Metadate ER Side Effects
Generic name: methylphenidate
Medically reviewed by Drugs.com. Last updated on Apr 30, 2024.
Note: This document provides detailed information about Metadate ER Side Effects associated with methylphenidate. Some dosage forms listed on this page may not apply specifically to the brand name Metadate ER.
Applies to methylphenidate: transdermal patch extended release.
Other dosage forms:
Important warnings
This medicine can cause some serious health issues
Transdermal route (patch, extended release)
Warning: Abuse, Misuse, and Addiction. Methylphenidate 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 methylphenidate, can result in overdose and death, and this risk is increased with higher doses or unapproved methods of administration, such as snorting or injection.
Before prescribing methylphenidate, 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 methylphenidate treatment, reassess each patient’s risk of abuse, misuse, and addiction and frequently monitor for signs and symptoms of abuse, misuse, and addiction.
Serious side effects of Metadate ER
Along with its needed effects, methylphenidate (the active ingredient contained in Metadate ER) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking methylphenidate:
More common side effects
- aggressive and violent behavior
- arm, back, or jaw pain
- black, tarry stools
- blistering, peeling, or loosening of the skin
- blood in the urine
- bloody nose
- chest pain, discomfort, heaviness, or tightness
- chills
- cold
- confusion
- cough or hoarseness
- cracks in the skin
- crying
- depersonalization
- diarrhea
- dizziness
- dysphoria
- euphoria
- fainting
- fast, pounding, or irregular heartbeat or pulse
- fever
- flu-like symptoms
- heavier menstrual periods
- joint or muscle pain
- loss of heat from the body
- nausea
- nervousness
- paranoia
- pinpoint red spots on the skin
- quick to react or overreact emotionally
- rapidly changing moods
- red, irritated eyes
- red, swollen skin
- scaly skin
- seeing, hearing, or feeling things that are not there
- severe or sudden headache
- skin rash or itching
- sore throat
- sores, ulcers, or white spots in the mouth or on the lips
- sudden loss of coordination
- sudden slurring of speech
- sweating
- twitching, twisting, or uncontrolled repetitive movements of the tongue, lips, face, arms, or legs
- unusual bleeding or bruising
- unusual tiredness or weakness
Rare side effects
- difficulty with breathing
- high fever
- increased sweating
- loss of bladder control
- seizures
- severe muscle stiffness
- tiredness
- uncontrolled vocal outbursts or tics (uncontrolled repeated body movements)
- unusually pale skin
Incidence not known
- blistering, burning, crusting, dryness, or flaking of the skin
- chest pain
- difficulty with swallowing
- hives, itching, scaling, severe redness, soreness, or swelling of the skin
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- painful or difficult urination
- pale skin
- paleness or cold feeling in the fingertips and toes
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- swollen glands
- tingling or pain in the fingers or toes when exposed to cold
- trouble breathing
Get emergency help immediately if any of the following symptoms of overdose occur while taking methylphenidate:
Symptoms of overdose
- agitation
- blurred vision
- change in consciousness
- chest pain or discomfort
- confusion
- dark urine
- diarrhea
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- fast, slow, or irregular heartbeat
- fever
- headache
- inability to speak
- loss of consciousness
- muscle cramps, spasms, pain, or stiffness
- nausea
- nervousness
- overactive reflexes
- pain or discomfort in the arms, jaw, back, or neck
- pale, clammy skin
- palpitations
- pounding in the ears
- seeing, hearing, or feeling things that are not there
- seizures
- shivering
- slow or fast heartbeat
- slurred speech
- sweating
- talking or acting with excitement you cannot control
- temporary blindness
- thirst
- tremor
- trouble breathing
- unusual tiredness or weakness
- vomiting
- weakness in the arm or leg on one side of the body, sudden and severe
Other side effects of Metadate ER
Some side effects of methylphenidate may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common side effects
- decreased weight
- difficulty with moving
- drowsiness
- headache
- loss of appetite
- muscle pain or stiffness
- redness of the skin
- stomach pain
- trouble sleeping
- vomiting
Less common side effects
- decreased appetite
- stuffy or runny nose
- weight loss
Incidence not known
- bigger, dilated, or enlarged pupils (black part of the eye)
- bleeding, bruising, burning, itching, redness, skin rash, swelling, or soreness at the application site
- blurred or loss of vision
- disturbed color perception
- double vision
- hair loss or thinning of the hair
- halos around lights
- increased sensitivity of the eyes to light
- night blindness
- overbright appearance of lights
- tunnel vision
For healthcare professionals
Applies to methylphenidate: oral capsule extended release, oral powder for reconstitution extended release, oral solution, oral tablet, oral tablet chewable, oral tablet chewable extended release, oral tablet disintegrating extended release, oral tablet extended release, transdermal film extended release.
