school holidays) to see whether it is still needed. Breaks from treatment also help to prevent a slow-down in growth that sometimes happens when children take this medicine for a long time.
If you forget to take it
If you forget to take a dose of Ritalin LA capsules and you remember before mid-day, take the dose as soon as you remember. Then go back to your usual schedule on the following day.
If you do not remember before mid-day, miss your dose of Ritalin LA for that day and wait until the following morning to take your next dose.
Do not take a double dose to make up for the one that you missed.
Your chance of an unwanted side effect may be increased if you do.
If you have trouble remembering when to take your medicine, ask your pharmacist for some hints.
If you take too much (overdose)
Immediately telephone your doctor or the National Poisons Information Centre, Dunedin (telephone 0800 POISON or 0800 764 766), or go to the Accident and Emergency Department at your nearest hospital if you think that you or anyone else may have taken too much Ritalin LA. Do this even if there are no signs of discomfort or poisoning. Keep the telephone numbers for these places handy.
Some of the symptoms of an overdose may include vomiting, agitation, headache, tremors, muscle twitching, irregular heart beat, flushing, fever, sweating, dilated pupils, breathing problems, confusion and seizures.
While you are taking Ritalin LA
Things you must do
Take Ritalin LA exactly as your doctor has prescribed.
Like all stimulants, this medicine may become habit-forming and can be abused by some people. If you take it correctly as instructed by your doctor, abuse or dependence should not be a problem, either now or later in life.
Be sure to keep all of your doctor's appointments so that your progress can be checked.
Your doctor will want to check your blood pressure and do blood tests from time to time to prevent unwanted side effects from happening.
If you become pregnant while taking Ritalin LA, tell your doctor.
Your doctor can discuss with you the risks and benefits of taking it while you are pregnant.
If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking Ritalin LA.
Tell any doctor, dentist or pharmacist who treats you that you are taking Ritalin LA.
Things you must not do
Do not stop your treatment without first checking with your doctor.
If you suddenly stop taking this medicine, your condition may reappear or you may get unwanted effects such as depression. To prevent this, your doctor may want to gradually reduce the amount of medicine you take each day before stopping it completely.
Do not take this medicine to treat any other complaints unless your doctor tells you to.
Do not give it to anyone else, even if their condition seems similar to yours.
Things to be careful of
Be careful driving, operating machinery or doing jobs that require you to be alert while you are taking Ritalin LA until you know how it affects you.
This medicine may cause dizziness, drowsiness or blurred vision in some people. If you have any of these symptoms, do not drive or do anything else that could be dangerous.
Be careful when drinking alcohol while you are taking Ritalin LA.
Drinking alcohol is not recommended because it can worsen some of the unwanted effects of this medicine, such as dizziness and drowsiness.
Side effects
Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking Ritalin LA.
All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.
Do not be alarmed by these lists of possible side effects. You may not experience any of them. Ask your doctor or pharmacist to answer any questions you may have.
Tell your doctor if you notice any of the following and they worry you:
- nausea (feeling sick), vomiting or stomach pain
- loss of appetite
- loss of weight and slower growth in children
- feeling nervous or unable to sleep
- dry mouth
- headache
- drowsiness
- dizziness
- mood changes such as depression or irritability
- blurred vision or problems focussing your eyes
- muscle cramps
- hair loss
Tell your doctor immediately or go to Accident and Emergency at your nearest hospital if you notice any of the following:
- signs of allergy such as swelling of the face, lips or tongue, shortness of breath, wheezing or troubled breathing
- weakness or paralysis of limbs or face, difficulty speaking, or unexplained fainting
- rash, itching, red blotches, blisters or peeling of the skin
- sudden increase in body temperature, sweating, fast heartbeat, muscle stiffness and fluctuating blood pressure, which may lead to coma
- constant "flu-like" symptoms such as chills, fever, sore throat, swollen glands, aching muscles or joints
- unusual bleeding or bruising
- unusual tiredness, shortness of breath when exercising, dizziness, pale skin
- uncontrollable twitching, jerking or writhing movements
- seizures (fits) or unexplained fainting
- pain or tightness in the chest
- fast or irregular heartbeat
- changes in blood pressure
- yellow colour to the skin or eyes, dark coloured urine or light coloured bowel motions
- confusion, delusions or hallucinations (seeing or feeling things that are not really there)
- excitement, overactivity and uninhibited behaviour
- new or worsening agressive behaviour
- severe or persistent headache
The above side effects may be serious. You may need urgent medical attention.
Tell your doctor if you notice anything else that is making you feel unwell.
Some people may have other side effects not yet known or mentioned in this leaflet.
After taking Ritalin LA
Storage
- Keep your medicine in the original container until it is time to take a dose.
- Store it in a cool dry place.
- Do not store Ritalin LA or any other medicine in the bathroom or near a sink.
- Do not leave it in the car or on window sills.
Keep this medicine where children cannot reach it.
A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.
Disposal
If your doctor tells you to stop taking this medicine or the expiry date has passed, ask your pharmacist what to do with any medicine you have left over.
Product description
What it looks like
Ritalin LA 20 mg capsules are white to off-white beads in a white capsule with imprint NVR and R20 in tan-coloured ink; bottles of 30 capsules.
Ritalin LA 30 mg capsules are white to off-white beads in a yellow capsule with imprint NVR and R30 in tan-coloured ink; bottles of 30 capsules.
Ritalin LA 40 mg capsules are white to off-white beads in a light brown capsule with imprint NVR and R40 in tan-coloured ink; bottles of 30 capsules.
Ingredients
Ritalin LA capsules contain 20 mg, 30 mg or 40 mg of methylphenidate hydrochloride as the active ingredient. They also contain:
- sugar spheres (sucrose and maize starch)
- methacrylic acid copolymer
- purified talc
- triethyl citrate
- macrogol 6000
- gelatin
- titanium dioxide
- iron oxide yellow CI77492 (30 mg and 40 mg capsules only)
- iron oxide black CI77499 (40 mg capsules only)
- iron oxide red CI77491 (40 mg capsules only)
- TekPrint SW-8010