RITALIN- methylphenidate hydrochloride tablet

Negara: Amerika Serikat

Bahasa: Inggris

Sumber: NLM (National Library of Medicine)

Bahan aktif:

METHYLPHENIDATE HYDROCHLORIDE (UNII: 4B3SC438HI) (METHYLPHENIDATE - UNII:207ZZ9QZ49)

Tersedia dari:

Novartis Pharmaceuticals Corporation

INN (Nama Internasional):

METHYLPHENIDATE HYDROCHLORIDE

Komposisi:

METHYLPHENIDATE HYDROCHLORIDE 5 mg

Rute administrasi :

ORAL

Jenis Resep:

PRESCRIPTION DRUG

Indikasi Terapi:

Ritalin is indicated for the treatment of: Pregnancy Exposure Registry There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to ADHD medications, including Ritalin, during pregnancy. Healthcare providers are encouraged to register patients by calling the National Pregnancy Registry for ADHD Medications at 1-866-961-2388 or visiting https://womensmentalhealth.org/adhd-medications/. Risk Summary Published studies and postmarketing reports on methylphenidate use during pregnancy have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. There may be risks to the fetus associated with the use of CNS stimulants use during pregnancy (see Clinical Considerations) . No effects on morphological development were observed in embryo-fetal development studies with oral administration of methylphenidate to pregnant rats and rabbits during organogenesis at doses up to 10 and 15 times, respectively, the maximum recommended human dose (MRHD) of 60 mg/day given to adolescents on a mg/m2 basis. However, spina bifida was observed in rabbits at a dose 52 times the MRHD given to adolescents. A decrease in pup body weight was observed in a pre- and post-natal development study with oral administration of methylphenidate to rats throughout pregnancy and lactation at doses 6 times the MRHD given to adolescents (see Data) . The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Clinical Considerations Fetal/Neonatal Adverse Reactions CNS stimulants, such as Ritalin, can cause vasoconstriction and thereby decrease placental perfusion. No fetal and/or neonatal adverse reactions have been reported with the use of therapeutic doses of methylphenidate during pregnancy; however, premature delivery and low birth weight infants have been reported in amphetamine-dependent mothers. Data Animal Data In embryo-fetal development studies conducted in rats and rabbits, methylphenidate was administered orally at doses of up to 75 and 200 mg/kg/day, respectively, during the period of organogenesis. Malformations (increased incidence of fetal spina bifida) were observed in rabbits at the highest dose, which is approximately 52 times the MRHD of 60 mg/day given to adolescents on a mg/m2 basis. The no effect level for embryo-fetal development in rabbits was 60 mg/kg/day (15times the MRHD given to adolescents on a mg/m2 basis). There was no evidence of morphological development effects in rats, although increased incidences of fetal skeletal variations were seen at the highest dose level (10 times the MRHD of 60 mg/day given to adolescents on a mg/m2 basis), which was also maternally toxic. The no effect level for embryo-fetal development in rats was 25 mg/kg/day (3 times the MRHD on a mg/m2 basis). When methylphenidate was administered to rats throughout pregnancy and lactation at doses of up to 45 mg/kg/day, offspring body weight gain was decreased at the highest dose (6 times the MRHD of 60 mg/day given to adolescents on a mg/m2 basis), but no other effects on postnatal development were observed. The no effect level for pre- and postnatal development in rats was 15 mg/kg/day (approximately 2 times the MRHD given to adolescents on a mg/m2 basis). Risk Summary Limited published literature, based on milk sampling from seven mothers, reports that methylphenidate is present in human milk, which resulted in infant doses of 0.16% to 0.7% of the maternal weight-adjusted dosage and a milk/plasma ratio ranging between 1.1 and 2.7. There are no reports of adverse effects on the breastfed infant and no effects on milk production. Long-term neurodevelopmental effects on infants from stimulant exposure are unknown. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Ritalin and any potential adverse effects on the breastfed infant from Ritalin or from the underlying maternal condition. Clinical Considerations Monitor breastfeeding infants for adverse reactions, such as agitation, insomnia, anorexia, and reduced weight gain. The safety and effectiveness of Ritalin for the treatment of ADHD have been established in pediatric patients aged 6 to 17 years. The safety and effectiveness of Ritalin in pediatric patients less than aged 6 years have not been established. The long-term efficacy of methylphenidate in pediatric patients has not been established. Long-Term Suppression of Growth Growth should be monitored during treatment with stimulants, including Ritalin. Pediatric patients who are not growing or gaining weight as expected may need to have their treatment interrupted [see Warnings and Precautions (5.7)] . Juvenile Animal Toxicity Data Rats treated with methylphenidate early in the postnatal period through sexual maturation demonstrated a decrease in spontaneous locomotor activity in adulthood. A deficit in acquisition of a specific learning task was observed in females only. The doses at which these findings were observed are at least 4 times the MRHD of 60 mg/day given to children on a mg/m2 basis. In a study conducted in young rats, methylphenidate was administered orally at doses of up to 100 mg/kg/day for 9 weeks, starting early in the postnatal period (postnatal Day 7) and continuing through sexual maturity (postnatal Week 10). When these animals were tested as adults (postnatal Weeks 13 to 14), decreased spontaneous locomotor activity was observed in males and females previously treated with 50 mg/kg/day (approximately 4 times the MRHD of 60 mg/day given to children on a mg/m2 basis) or greater, and a deficit in the acquisition of a specific learning task was seen in females exposed to the highest dose (8 times the MRHD given to children on a mg/m2 basis). The no effect level for juvenile neurobehavioral development in rats was 5 mg/kg/day ( approximately 0.5 times the MRHD given to children on a mg/m2 basis). The clinical significance of the long-term behavioral effects observed in rats is unknown. Ritalin has not been studied in the geriatric population. Ritalin contains methylphenidate hydrochloride, a Schedule II controlled substance. Ritalin has a high potential for abuse and misuse which can lead to the development of a substance use disorder, including addiction [see Warnings and Precautions (5.1)] . Ritalin can be diverted for non-medical use into illicit channels or distribution. Abuse is the intentional non-therapeutic use of a drug, even once, to achieve a desired psychological or physiological effect. Misuse is the intentional use, for therapeutic purposes, of a drug by an individual in a way other than prescribed by a health care provider or for whom it was not prescribed. Drug addiction is a cluster of behavioral, cognitive, and physiological phenomena that may include a strong desire to take the drug, difficulties in controlling drug use (e.g., continuing drug use despite harmful consequences, giving a higher priority to drug use than other activities and obligations), and possible tolerance or physical dependence. Misuse and abuse of methylphenidate hydrochloride may cause increased heart rate, respiratory rate, or blood pressure; sweating; dilated pupils; hyperactivity; restlessness; insomnia; decreased appetite; loss of coordination; tremors; flushed skin; vomiting; and/or abdominal pain. Anxiety, psychosis, hostility, aggression, and suicidal or homicidal ideation have also been observed with CNS stimulants abuse and/or misuse. Misuse and abuse of CNS stimulants, including Ritalin, can result in overdose and death [see Overdosage (10)] , and this risk is increased with higher doses or unapproved methods of administration, such as snorting or injection. Physical Dependence Ritalin may produce physical dependence. Physical dependence is a state that develops as a result of physiological adaptation in response to repeated drug use, manifested by withdrawal signs and symptoms after abrupt discontinuation or a significant dose reduction of a drug. Withdrawal signs and symptoms after abrupt discontinuation or dose reduction following prolonged use of CNS stimulants including Ritalin include dysphoric mood; depression; fatigue; vivid, unpleasant dreams; insomnia or hypersomnia; increased appetite; and psychomotor retardation or agitation. Tolerance Ritalin may produce tolerance. Tolerance is a physiological state characterized by a reduced response to a drug after repeated administration (i.e., a higher dose of a drug is required to produce the same effect that was once obtained at a lower dose).