General adverse events
The more commonly reported adverse reactions have included decreased appetite, abdominal pain, nausea, vomiting, dyspepsia, insomnia, weight loss, anxiety, dizziness, irritability, affect lability, tachycardia, and increased blood pressure.[Ref]
Other
- Common (1% to 10%): Lethargy, ear infection, pyrexia, fatigue, ear and labyrinth disorders, asthenia, injury/poisoning/procedural complications
- Postmarketing reports: Hyperpyrexia[Ref]
Psychiatric
- Very common (10% or more): Psychiatric disorders (27.9%), insomnia (13.3%), irritability (11%)
- Common (1% to 10%): Anxiety, restlessness, sleep disorder, agitation, affect lability, aggression, depression, depressed mood, abnormal behavior, bruxism, confusional state, initial insomnia, decreased libido, nervousness, emotional poverty, tension, panic attack
- Uncommon (0.1% to 1%): Psychotic disorders, hallucinations (auditory, visual, tactile), anger, suicidal ideation, altered mood, mood swings, tearfulness, tics, worsening of pre-existing tics or Tourette's syndrome, hypervigilance
- Rare (less than 0.1%): Mania, disorientation, libido disorder
- Very rare (less than 0.01%): Suicidal attempt/completed suicide, transient depressed mood, abnormal thinking, apathy, repetitive behaviors, over-focusing
- Frequency not reported: Delusions, thought disturbances, confessional state, logorrhea[Ref]
Metabolic
- Very common (10% or more): Decreased appetite (27.1%), metabolism and nutrition disorders (11.5%)
- Common (1% to 10%): Anorexia, decreased weight, thirst[Ref]
Gastrointestinal
- Very common (10% or more): Gastrointestinal disorders (23.5%), dry mouth (21.5%), nausea (12.2%), vomiting (10.2%)
- Common (1% to 10%): Abdominal pain (upper and general), diarrhea, dyspepsia, toothache, stomach discomfort
- Uncommon (0.1% to 1%): Constipation[Ref]
Nervous system
- Very common (10% or more): Nervous system disorders (23.5%), headache (23.2%)
- Common (1% to 10%): Dizziness, dyskinesia, tremor, drowsiness, feeling jittery, psychomotor hyperactivity, somnolence, vertigo, paresthesia, motion sickness, tension headache
- Uncommon (0.1% to 1%): Sedation, tremor
- Very rare (less than 0.01%): Convulsions, choreoathetoid movements, reversible ischemic neurological deficit, cerebrovascular disorders (vasculitis, cerebral hemorrhages, cerebrovascular accidents, cerebral arteritis, cerebral occlusion), neuroleptic malignant syndrome (NMS)
- Frequency not reported: Grand mal convulsions, migraine, sedation, serotonin syndrome (in combination with serotonergic drugs)[Ref]
Endocrine
- Common (1% to 10%): Reproductive system and breast disorders
- Rare (less than 0.1%): Gynecomastia
Respiratory
- Very common (10% or more): Nasopharyngitis (19.1%), respiratory/thoracic/mediastinal disorders (10.6%)
- Common (1% to 10%): Upper respiratory tract infection, cough, oropharyngeal/pharyngolaryngeal pain, sinusitis, dyspnea[Ref]
Musculoskeletal
- Very common (10% or more): Musculoskeletal and connective tissue disorders (14.4%),
- Common (1% to 10%): Joint sprain, arthralgia
- Uncommon (0.1% to 1%): Myalgia, muscle twitching, muscle tightness, muscle spasms
- Very rare (less than 0.01%): Muscle cramps
- Frequency not reported: Rhabdomyolysis, growth suppression, arthralgia[Ref]
Among patients 7 to 10 years old, consistently medicated (i.e., receiving methylphenidate for 7 days per week) for over 14 months, as well as in naturalistic subgroups of newly methylphenidate-treated patients over 36 months (ages of 10 to 13 years), a temporary slowing in growth rate (on average, a total of about 2 cm less growth in height and 2.7 kg less growth in weight over 3 years), has been observed compared to non-medicated patients. This slowing in growth rate has been observed without evidence of growth rebound.[Ref]
