Medication and Treatment Reviews

Concerta

Generic Name: Methylphenidate HCl

Uses

Concerta is a central nervous system stimulant primarily used to treat attention deficit hyperactivity disorder (ADHD) in children ages 6-12, adolescents, and adults up to age 65. Concerta may improve focus, and decrease impulsivity and hyperactive behavior, the hallmark symptoms in patients with the condition. It contains the same active ingredient as medications like Ritalin and Daytrana. According to the FDA, Concerta is a federally controlled substance (CII) because it can be abused or lead to dependence. It has not been studied in children under the age of 6.

The American Academy of Pediatrics recommends treatment with behavioral therapy before medication for children under the age of 6. For children ages 6 to 11, the AAP says “The primary care clinician should prescribe US Food and Drug Administration–approved medications for ADHD and/or evidence-based parent- and/or teacher-administered behavior therapy as treatment for ADHD, preferably both.” Likewise, the National Institute of Mental Health finds the most successful treatment plans use a combination of ADHD medication, like Adderall XR, and behavior therapies.

Concerta can also be used to treat narcolepsy.

How to Use Concerta

Before starting or refilling a Concerta prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage

As with all medications, follow your Concerta prescription instructions exactly. Concerta is taken orally, with or without food, once daily. The first dose is typically taken first thing in the morning; it should be taken at the same time each day for the best results.

Capsules should be swallowed whole with water or other liquids. If your child is unable to swallow the pill, your doctor may recommend another medication. Capsules should never by crushed or chewed. The Concerta capsule is designed to release the medication without dissolving the capsule. The empty capsule passes through the digestive tract and out of the body without being digested.

Capsules are available in 18mg, 27mg, 36mg, and 54mg dosages. The time-release formulation is designed to maintain a steady level of medication in your body throughout the day. Dosage should not exceed 54mg daily for children and adolescents, and 72mg daily for adults.

During treatment, your doctor may periodically ask you to stop taking your Concerta so that he or she can monitor ADHD symptoms; check vital statistics including blood, heart, and blood pressure; or evaluate height and weight. If any problems are found, your doctor may recommend discontinuing treatment.

Some patients report developing a tolerance to Concerta after long-term usage. If you notice that your dosage is no longer controlling your symptoms, talk to your doctor to plan a course of action.

Side Effects

The most common side effects of Concerta are as follows: decreased appetite, dry mouth, sleep disruption, dizziness, stomach ache, increase sweating, headache, nausea, anxiety, weight loss, and irritability.

Other serious side effects include slowing of growth in children, seizures, priapism and eyesight changes or blurred vision.

Taking Concerta may impair your or your teenager’s ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor. Most people taking this medication do not experience any of these side effects.

Report to your doctor any heart-related problems or a family history of heart and blood pressure problems. Patients with structural cardiac abnormalities and other serious heart problems have experienced sudden death, stroke, heart attack, and increased blood pressure while taking Concerta. Stimulants can increase blood pressure and heart rate. Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you or your child experiences warning signs such as chest pain, shortness of breath, or fainting while taking Concerta.

Also disclose to your physician all mental health issues including any family history of suicide, bipolar illness, tics, or depression. The drug manufacturer, Janssen Pharmaceuticals, recommends evaluating patients for bipolar disorder, tics, and Tourette’s syndrome prior to stimulant administration. Concerta may create new or exacerbate existing behavior problems, bipolar illness, or Tourette’s syndrome. It can cause psychotic or manic symptoms in children and teenagers. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including hallucinations or sudden suspicions.

Discuss circulation problems with your doctor before taking Concerta, which has been known to cause numbness, coolness, or pain in fingers or toes, including Raynaud’s phenomenon. Report to your doctor any new blood-flow problems, pain, skin color changes, or sensitivities to temperature while taking Concerta.

Stimulants like Concerta have a high potential for abuse and addiction, especially among people who do not have ADHD. It is a “Schedule II Stimulant,” a designation that the Drug Enforcement Agency uses for drugs with a high potential for abuse. Other Schedule II drugs include Dexedrine, Ritalin, and cocaine. People with a history of drug abuse should use caution when trying this medication. Taking the medication exactly as prescribed can reduce potential for abuse.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions

Store Concerta in a secure place out of the reach of children, and at room temperature. Do not share your Concerta prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal, and can cause harm.

You should not take Concerta if you have any of the following conditions: allergy or hypersensitivity to methylphenidate HCI, anxiety, glaucoma, tics or history of Tourette’s syndrome, or if you are taking monoamine oxidase inhibitors (MAOIs).

