Pediatric Medication

Brand Names: US

Aptensio XR; Concerta; Cotempla XR-ODT; Daytrana; Metadate CD [DSC]; Metadate ER; Methylin; QuilliChew ER; Quillivant XR; Relexxii; Ritalin; Ritalin LA; Ritalin SR [DSC]

Brand Names: Canada

Biphentin; Concerta; Foquest; Ritalin; Ritalin SR


  • This drug may be habit-forming. Give this drug as you were told by the doctor. Tell the doctor if your child has ever abused drugs or alcohol. Misuse of this drug may cause it to not work as well. Mood or behavior changes may also happen.
  • Do not stop giving this drug to your child all of a sudden without calling the doctor. Your child may have a greater risk of mood changes like very low mood (depression). If your child needs to stop this drug, you may need to slowly stop it as told by the doctor.

What is this drug used for?

  • It is used to treat attention deficit problems with hyperactivity.
  • It is used to treat narcolepsy.
  • It may be given to your child for other reasons. Talk with the doctor.

What do I need to tell the doctor BEFORE my child takes this drug?

All products:

  • If your child has an allergy to this drug or any part of this drug.
  • If your child is allergic to any drugs like this one or any other drugs, foods, or other substances. Tell the doctor about the allergy and what signs your child had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
  • If your child or a family member has any of these health problems: Blood vessel disease, high blood pressure, heart structure problems or other heart problems, or Tourette’s syndrome or tics.
  • If your child has any of these health problems: Glaucoma; nervous, anxious, or tense state; or overactive thyroid.
  • If your child has ever had any of these health problems: Drug abuse or stroke.
  • If your child has taken certain drugs used for low mood (depression) like isocarboxazid, phenelzine, or tranylcypromine or drugs used for certain other health problems in the last 14 days. Taking this drug within 14 days of those drugs can cause very bad high blood pressure.
  • If your child is taking any of these drugs: Linezolid or methylene blue.

All chewable products:

  • If your child has trouble swallowing, talk with the doctor.

Long-acting tablets:

  • If your child cannot swallow this product whole.
  • If your child has ever had any of these health problems: Cystic fibrosis; narrowing of the GI (gastrointestinal) tract or other GI problems like bowel block, small bowel disease, short gut syndrome, or slow-moving swallowing tube (esophagus) or bowel tract; peritonitis.

Oral-disintegrating tablet:

  • If your child is taking any of these drugs: Famotidine, omeprazole, or sodium bicarbonate.

This is not a list of all drugs or health problems that interact with this drug.

Tell the doctor and pharmacist about all of your child’s drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for your child to take this drug with all of his/her drugs and health problems. Do not start, stop, or change the dose of any drug your child takes without checking with the doctor.

What are some things I need to know or do while my child takes this drug?

All products:

  • Tell all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
  • Have your child avoid tasks or actions that call for alertness until you see how this drug affects your child. These are things like riding a bike, playing sports, or using items such as scissors, lawnmowers, electric scooters, toy cars, or motorized vehicles.
  • If your child has been taking this drug for a long time or at high doses, it may not work as well and your child may need higher doses to get the same effect. This is known as tolerance. Call the doctor if this drug stops working well. Do not give more than ordered.
  • Heart attacks, strokes, and sudden deaths have happened in adults taking this drug. Sudden deaths have also happened in children with very bad heart problems or heart defects. Call your doctor right away if you have a change in strength on 1 side that is greater than the other, trouble speaking or thinking, change in balance, drooping on 1 side of the face, change in eyesight, chest pain or pressure, shortness of breath, or very bad dizziness or passing out.
  • Have your child’s blood work checked if he/she is on this drug for a long time. Talk with your child’s doctor.
  • Your child may have some heart tests before starting this drug. Talk with your child’s doctor.
  • Have your child’s blood pressure and heart rate checked often. Talk with your child’s doctor.
  • This drug may raise the chance of seizures in some people, including people who have had seizures in the past. Talk to the doctor to see if your child has a greater chance of seizures while taking this drug.
  • Limit your child’s use of caffeine and chocolate. Use with this drug may cause nervousness, shakiness, and a fast heartbeat.
  • If your child is taking this drug and has high blood pressure, talk with the doctor before giving OTC products that may raise blood pressure. These include cough or cold drugs, diet pills, stimulants, ibuprofen or like products, and some natural products or aids.
  • Alcohol may interact with this drug. Be sure your child does not drink alcohol.
  • Do not switch between different forms of this drug without first talking with the doctor.
  • This drug may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.