Local
- Very common (10% or more): Administration site and general disorders (12.9%)
- Postmarketing reports: Patch application site reactions[Ref]
Cardiovascular
- Common (1% to 10%): Palpitations, tachycardia, cardiac disorders, vascular disorders, arrhythmias, hypertension, hot flush, changes in blood pressure and heart rate (usually an increase)
- Uncommon (0.1% to 1%): Cardiac murmur
- Rare (less than 0.1%): Angina pectoris
- Very rare (less than 0.01%): Cardiac arrest, myocardial infarction, peripheral coldness, Raynaud's phenomenon, sudden cardiac death
- Frequency not reported: Supraventricular tachycardia, bradycardia, ventricular extrasystoles, extrasystoles
- Postmarketing reports: Angina pectoris, bradycardia extrasystole, supraventricular tachycardia, ventricular extrasystole, chest pain, chest discomfort[Ref]
Dermatologic
- Common (1% to 10%): Rash, pruritus, urticaria, fever, scalp hair loss/alopecia, dermatitis, excoriation hyperhidrosis, skin and subcutaneous tissue disorders
- Uncommon (0.1% to 1%): Angioneurotic edema, bullous conditions, exfoliative conditions
- Rare (less than 0.1%): Macular rash, erythema
- Very rare (less than 0.01%): Thrombocytopenic purpura, exfoliative dermatitis, erythema multiforme, fixed drug eruption[Ref]
Immunologic
- Very common (10% or more): Infections and infestations (45.2%)
- Common (1% to 10%): Immune systems disorders, influenza[Ref]
Ocular
- Common (1% to 10%): Eye disorders, eye pain
- Uncommon (0.1% to 1%): Diplopia, blurred vision
- Rare (less than 0.1%): Visual accommodation difficulties, mydriasis, visual disturbance
- Frequency not reported: Dry eye
- Postmarketing reports: Visual impairment, mydriasis, diplopia[Ref]
Genitourinary
- Uncommon (0.1% to 1%): Hematuria, pollakiuria
- Frequency not reported: Increased erection, prolonged erection, priapism[Ref]
Hepatic
- Uncommon (0.1% to 1%): Hepatic enzyme elevations
- Very rare (less than 0.01%): Abnormal liver function, hepatic coma, increased blood alkaline phosphatase, increased blood bilirubin
- Postmarketing reports: Hepatocellular injury, acute hepatic failure[Ref]
Hypersensitivity
- Uncommon (0.1% to 1%): Hypersensitivity reactions (angioedema, anaphylaxis, auricular swelling, exanthemas)[Ref]
Hematologic
- Very rare (less than 0.01%): Leukopenia, thrombocytopenia, anemia, decreased platelet count, abnormal white blood count
- Postmarketing reports: Pancytopenia, thrombocytopenia, thrombocytopenia purpura[Ref]
References
1. (2022) "Product Information. Metadate CD (methylphenidate)." Celltech Pharmaceuticals Inc
2. (2002) "Product Information. Metadate ER (methylphenidate)." Celltech Pharmaceuticals Inc
3. (2002) "Product Information. Concerta (methylphenidate)." Alza
4. Cerner Multum, Inc. "UK Summary of Product Characteristics."
5. Cerner Multum, Inc. "Australian Product Information."
6. (2013) "Product Information. Quillivant XR (methylphenidate)." NextWave Pharmaceuticals
7. (2019) "Product Information. Cotempla XR-ODT (methylphenidate)." Neos Therepeautics, Inc
8. (2019) "Product Information. Methylin (methylphenidate)." Mallinckrodt Medical Inc
9. (2019) "Product Information. Adhansia XR (methylphenidate)." Adlon Therapeutics
10. (2019) "Product Information. Daytrana (methylphenidate)." Noven Pharmaceuticals, Inc.
11. (2019) "Product Information. Jornay PM (methylphenidate)." Ironshore Pharmaceuticals Inc.
12. (2001) "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals
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Further information
Metadate ER side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA.