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Methylphenidate ER is a medication that requires careful use due to several potential risks and important precautions. Please review the following safety information and discuss any concerns with your healthcare provider:

• Misuse and Dependence: This medication has a potential for misuse and dependence. Misuse can lead to severe side effects such as increased heart rate, high blood pressure, aggressive behavior, and harmful thoughts. If you have a history of substance or alcohol use disorder, or if you take more than the prescribed dose or stop suddenly, your risk increases.

• Serious Heart Problems: There are reports of sudden death, stroke, and heart attack in individuals taking methylphenidate ER, even at usual doses. The medication can elevate your heart rate and blood pressure. Inform your healthcare provider if you have a history of heart issues; they will assess your condition before starting treatment. Seek immediate medical attention if you experience fainting, chest pain during physical activity, or irregular heartbeat.

• Behavioral and Thought Changes: Methylphenidate ER can lead to mental health issues such as hallucinations, unclear thinking, and mania, and may worsen existing mood disorders. Notify your healthcare provider immediately if you experience these symptoms, as you may need to discontinue the medication.

• Prolonged and Painful Erection: Although rare, prolonged and painful erections have been reported, sometimes requiring surgical intervention. This can occur after dose adjustments or discontinuation. If you experience an erection lasting more than 4 hours, immediately stop taking the medication and seek medical help.

• Blood Circulation Problems: The medication may be linked to Raynaud's phenomenon, causing poor blood flow to fingers and toes, leading to discomfort or pain. If you notice symptoms of circulation issues, inform your healthcare provider, as dosage adjustments may be necessary.

• Slowed Growth in Children: Stimulants like methylphenidate ER may temporarily slow growth in children. Your child’s provider will monitor growth and may adjust treatment if necessary.

• Serotonin Syndrome: This rare but serious condition can occur if methylphenidate ER is taken with drugs that increase serotonin levels, such as certain antidepressants and migraine medications. Symptoms include rapid heart rate, sweating, muscle stiffness, fever, and confusion. Seek immediate medical attention if these symptoms occur.

• Drug Interactions: Methylphenidate ER can interact with various medications, including blood pressure drugs and MAOIs, potentially leading to ineffective treatment or high blood pressure. Discuss all medications and supplements you take with your healthcare provider before starting treatment.

• Contraindications: Do not use methylphenidate ER if you have severe allergies to its components, have taken MAOIs in the last 14 days, have certain sugar digestion issues, marked anxiety, tension, distress (Relexxi brand), glaucoma (Relexxi brand), or a history of motor tics or Tourette syndrome.

Always use methylphenidate ER as prescribed and consult your healthcare provider for any concerns or questions regarding its use.

When taking this medication, some individuals may experience common side effects, usually mild, such as nervousness, headache, loss of appetite, weight loss, trouble sleeping, stomach pain, and dizziness. If these persist or worsen, it's advisable to consult a healthcare professional. Additionally, dry mouth, nausea, vomiting, anxiety, irritability, and sweating may also occur.

This medication can also affect the cardiovascular system by potentially raising blood pressure, so regular monitoring is recommended. In rare situations, it might cause more severe reactions that require immediate medical attention. These include signs of blood flow issues in fingers or toes like coldness or numbness, sudden vision changes, uncontrolled muscle movements, or changes in mental state such as agitation, mood swings, or thoughts of suicide. Serious heart-related issues like heart attack symptoms (chest pain, shortness of breath) or signs of a stroke (sudden weakness, speech difficulties) should be addressed urgently.

In very rare cases, males might experience a prolonged or painful erection lasting more than four hours, which requires prompt medical intervention to prevent long-term damage. Allergic reactions, though uncommon, can be severe, presenting with rash, itching, swelling, or trouble breathing, and necessitate immediate medical attention. It is essential to remain vigilant for any unusual or severe symptoms and seek medical guidance when necessary.

When taking Methylphenidate or its extended-release form, it's important to be aware of potential drug interactions. Avoid using MAO inhibitors such as isocarboxazid, Linezolid, methylene blue, moclobemide, phenelzine, procarbazine, Rasagiline, safinamide, Selegiline, and Tranylcypromine with this medication. These combinations can lead to a severe, possibly life-threatening reaction. Additionally, MAO inhibitors should generally be discontinued at least two weeks prior to starting Methylphenidate. Consult your doctor for precise guidance on when to safely start or stop these medications.

Alcohol should also be avoided as it may lead to the medication being released too quickly, increasing the risk of side effects.

Methylphenidate is closely related to Dexmethylphenidate, and using both can be harmful. Also, this medication may interfere with specific medical or laboratory tests, such as brain scans for Parkinson's disease, potentially leading to inaccurate results. Ensure that healthcare professionals conducting your tests are informed about your use of this drug.

Lastly, share a complete list of all medications and supplements you are taking with your doctor and pharmacist, including prescription, over-the-counter drugs, vitamins, and herbal supplements, to avoid additional interactions not listed here.