extended-release tablets
Methylphenidate hydrochloride
Consumer Medicine Information
What is in this leaflet
This leaflet answers some common questions about CONCERTA extended-release tablets. It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.
All medicines have risks and benefits. Your doctor has weighed the risks of you or your child taking CONCERTA against the benefits this medicine is expected to have for you or your child.
If you have any concerns about taking CONCERTA ask your doctor or pharmacist.
Keep this leaflet with your medicine. You may need to read it again.
What is CONCERTA used for
CONCERTA is used to treat Attention Deficit Hyperactivity Disorder (ADHD). CONCERTA is part of a comprehensive treatment program which usually includes psychological, educational and social therapy.
CONCERTA is a stimulant that increases attention and decreases impulsiveness and hyperactivity in patients with ADHD.
CONCERTA should be used as part of a total treatment program for ADHD that may include counselling or other therapies.
CONCERTA should not be used in children less than 6 years old because it has not been studied in this age group.
CONCERTA tablets are made in an extended release form. This means that they release the active ingredient slowly. The outer layer of the CONCERTA tablet dissolves right after it is swallowed in the morning, giving an initial dose of methylphenidate hydrochloride.
The tablets have a special shell that allows the rest of the methylphenidate hydrochloride to be released from the tablet at a slow rate throughout the day.
The tablet shell does not dissolve completely after all the drug has been released and sometimes the tablet shell may be seen in your stool. This is normal.
Your doctor may have prescribed CONCERTA for another reason. Ask your doctor if you have any questions about why this medicine has been prescribed for you/your child.
CONCERTA can be abused or lead to dependence. Keep CONCERTA in a safe place to prevent misuse and abuse.
Before you take CONCERTA
When you must not take it
Do not take CONCERTA if you/your child have an allergy to:
methylphenidate hydrochloride (the active ingredient in CONCERTA) or
any of the other ingredients in CONCERTA. See Product Description at the end of this leaflet for a list of ingredients.
Symptoms of an allergic reaction may include: rash, itching or hives on the skin; shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body.
Do not take CONCERTA if you/your child have any of the following medical conditions:
glaucoma (increased pressure in the eye) which is poorly controlled
overactive thyroid gland
heart problems, including severe angina (chest pain), irregular heart beat and high blood pressure (untreated or not under control)
severe depression, anorexia nervosa, suicidal tendency or other mental illness
currently taking or have taken a monoamine oxidase (MAO) inhibitor, medicines used to treat major depression (eg. phenelzine, tranylcypromine) or medicines used in Parkinson's disease (eg. selegiline) within the last 14 days
phaeochromocytoma (a tumour of the adrenal gland)
have a history of drug or alcohol abuse
Do not use CONCERTA if the packaging is torn or shows signs of tampering.
Do not use CONCERTA beyond the expiry date (month and year) printed on the pack.
If you/your child take CONCERTA after the expiry date it may not work.
Before you/your child start to take it
You must tell your doctor if you/your child:
are/is pregnant or planning to become pregnant
are/is breastfeeding or wish to breastfeed.
The active ingredient in CONCERTA passes into breast milk and there is a possibility that your baby may be affected. Your doctor can discuss with you the risks and benefits involved
are/is or have/has been alcohol or drug dependent
have/has seizures or fits
have/has heart problems
Heart-related problems including sudden death in patients who have heart problems or heart defects, stroke and heart attack in adults and increased blood pressure and heart rate have been reported with the use of methylphenidate, the active ingredient in CONCERTA.
have / had thoughts about suicide or attempted suicide
have/has high blood pressure
have/has aggressive behaviour or hostility
have/has a narrowing or blockage in your digestive tract (stomach, small or large intestine)
Tourette's syndrome (tics) or a family history of this disorder
Have a problem with the blood vessels in your brain (such as an aneurysm)
Develop severe headaches, weakness or paralysis of any body part, or develop problems with coordination, vision, speaking, finding words or with your memory
have/has eye problems, such as increased pressure in the eye, a condition called "glaucoma" or long-sightedness (difficulty seeing near objects)
have/has liver or kidney problems
have/has mental problems including psychosis, mania, bipolar illness, or depression.
Mental (Psychiatric) problems may develop or get worse, including behaviour and thought problems, bipolar illness, aggressive behaviour or hostility.
Your doctor may need to adjust the dose or adapt your treatment if you/your child have any of these conditions.