You should use caution taking Concerta if you have a history of heart or mental problems, seizures, abnormal brain wave tests, circulation problems, or esophagus, stomach or intestine problems.

If you’re thinking of becoming pregnant, discuss the use of Concerta with your doctor. Animal studies indicate a potential risk of fetal harm. Concerta is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

The safety of Concerta for children under 6 has not been established. The effects of Concerta on adults over age 65 have not been studied.

Interactions

Before taking Concerta, discuss all other active prescription medications with your doctor. Concerta can have a dangerous, possibly fatal, interaction with antidepressants including MAOIs.

Tell your doctor if you are taking seizure medications, blood thinners, blood pressure medication, or any medication containing a decongestant.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking Concerta before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

Sources:

http://www.concerta.net/pdfs/Prescribing_Info-short.pdf
http://www.fda.gov/downloads/drugs/drugsafety/ucm088575.pdf

32 reviews

  1. I am a 54 year old female who was diagnosed with ADHD 18 months ago. I have taken Concerta since receiving the diagnosis. I noticed immediately positive changes in my behavior. During the past year I have been taking 72 mg of Concerta with no other medications. I take 36mg early in the morning, and the additional 36mg around 11a.m. I was unable to handle the total 72mg taken at one time, and it was not pleasant by 5p.m. when everything appeared to “leave” me. Now, the 36mg I take at 11 seems to carry me through the day and into the evening.

  2. I’m an adult with ADHD, primarily inattentive. I’ve been on Concerta since summer of 2015. I am currently on 54 mg. Best effects: emotional stability, motivation, bouncing back fast if distracted or forgetful, making intent equal action. Side effects: very small and short-lived, e.g., tiny headaches for just two days, grinding jaw (minor to start with, but none of that for months).

  3. I’ve been on Concerta at varying doses since I was diagnosed at age 21 and I’m now 24 years old. When I first started taking them I did notice an improvement and I shed a few pounds too! The thing is that I’m now on 108mg (even tried 126mg the other day) as I have been prescribed and I get no real benefit from them. When I don’t take them, I feel very lethargic.

  4. I was put on Adderall XR for ADHD. I started at the normal 5 mg dosage and then I started increasing my dosage according to my tolerance level. I’ve struggled with depression, so I’m on Celexa 10 mg daily as well. I decided that the stimulant medication just wasn’t doing it for me (I felt like it made my anxiety worse) so the doctor switched me to Concerta 36 mg. It was too much for me (I was like the walking dead!) so I went down to 18 mg. At first it seemed okay, but now I’ve noticed my symptoms of ADHD have been coming through.

    Not only has it been ineffective, but I’ve gained about 40 pounds since I’ve been on it. I started Concerta in October, and it seemed like suddenly I started packing on the pounds. My appetite has increased and my metabolism has slowed down it seems like. I’m 5’2”, and back when I was on the Adderall I was 110-115 pounds. Now I’m pushing past 150 pounds.

  5. I started taking Concerta (18 mg) 10 months ago for making mistakes at work. I immediately noticed a feeling like my head was clear and I could concentrate. Gradually it got back to where it was and my doctor increased the dose to 27 mg. Again, my head felt clear at first, but gradually that effect was unnoticeable. 4 months ago the doctor prescribed Lipitor for high cholesterol (just over the limit). I don’t know if it was coincidence or not, but I had more problems with insomnia (racing thoughts), but especially “foggy headedness.”

  6. I am 21 and was only diagnosed with ADHD in June this year. I will never take Concerta again! After only one low dose, I got very aggressive and I felt like I had no control over my own body and mind. I got really anxious and worried. I also started to feel really paranoid.

  7. For me, when I take Concerta 36mg, I know it works because I find it easier to manage my thoughts and to focus on key tasks. At the same time I know that taking Concerta, though helpful to feeling motivated, is not a guarantee that I will feel motivated.

  8. My daughter takes Concerta 18mg. When she takes it too late in the morning, she may have difficulty falling asleep at night. On those evenings, I give her chamomile tea and allow her to wind down with a book during bedtime. So far, it has been working well for her.

    1. I have the opposite problem. In high school, I took Concerta every morning before leaving for school at 7 AM. I would then inevitably crash between 7:30 and 9 pm, which caused some serious problems in my extra curricular activities. Falling asleep in the middle of a band concert tends to be viewed as rather disrespectful… I usually experience about a 30 minute period of complete and utter exhaustion about 12-13 hours after taking the drug. Then, I can’t stop eating, because the appetite suppressing side effect is gone and I’m hungry. As a college student, I’m now having to learn to focus better late at night. It’s pretty difficult on those nights when I’m trying to read or study and my average bedtime has changed to about 2 or 3 AM.

