Dosage and how to give your child methylphenidate
Always follow the instructions that come with your child's medicine carefully. Different brands of methylphenidate tablets and capsules may have different instructions.
Dosage
Your child's dose of methylphenidate depends on whether they've been prescribed standard or slow release medicine. In some cases, the specialist may prescribe both.
Your child will usually start on a low dose of methylphenidate, taken once or twice a day. Their doctor will increase the dose gradually, until they find the dose that works best for them.
If your child starts on standard methylphenidate tablets, their doctor may later switch them to slow release tablets or capsules. They only have to take this once a day.
Standard tablets
The usual starting dose for children is 5mg, given once or twice a day.
Your child's doctor may increase their dose gradually (usually weekly) until they find the dose that works best. Your child may need to take it 2 or 3 times a day.
Slow release tablets and capsules
The usual starting dose for:
- tablets is 18mg, given once a day in the morning – your child's doctor may gradually increase the dose by 18mg at a time (usually weekly, up to a maximum of 54mg) until they find the dose that works well for your child
- capsules is 10mg, given once a day in the morning – your child's doctor may increase the dose gradually (usually weekly, up to a maximum of 60mg) until they find the dose that works well for your child
How to give your child methylphenidate
Give your child their tablet or capsule with a drink of water, milk or juice. Tell them to swallow the medicine whole, not chew it.
Depending on what type of methylphenidate your child needs, they'll need to take it at different times. If your child is taking slow release methylphenidate, such as:
- Equasym XL, give it to them before breakfast
- Medikinet XL, give it to them with or after breakfast
For other types of methylphenidate, give your child their dose first thing in the morning. If they have 2 doses a day, give the next dose around lunchtime (early afternoon). If they've been prescribed 3 doses, they can take the last dose in the late afternoon or evening.
Try to leave at least 4 hours between doses.
If your child has 3 doses, try to give them the last one at least 4 hours before bedtime so it does not affect their sleep.
Let your child's school know if they need to take their medicine during the school day.
If your child has problems swallowing standard tablets, such as Medikinet or Ritalin, then it's OK to crush them up. Mix the crushed tablets with a small amount of soft food such as yogurt, honey or jam.
If your child takes slow release capsules, you can open the capsule and mix the contents with a small amount of soft food such as yogurt, honey or jam.
Give your child the mixture straight away and tell them to swallow it without chewing.
Important
Do not crush or break slow release tablets because the medicine will not work properly.
Check the leaflet that comes with the medicine for when to take it and whether to take it with food.
How long to take it for
If methylphenidate is working well to control your child's symptoms, they might need to take it for several months or even years. However, it's not usually a life-long medicine.
Your child will usually have a check-up every 6 months. This gives their doctor a better idea about how your child is getting on with their medicine and whether they still need it.
Their doctor may recommend stopping methylphenidate for a while, or reducing the dose. This will normally be during the school holidays and can be called a "medicine break". This is to check whether it's still helping.
As your child gets to puberty, or just after, the doctor may stop their methylphenidate. But if the medicine is still helping, they may recommend that your child keep taking it, even as an adult.
If your child is sick
If your child is sick (vomits) less than 30 minutes after taking their methylphenidate, give them the same dose again.
If it's more than 30 minutes after taking their medicine, do not give your child another dose, just wait until their next dose is due.
If your child is sick again, ask your doctor or pharmacist for advice.
If you forget to give a dose
If you forget to give your child their medicine, skip the missed dose and give them the next dose at the usual time.
Never give your child 2 doses to make up for a forgotten dose.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to give your child their medicine.
If they take too much
The amount of methylphenidate it takes to cause an overdose is different for everyone.
It's important to get medical advice if your child has taken more than their prescribed dose of methylphenidate.
Immediate action required: Call 999 or go to A&E if:
Your child has had more than their prescribed dose of methylphenidate and has:
- a seizure or fit (uncontrollable jerking and shaking)
- a fast, slow or irregular heartbeat (palpitations) – your child may feel their heart is beating faster or slower than normal, or may say it's racing
Urgent advice: Contact 111 for advice now if:
- your child has more than their prescribed dose of methylphenidate
Go to 111 online or call 111. If you need advice for a child under the age of 5 years, call 111.
If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.
Bring the methylphenidate packet or leaflet inside it, any remaining medicine, and any other medicines your child takes.
Important
Keep methylphenidate in a cupboard. Make sure children cannot see or reach this medicine.
Stopping methylphenidate
If your child suddenly stops taking methylphenidate, you may notice withdrawal symptoms such as depression.
Talk to your doctor if you want to stop giving your child methylphenidate. They may want to slowly reduce the amount that your child takes before stopping completely.
This helps to avoid any extra side effects.