If you have not told your doctor or pharmacist about any of the above, tell them before you/your child start taking CONCERTA.
Taking other medicines:
Tell your doctor or pharmacist if you/your child are taking any other medicines, including medicines you can buy without a prescription from a pharmacy, supermarket or health food shop.
In particular, tell your doctor or pharmacist if you/your child are taking any of the following:
Monoamine oxidase (MAO) inhibitors such as phenelzine, selegiline
medicines that increase blood pressure
medicines used to treat depression such as amitriptyline and imipramine
medicines used to prevent seizures such as phenytoin, phenobarbitone, and primidone and valproate.
These medicines may be affected by CONCERTA or may affect how well CONCERTA works. Your doctor or pharmacist can tell you what to do if you/your child are taking any of these medicines.
Taking CONCERTA
Follow the directions given to you by your doctor and pharmacist.
These directions may differ from the information contained in this leaflet.
How much to take:
If you/your child are currently taking other formulations of methylphenidate, your doctor will decide the best starting dose
Children and Adolescents
The starting dose is one CONCERTA 18 mg extended-release tablet in the morning
The maximum dose is 54 mg a day taken as one dose.
Adults
The starting dose is one CONCERTA 18 mg or 36 mg extended-release tablet in the morning
The maximum dose is 72 mg a day taken as one dose.
How to take it:
CONCERTA should be swallowed whole with a glass of liquid. It should not be chewed, broken or crushed
CONCERTA may be taken with or without food.
If you do not understand the instructions provided with this medicine, ask your doctor or pharmacist for help.
If you/your child forget to take it
It may be best to wait until the following morning to take the next dose. Remember the effects of CONCERTA are designed to last approximately 12 hours from the time it is taken.
Do not take or give your child a double dose to make up for the dose missed.
If you/your child have missed more than one dose, or are not sure what to do, check with your doctor or pharmacist.
If you have trouble remembering when to take your medicine, ask your pharmacist for some hints.
If you/your child have taken too much (overdose)
Immediately telephone your doctor or the Poisons Information Centre for advice, or go to Accident and Emergency at your nearest hospital.
Do this even if there are no signs of discomfort or poisoning. You/your child may need urgent medical attention.
Poisons Information Centre telephone numbers:
Keep these telephone numbers handy.
If you/your child take too much CONCERTA you/your child may experience symptoms such as vomiting, headache, irregular heart beat, dilated pupils, convulsions/fits, breathing problems, confusion and seizures.
While you are taking CONCERTA
Things you must do
Always follow your doctor's instructions carefully
Take CONCERTA exactly as your doctor has prescribed. Like all stimulants, CONCERTA may become habit-forming and can be abused by some people. If you/your child 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/your child's progress can be checked
Your doctor will want to check your/your child's blood pressure and pulse and do blood test from time to time to prevent unwanted side effects from happening
Tell your doctor if you become pregnant while taking CONCERTA
Parents and/or caregivers should be alert for the development of thoughts or acts of self-harm, hallucinations, abnormal thinking (psychosis) or new or worsening hostility. These were uncommon symptoms seen in clinical studies with CONCERTA and it is not known if they were caused by CONCERTA. Contact your/your child's doctor or mental health professional straight away or seek urgent medical attention if these occur
Tell your doctor if you or your child become aggressive, anxious or agitated, or feel more aggressive, anxious or agitated than usual
Parents and/or caregivers should contact their/their child's doctor or seek urgent treatment if they/their child develops chest pain, tightness in the chest, shortness of breath, irregular heart beat, feeling faint or loss of consciousness while taking CONCERTA
Children should have their height and weight checked regularly as CONCERTA may slow children's rate of growth
If you/your child experience numbness, tingling and a changing colour of the fingers and toes when cold ('Raynaud's phenomenon')
If you or your child develop prolonged and painful erections, seek immediate medical attention
If you/your child are about to start taking a new medicine, tell your doctor and pharmacist that you/your child are taking CONCERTA
Things you must not do
Do not use CONCERTA to treat any other complaint unless your doctor says so.
Do not give this medicine to anyone else, even if their symptoms seem similar.
Do not stop treatment without first checking with your doctor.
If you/your child suddenly stop taking this medicine, you/your child's condition may reappear or you/your child may get unwanted effects such as depression. Your doctor may want to gradually reduce the amount of medicine taken each day before stopping it completely.