Ringkasan produk:

Ritalin Tablets Store at 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C and 30°C (59°F and 86°F) [see USP controlled room temperature]. Protect from light. Dispense in tight, light-resistant container (USP).

Status otorisasi:

New Drug Application

Selebaran informasi

Novartis Pharmaceuticals Corporation
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MEDICATION GUIDE
RITALIN® (rit-ah-lin)
(methylphenidate hydrochloride)
tablets, for oral use, CII
What is the most important information I should know about RITALIN?
RITALIN may cause serious side effects, including:
•
Abuse, misuse, and addiction. RITALIN has a high chance for abuse and
misuse and may lead to
substance use problems, including addiction. Misuse and abuse of
RITALIN, other
methylphenidate containing medicines, and amphetamine containing
medicines, can lead to
overdose and death. The risk of overdose and death is increased with
higher doses of RITALIN or
when it is used in ways that are not approved, such as snorting or
injection.
o
Your healthcare provider should check you or your child’s risk for
abuse, misuse, and addiction
before starting treatment with RITALIN and will monitor you or your
child during treatment.
o
RITALIN may lead to physical dependence after prolonged use, even if
taken as directed by your
healthcare provider.
o
Do not give RITALIN to anyone else. See “What is RITALIN?” for
more information.
o
Keep RITALIN in a safe place and properly dispose of any unused
medicine. See “How should I
store RITALIN?” for more information.
o
Tell your healthcare provider if you or your child have ever abused or
been dependent on alcohol,
prescription medicines, or street drugs.
•
Risks for people with serious heart disease. Sudden death has happened
in people who have heart
defects or other serious heart disease.
Your healthcare provider should check you or your child carefully for
heart problems before
starting RITALIN.
Tell your healthcare provider if you or your child have any heart
problems, heart disease, or heart
defects.
Call your healthcare provider or go to the nearest hospital emergency
room right away if you or
your child has any signs of heart problems, such as chest pain,
shortness of breath, or fainting while
taking RITALIN.
•
Increased blood pressure and heart rate.
Your healthcare provider should check you or your

Karakteristik produk

RITALIN- METHYLPHENIDATE HYDROCHLORIDE TABLET
NOVARTIS PHARMACEUTICALS CORPORATION
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HIGHLIGHTS OF PRESCRIBING INFORMATION
THESE HIGHLIGHTS DO NOT INCLUDE ALL THE INFORMATION NEEDED TO USE
RITALIN SAFELY AND
EFFECTIVELY. SEE FULL PRESCRIBING INFORMATION FOR RITALIN.
RITALIN (METHYLPHENIDATE HYDROCHLORIDE) TABLETS, FOR ORAL USE, CII
INITIAL U.S. APPROVAL: 1955
WARNING: ABUSE, MISUSE, AND ADDICTION
_SEE FULL PRESCRIBING INFORMATION FOR COMPLETE BOXED WARNING._
RITALIN HAS A HIGH POTENTIAL FOR ABUSE AND MISUSE, WHICH CAN LEAD TO
THE DEVELOPMENT
OF A SUBSTANCE USE DISORDER, INCLUDING ADDICTION. MISUSE AND ABUSE OF
CNS STIMULANTS,
INCLUDING RITALIN, CAN RESULT IN OVERDOSE AND DEATH (5.1, 9.2, 10):
• BEFORE PRESCRIBING RITALIN, ASSESS EACH PATIENT’S RISK FOR
ABUSE, MISUSE, AND
ADDICTION.
• EDUCATE PATIENTS AND THEIR FAMILIES ABOUT THESE RISKS, PROPER
STORAGE OF THE DRUG,
AND PROPER DISPOSAL OF ANY UNUSED DRUG.
• THROUGHOUT TREATMENT, REASSESS EACH PATIENT’S RISK AND
FREQUENTLY MONITOR FOR SIGNS
AND SYMPTOMS OF ABUSE, MISUSE, AND ADDICTION.
RECENT MAJOR CHANGES
Boxed Warning 10/2023
Dosage and Administration (2.1) 10/2023
Warnings and Precautions (5.1, 5.2, 5.8, 5.9, 5.10) 10/2023
INDICATIONS AND USAGE
Ritalin is a central nervous system (CNS) stimulant indicated for the
treatment of Attention Deficit
Hyperactivity Disorders (ADHD) and Narcolepsy (1).
DOSAGE AND ADMINISTRATION
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•
DOSAGE FORMS AND STRENGTHS
•
CONTRAINDICATIONS
•
•
WARNINGS AND PRECAUTIONS
•
•
•
•
•
®
Pediatric Patients 6 Years and Older: Start with 5 mg twice daily
(before breakfast and lunch), titrating
the dose weekly in 5- to 10-mg increments.
Dosages above 60 mg/day are not recommended (2.2).
Adults: Average daily dosage is 20 mg to 30 mg, administered 2 or 3
times daily, preferably 30 to 45
minutes before meals. Maximum total daily dosage is 60 mg (2.2).
Tablets: 5 mg, 10 mg, and 20 mg (3)
Known hypersensitivity to methylphenidate or other product components
of Ritalin (4).
Concurrent treatment with a monoami