Methylphenidate transdermal patch

What is this medicine?

METHYLPHENIDATE (meth il FEN i date) is used to treat attention-deficit hyperactivity disorder (ADHD).

How should I use this medicine?

This medicine is for external use only. Follow the directions on the prescription label. Apply the patch to dry, smooth skin on the hip. Alternate hips each day. Avoid injured, irritated, or oily areas. Apply the patch 2 hours before the effect of the medicine is needed. Use care separating the patch from the release liner. Follow package instructions carefully. Do not apply to waistline where clothing may cause the patch to rub off. Do not use patches that have been cut or torn. Wash hands after applying this medicine. Do not heat the area where the patch is with heating pads, electric blankets or hot water beds. Do not use your medicine more often than directed.

Take this patch off after the prescribed number of hours. After removing fold the patch so it sticks to itself. Flush used patches down the toilet or throw away in a lidded trash can. Do not flush pouch and protective liner down the toilet. Throw them away in a lidded trash can.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 6 years for selected conditions, precautions do apply.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• changes in vision

• chest pain or chest tightness

• confusion, trouble speaking or understanding

• fast, irregular heartbeat

• fingers or toes feel numb, cool, painful

• hallucination, loss of contact with reality

• high blood pressure

• loss of skin color, especially under and around the patch

• males: prolonged or painful erection

• seizures

• severe headaches

• shortness of breath

• skin blisters, swelling at site where applied

• suicidal thoughts or other mood changes

• trouble walking, dizziness, loss of balance or coordination

• uncontrollable head, mouth, neck, arm, or leg movements

• unusual bleeding or bruising

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• anxious

• headache

• loss of appetite

• nausea, vomiting

• skin redness at site where applied

• trouble sleeping

• weight loss

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• lithium

• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

• other stimulant medicines for attention disorders, weight loss, or to stay awake

• procarbazine

This medicine may also interact with the following medications:

• atomoxetine

• caffeine

• certain medicines for blood pressure, heart disease, irregular heart beat

• certain medicines for depression, anxiety, or psychotic disturbances

• certain medicines for seizures like carbamazepine, phenobarbital, phenytoin

• cold or allergy medicines

• warfarin

What if I miss a dose?

If the patch falls off, you may replace it with another patch at a different site on the same hip. You must remove that patch also at the same time; do not wear it for a longer period of time.

If you forget to apply a patch in the morning, you may do so later in the day, but you should remove the patch at the same time of day you normally remove the patch to reduce the possibility of side effects late in the day or at night.

Where should I keep my medicine?

Keep out of the reach of children. This medicine can be abused. Keep your medicine in a safe place to protect it from theft. Do not share this medicine with anyone. Selling or giving away this medicine is dangerous and against the law.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Keep patches in the package until ready to use.

This medicine may cause harm and death if it is taken by other adults, children, or pets. Return medicine that has not been used to an official disposal site. Contact the DEA at 1-800-882-9539 or your city/county government to find a site. If you cannot return the medicine, flush it down the toilet. Do not use the medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• anxiety or panic attacks

• circulation problems in fingers and toes

• glaucoma

• hardening or blockages of the arteries or heart blood vessels

• heart disease or a heart defect

• high blood pressure

• history of a drug or alcohol abuse problem

• history of stroke

• liver disease

• mental illness

• motor tics, family history or diagnosis of Tourette's syndrome

• seizures

• suicidal thoughts, plans, or attempt; a previous suicide attempt by you or a family member

• thyroid disease

• vitiligo or a family history of vitiligo

• an unusual or allergic reaction to methylphenidate, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Visit your doctor or healthcare professional for regular checks on your progress. This prescription requires that you follow special procedures with your doctor and pharmacy. You will need to have a new written prescription from your doctor or health care professional every time you need a refill.

This medicine may affect your concentration, or hide signs of tiredness. Until you know how this drug affects you, do not drive, ride a bicycle, use machinery, or do anything that needs mental alertness.

Tell your doctor or healthcare professional right away if you notice unexplained wounds on your fingers and toes while taking this medicine. You should also tell your healthcare provider if you experience numbness or pain, changes in the skin color, or sensitivity to temperature in your fingers or toes.

Permanent loss of skin color may occur with the use of this medicine. Patches of lighter skin may appear in and around the area where the patch is applied. Lighter skin can also occur in places where the patch has never been applied. Monitor for signs of lighter areas of skin and report any changes in skin color to your health care professional right away.

This medicine patch is sensitive to certain body heat changes. If your skin gets too hot, more medicine will come out of the patch. Call your healthcare provider if you get a fever. Do not take hot baths. Do not sunbathe. Do not use hot tubs, saunas, hair dryers, heating pads, electric blankets, heated waterbeds, or tanning lamps. Do not do exercise that increases your body temperature.

For males, contact your doctor or healthcare professional right away if you have an erection that lasts longer than 4 hours or if it becomes painful. This may be a sign of a serious problem and must be treated right away to prevent permanent damage.

Decreased appetite is a common side effect when starting this medicine. Eating small, frequent meals or snacks can help. Talk to your doctor if you continue to have poor eating habits. Height and weight growth of a child taking this medicine will be monitored closely.

If you are going to need surgery, a MRI, CT scan, or other procedure, tell your doctor that you are using this medicine. You may need to remove this patch before the procedure.

Do not apply this patch close to bedtime or wear longer than directed. It may prevent you from sleeping.

Tell your doctor or healthcare professional if this medicine loses its effects, or if you feel you need to take more than the prescribed amount. Do not change the dosage without talking to your doctor or healthcare professional.