Things to be careful of
CONCERTA may impair your ability to operate potentially hazardous machinery or vehicles. You should exercise caution until you are reasonably certain how you react to CONCERTA before you drive a car, operate machinery, or do anything else that could be dangerous.
Side Effects
All medicines can have side effects. Sometimes they are serious, most of the time they are not. You/your child may need medical treatment if you get some side effects. Do not be alarmed by this list of possible side effects. You/your child may not experience any of them.
Ask your doctor or pharmacist to answer any questions you may have. Tell your doctor if you/your child experience any of the following and they worry you:
stomach or bowel problems such as:
loss of appetite
stomach pain
difficulty thinking or working because of:
headache
trouble sleeping
dizziness
throat or lung infections such as:
cold
sore throat and hoarse/ loss of voice
feeling of tension or fullness in the nose, cheeks and behind your eyes, sometimes with a throbbing ache, fever, stuffy nose and loss of the sense of smell
joints or movement changes such as:
painful and/ or swollen joints
aching muscles, muscle tenderness or weakness, not caused by exercise
Tell your doctor immediately if you notice any of the following:
behavioural changes such as:
aggression
confusion
disorientation
seeing, feeling or hearing things that are not there
mood swings, overexcitement over-activity and uninhibited behaviour
feeling depressed
nervousness
restlessness
incoherent talkativeness
nervous system changes such as:
convulsions, fits or seizures
muscle twitching
numbness and tingling feeling in fingers and toes
reproductive system changes such as:
prolonged and painful erections
changes in your sight, namely:
visual disturbance
blurred or double vision
dilated pupils
changes to the skin or hair such as:
unusual hair loss or thinning of the hair
redness of the skin
excessive sweating
signs of allergy such rash, itching or hives on the skin; shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body
body temperature changes such as:
fever
abnormally high body temperature
heart or blood problems such as:
fast or abnormal heart beat
increased blood pressure
chest pain
chest discomfort
low white blood cell count
low platelet count
Other side effects include:
slowing of growth (height and weight) in children)
blockage of the oesophagus, stomach, small or large intestine in patients who already have a narrowing in any of these organs
Common side effects include:
decreased appetite
dry mouth
nausea
weight loss
irritability
weakness
muscle spasm
brief periods of acute anxiety where symptoms being suddenly and usually include difficulty breathing, chest pains, fast heart rate, dizziness and lightheadedness, sweating, trembling and faintness
hot flushes
increased levels of the liver enzyme ALT
Other side effects not listed above may also occur in some people. Tell your doctor if you notice any other effects.
After using CONCERTA
Storage
Keep the tablets in the bottle until it is time to take them.
Store CONCERTA in a cool dry place where the temperature is below 25°C. Keep the container tightly closed.
Keep medicines where children cannot reach them.
A locked cupboard at least one-and-a-half metres (1.5 m) above the ground is a good place to store medicines.
Do not store CONCERTA, or any other medicine, in the bathroom or near a sink. Do not leave medicines in the car or on windowsills. Heat and dampness can destroy some medicines.
Disposal
If your doctor tells you/your child to stop taking CONCERTA extended-release tablets or the medicine has passed its expiry date, ask your pharmacist what to do with any medicine that may be left over.
Product Description
What it looks like
CONCERTA 18 mg are yellow capsule-shaped tablets, with "alza 18" printed in black ink on one side.
CONCERTA 27 mg are grey capsule-shaped tablets, with "alza 27" printed in black ink on one side.
CONCERTA 36 mg are white capsule-shaped tablets, with "alza 36" printed in black ink on one side.
CONCERTA 54 mg are brownish-red capsule-shaped tablets, with "alza 54" printed in black ink on one side.
Ingredients
Each CONCERTA extended-release tablet contains 18 mg, 27 mg, 36 mg or 54 mg of methylphenidate hydrochloride as the active ingredient.
Each tablet also contains the following other ingredients: butylated hydroxytoluene, carnauba wax, cellulose acetate, hypromellose, Opacode black NS-78-17715, Opadry clear YS-1-19025-A, phosphoric acid, poloxamer, polyethylene oxide, povidone, sodium chloride, stearic acid, succinic acid and synthetic iron oxides. The 18 mg tablet also contains Opradry II yellow YS-30-12788-A. The 27 mg tablet also contains Opadry II grey Y-30-17528. The 36 mg tablet also contains Opradry II white Y-30-18037. The 54 mg tablet also contains Opradry II red Y-30-15567-A.
CONCERTA extended-release tablets contain lactose.
