CNS stimulant

Methylphenidate hydrochloride

Brand names: Ritalin, Concerta XL, Equasym XL, Medikinet XL, Xaggitin

Adult dose

Dose: Specialist initiation. Initial 5mg BD-TDS, titrate weekly. MR preparations 18–54mg OD. Brand-specific — formulations not interchangeable

Route: PO

Frequency: OD-TDS

Clinical pearls

First-line for ADHD (children ≥5y, adults). CD2 controlled drug (Concerta XL CD2; Ritalin CD2). Brand-specific
Cardiac history + BP/HR before initiation; growth monitoring in children

Contraindications

Symptomatic cardiovascular disease
Moderate-severe hypertension
Hyperthyroidism
Concurrent MAOI / within 14 days
Glaucoma
Phaeochromocytoma
Severe depression / psychosis

Side effects

Reduced appetite
Insomnia
Tachycardia
Hypertension
Anxiety
Tics
Psychosis
Cardiomyopathy (rare)
Priapism (rare)

Interactions

MAOIs (avoid)
Sympathomimetics
Antihypertensives
Antiepileptics

Monitoring

BP
HR
Weight
Height
Mental state

Reference: BNF; NICE NG87; https://bnf.nice.org.uk/drugs/methylphenidate-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Pathways