  9. I’m 16 and got diagnosed with ADD last summer. I started taking 18mg of Concerta about 6 weeks ago. Two weeks ago, I tried 27mg instead of 18– because my doctor felt that it was needed and I did too. However, by the next Sunday my irritability had gone through the rood, I had developed all of the side effects including a rash. So, after this I was moved back down to the 18mg tablet. All of the other side effects have gone away by today except for the rash. It’s only on my upper body especially on my breasts and stomach areas. Not only does it blister and peel, but it itches. I want to rip my skin off sometimes. My psychologist said that it isn’t normal but the doctor thinks it doesn’t have anything to do with the medication at all. However, I haven’t changed anything about my routine nor my diet.

  10. Diagnosed in Jan, got perscription in March, started yestorday. My son is taking Concerta 18. We are on day 2. The teacher said today he stayed in his seat, he looks normal to me just a little calmer. I spy on him in class and he’s focused and doing his work. Im shocked really. He doesnt want lunch but has a big breakfast and dinner. I probably shouldn’t but I stick it in 1/2 teaspoon of chocolate frosting….i couldn’t get him to swallow it any other way. Applesauce is too thin. Either way it works. I was scared but its okay..

  11. Warning!! A new generic Methylpehnidate ER Tab by Mylan (Manufacturers of Epi-Pen) was released in December of 2016. Because our pharmacy benefits provider, Express Scripts, uses the cheapest generic, and I thought all “bad” generics were pulled last fall it never occurred to me that my sons wheels falling off this spring were related to his medicine. Quite the opposite, we thought he needed a higher dose. Our son was a senior in high school, and has been on Concerta since Kindergarten. We’ve tried other drugs, but it is the only one that works for him. He takes two pills to make one dose. (27mg and 54mg) They only last 12 hours, so we’ve overlayed Intunive 4mg on top of it to help balance him around the clock. Otherwise he was awful in the morning. This spring he started failing classes deemed the easiest class schedule for a senior that his special education teachers had ever seen. One class was ceramics! At first we thought it was senioritis, then we thought maybe the new girlfriend, then I asked my teen to talk to his doctor about a higher dose. That was denied because he needs to gain weight. He was in a car accident and ticketed for distracted driving, and had two more tickets in the month of April. Finally I was at a parent teacher conference May 1st with two of my son’s three special education teachers. They said “he was a different kid than they had worked with for the past three and a half years.” BAM!! It was the drugs! I’ve always relied on his teachers to tell us when a new dose was needed. I called the doctor. My teen was 18 and I could no longer talk to her. She called my teen back. He couldn’t advocate for himself. I asked him to go to the doctor’s office and sign the release form. He couldn’t pull that off on his own. I had him meet me there and sign the form. Then we were granted an emergency meeting with the doctor, which my teen missed!! Around this time I discovered my teen had been switched to this new generic in January, and was never notified!!! I couldn’t believe that a PBM had the right to switch a childs medicine and not tell the parents!!! Especially to a new drug!!! It was absolute garbage for my child and did nothing for him. His senior year was ruined. He had become moody, irritable, irrational, extremely sad and lost his self esteem. It should have been the best time of his life, and instead he chose not to go to PROM. He skipped the senior dinner, skipped the senior party, and didn’t want a party at home. On top of that his job was delivering pizzas. Now his drivers license is in the hands of a judge we’ll see in July.

    If that wasn’t bad enough, I was getting the run-around from Express Scripts. When I called and complained about the garbage generic and asked my options they said my only options were that generic by Mylan or brand name Concerta at a price of around $350 for a 90 day supply. I asked my son’s physician for a 7 day supply locally and a 90 day supply via mail order. When I went to pick up the 7 day supply they asked me why not the generic by Actavis. It supplied 70% of the generic market, and was Concerta under a different brand name. WHAT!!!! I called Express Scripts…again my only options were Mylan and brand name. I asked for a supervisor, and went three levels up. That person when confronted put me on hold, then came back and said “yes, they could supply the Actavis if the script was written for that.” Then the 90 days would be the $29 for each of the two prescriptions that make the one dose. They also said that my child’s record would be labeled “Therapy Failure” for the Mylan generic. I was so angry, and felt betrayed! These people were looking out for their pennies, not my child’s welfare!!!! And they would gladly rip me off in the process!!!

    I hope all drug and PBM execs lose their jobs and drivers licenses and need to be hauled around by their parents!!! Greedy, horrible people!!!

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