Methylphenidate Side Effects

Medically reviewed by Drugs.com. Last updated on Apr 30, 2024.

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

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]

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Further information

Methylphenidate 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.

Medical Disclaimer