Methylphenidate Patches

What is this medication?

METHYLPHENIDATE (meth il FEN i date) treats attention-deficit hyperactivity disorder (ADHD). It works by improving focus and reducing impulsive behavior. It belongs to a group of medications called stimulants.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Daytrana

What should I tell my care team before I take this medication?

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

• Anxiety or panic attacks
• Circulation problems in fingers and toes
• Glaucoma
• Heart disease or a heart defect
• High blood pressure
• History of substance use disorder
• Liver disease
• Mental health condition
• Motor tics, family history or diagnosis of Tourette's syndrome
• Seizures
• Stroke
• Suicidal thoughts, plans, or attempt by you or a family member
• Thyroid disease
• Vitiligo or a family history of vitiligo
• An unusual or allergic reaction to methylphenidate, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication 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 medication 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 your hands after applying this medication. Do not heat the area where the patch is with heating pads, electric blankets, or hot water beds. Do not use your medication 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 the 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 care team about the use of this medication in children. While it may be prescribed for children as young as 6 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

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.

What may interact with this medication?

Do not take this medication with any of the following:

• MAOIs, such as Marplan, Nardil, and Parnate
• Ozanimod

This medication may also interact with the following:

• Certain medications for blood pressure, heart disease, irregular heartbeat
• Certain medications for depression, anxiety, or other mental health conditions
• Certain medications that cause drowsiness before a procedure, such as isoflurane
• Linezolid
• Methylene blue
• Opioids
• Risperidone
• St. John's wort

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress. Tell your care team if your symptoms do not start to get better or if they get worse.

This medication requires a new prescription from your care team every time it is filled at the pharmacy.

This medication can be abused and cause your brain and body to depend on it after high doses or long term use. Your care team will assess your risk and monitor you closely during treatment.

Long term use of this medication may cause your brain and body to depend on it. You may be able to take breaks from this medication during weekends, holidays, or summer vacations. Talk to your care team about what works for you. If your care team wants you to stop this medication permanently, the dose may be slowly lowered over time to reduce the risk of side effects.

Tell your care team if this medication loses its effects, or if you feel you need to take more than the prescribed amount. Do not change your dose without talking to your care team.

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

This patch is sensitive to body heat changes. If your skin gets too hot, more medication will come out of the patch and can cause an overdose. Call your care team if you get a fever. Do not take hot baths. Do not sunbathe. Do not use hot tubs, saunas, hairdryers, heating pads, electric blankets, heated waterbeds, or tanning lamps. Do not engage in exercise that increases your body temperature.

Permanent loss of skin color may occur with the use of this medication. 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 care team right away.

Loss of appetite is common when starting this medication. Eating small, frequent meals or snacks can help. Talk to your care team if appetite loss persists. Children should have height and weight checked often while taking this medication.

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

Contact your care team 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.

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

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
• Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
• Increase in blood pressure
• Irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea, which may be signs of serotonin syndrome
• Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
• Prolonged or painful erection
• Raynaud syndrome—cool, numb, or painful fingers or toes that may change color from pale, to blue, to red
• Seizures
• Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
• Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss

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

• Dry mouth
• Headache
• Irritation at application site
• Loss of appetite with weight loss
• Nausea
• Pale skin, loss of color around application site
• Stomach pain
• Trouble sleeping

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets. This medication can be abused. Keep it in a safe place to protect it from theft. Do not share it with anyone. It is only for you. Selling or giving away this medication 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. Get rid of any unused medication after the expiration date.

This medication may cause harm and death if it is taken by other adults, children, or pets. It is important to get rid of the medication as soon as you no longer need it or it is expired. You can do this in two ways:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, flush it down the toilet.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.