Concerta Drug Interactions

CONCERTA should not be used in patients being treated (currently or within the preceding 2 weeks) with MAO inhibitors (see Contraindications).
Because of possible increases in blood pressure, CONCERTA should be used cautiously with vasopressor agents.
CONCERTA may decrease the effectiveness of drugs used to treat hypertension. It is recommended to monitor blood pressure and adjust the dosage of the antihypertensive drug as needed (see Conditions requiring caution: Underlying medical conditions that might be compromised by increases in blood pressure or heart rate under Precautions).
Concomitant use of halogenated anesthetics and CONCERTA may increase the risk of sudden blood pressure and heart rate increase during surgery. It is recommended to avoid use of CONCERTA in patients being treated with anesthetics on the day of surgery.
There have been reports of serotonin syndrome following coadministration of methylphenidate with serotonergic drugs. If concomitant use of CONCERTA with a serotonergic drug is warranted, prompt recognition of the symptoms of serotonin syndrome is important. CONCERTA must be discontinued as soon as possible if serotonin syndrome is suspected.
Because a predominant action of methylphenidate is to increase extracellular dopamine levels, CONCERTA may be associated with pharmacodynamic interactions when co-administered with some antipsychotics. Caution is warranted in patients receiving both CONCERTA and an antipsychotic, as extrapyramidal symptoms could emerge when these drugs are administered concomitantly or when adjusting the dosage of one or both drugs.
Human pharmacologic studies have shown that methylphenidate may inhibit the metabolism of coumarin anticoagulants, anticonvulsants (e.g., phenobarbital, phenytoin, primidone), and some antidepressants (tricyclics and selective serotonin reuptake inhibitors). Downward dose adjustment of these drugs may be required when given concomitantly with methylphenidate. It may be necessary to adjust the dosage and monitor plasma drug concentrations (or, in the case of coumarin, coagulation times), when initiating or discontinuing concomitant methylphenidate.