If your child is pregnant or breast-feeding a baby:

  • Talk with the doctor if your child is pregnant, becomes pregnant, or is breast-feeding a baby. You will need to talk about the benefits and risks of using this drug.

All chewable products:

  • If your child has phenylketonuria (PKU), talk with your child’s doctor. Some products have phenylalanine.

Long-acting tablets:

  • For some brands, you or your child may see the tablet shell in your child’s stool. For these brands, this is normal and not a cause for concern. If you have questions, talk with the doctor.
  • Tell the doctor that your child takes this drug if your child is getting x-rays near the stomach.

Skin patch:

  • Have your child avoid use of heat sources (such as sunlamps, tanning beds, heating pads, electric blankets, heat lamps, saunas, hot tubs, heated waterbeds). Avoid long, hot baths or sunbathing. Your child’s temperature may rise and cause too much drug to pass into your child’s body.
  • This drug may lead to loss of skin color at or around where the patch is put on. Sometimes, this has happened at other areas. This may last even after this drug is stopped. The chance may be higher if you or someone in your family has ever had a skin problem called vitiligo. Talk with the doctor.
  • This drug may cause harm if chewed or swallowed. If this drug has been put in the mouth, call a doctor or poison control center right away.

What are some side effects that I need to call my child’s doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your child’s doctor or get medical help right away if your child has any of the following signs or symptoms that may be related to a very bad side effect:

All products:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of high or low blood pressure like very bad headache or dizziness, passing out, change in eyesight.
  • Signs of liver problems like dark urine, feeling tired, not hungry, upset stomach or stomach pain, light-colored stools, throwing up, or yellow skin or eyes.
  • Joint pain.
  • Purple patches on the skin or mouth.
  • Blurred eyesight.
  • Fast or slow heartbeat.
  • A heartbeat that does not feel normal.
  • Change in eyesight.
  • Very upset stomach or throwing up.
  • Seizures.
  • Fever or chills.
  • Sore throat.
  • Shakiness.
  • Trouble controlling body movements.
  • Sweating a lot.
  • Feeling very tired or weak.
  • Change in color of hands or feet from pale to blue or red.
  • Numbness, pain, tingling, or cold feeling of the hands or feet.
  • Any sores or wounds on the fingers or toes.
  • Not able to pass urine or change in how much urine is passed.
  • Muscle pain or weakness.
  • Change in sex interest.
  • Call your child’s doctor right away if your child gets a painful erection (hard penis) or gets an erection that lasts for longer than 4 hours. If this is not treated right away, it may lead to lasting sex problems and your child may not be able to have sex in the future.
  • New or worse behavior and mood changes like change in thinking, anger, and hallucinations have happened with this drug. Tell the doctor if your child or a family member has any mental or mood problems like low mood (depression) or bipolar illness, or if a family member has killed themselves. Call the doctor right away if your child has hallucinations; change in the way your child acts; or signs of mood changes like low mood (depression), thoughts of killing him/herself, nervousness, emotional ups and downs, thinking that is not normal, anxiety, or lack of interest in life.
  • A very bad and sometimes deadly health problem called serotonin syndrome may happen if your child takes this drug with drugs for depression, migraines, or certain other drugs. Call the doctor right away if your child has agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; very bad diarrhea, upset stomach, or throwing up; or very bad headache.

Skin patch:

  • Change in skin color.
  • Very bad skin irritation.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:

All products:

  • Feeling nervous and excitable.
  • Not hungry.
  • Upset stomach or throwing up.
  • Weight loss.
  • Not able to sleep.
  • Dizziness.
  • Feeling sleepy.
  • Dry mouth.
  • Headache.
  • Belly pain.

Skin patch:

  • Skin irritation.

These are not all of the side effects that may occur. If you have questions about side effects, call your child’s doctor. Call your child’s doctor for medical advice about side effects.

You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.

All products:

  • To gain the most benefit, do not miss giving your child doses.


  • Give 30 to 45 minutes before meals.
  • If giving this drug to your child more than 1 time a day, give the last dose of the day before 6 pm.

All chewable products:

  • Have your child chew well before swallowing.
  • Give this drug with a full glass of water.

Fast-release chewable tablet:

  • Give 30 to 45 minutes before meals.
  • If giving this drug to your child more than 1 time a day, give the last dose of the day before 6 pm.

Extended-release chewable tablet:

  • Give in the morning.
  • Give this drug with or without food.
  • Some products may be broken in half. If you are not sure if you can break this product in half, talk with the doctor.

Oral-disintegrating tablet:

  • Give in the morning.
  • Give this drug with or without food but give it the same way each time. Always give with food or always give on an empty stomach.
  • Do not push the tablet out of the foil when opening. Use dry hands to take it from the foil. Place on your child’s tongue and let it melt. Water is not needed. Do not let your child swallow it whole. Do not let your child chew, break, or crush it.
  • Do not take this drug out of the blister pack until you are ready to give this drug to your child. Give this drug right away after opening the blister pack. Do not store the removed drug for future use.

All liquid products:

  • Measure liquid doses carefully. Use the measuring device that comes with this drug. If there is none, ask the pharmacist for a device to measure this drug.

Liquid (solution):

  • Give 30 to 45 minutes before meals.
  • If giving this drug to your child more than 1 time a day, give the last dose of the day before 6 pm.

Liquid (suspension):

  • Give in the morning with or without food. Shake bottle for 10 seconds or more before giving a dose.
  • Check to make sure the drug in the bottle is a liquid. If this drug is still a powder, do not use it. Take it back to the pharmacist.

Long-acting capsules and tablets:

  • Give in the morning.
  • Some drugs may need to be given with food or on an empty stomach. For some drugs, it does not matter. Check with your pharmacist about how to give this drug to your child.
  • Have your child swallow whole. Do not let your child chew, break, or crush.

Long-acting capsules:

  • You may sprinkle contents of capsule on applesauce. Have your child swallow right away without chewing and follow with water or juice.
  • Give the mixture right away. Do not store for use at a later time.

Skin patch:

  • Follow how to use as you have been told by the doctor or read the package insert.
  • Do not use patches that are cut or do not look right.
  • Wash your hands before and after use.
  • Put patch on clean, dry, healthy skin on your child’s hip. Do not put the patch on your child’s waistline.
  • Do not put on cuts, scrapes, eczema, or damaged skin.
  • Put patch on in the morning and take off 9 hours later or as you have been told by the doctor.
  • Put the patch in a new area each time you change the patch.
  • Water from bathing, swimming, or showering can make the patch not stick well or fall off. If the patch falls off, do not touch the sticky side with your fingers.
  • If the patch falls off, put on a new one on some other part of the same hip. Take the new patch off at the normal time.

What do I do if my child misses a dose?

Liquid (suspension):

  • Call your child’s doctor to find out what to do.

All other oral products:

  • Give a missed dose as soon as you think about it. Do not give this drug after 6 pm.
  • If it is close to the time for your child’s next dose, skip the missed dose and go back to your child’s normal time.
  • Do not give 2 doses at the same time or extra doses.

Skin patch:

  • You may apply the patch later in the day. Then take off the patch at your child’s normal time of day.
  • Do not put on 2 doses at the same time or extra doses.

How do I store and/or throw out this drug?

All oral products:

  • Store at room temperature.

Oral-disintegrating tablet:

  • After taking blister packs out of the carton, store in the plastic travel case that comes with this drug.

Liquid (suspension):

  • Throw away any part not used after 4 months.
  • Store upright with the cap on.

Skin patch:

  • Store at room temperature. Do not refrigerate or freeze.
  • Keep patches in the pouch. Use within 2 months of opening tray.
  • After you take off a skin patch, be sure to fold the sticky sides of the patch to each other.

All products:

  • Protect from light.
  • Store in a dry place. Do not store in a bathroom.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

General drug facts

  • If your child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Keep a list of all your child’s drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child’s doctor.
  • Talk with your child’s doctor before giving your child any new drug, including prescription or OTC, natural products, or vitamins.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your child’s doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

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