**READ FIRST for information on Concerta

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Concerta®

What is the active ingredient?

Methylphenidate

How does it work?

It uses a technology of release called OROS which is based on the integrity of the capsule housing the medication. There is a laser drilled hole on one side and a porous membrane on the other. Fluid from the gut comes in the back, mixes with the medication and causes it to be pushed out the hole on the other side. The methylphenidate leads to a decrease in reuptake of the dopamine from the presynaptic sites of the neuron and makes more dopamine available. You can see this in action in the following video:

How is it metabolized and excreted?

It is metabolized in the liver by cytochrome enzymes and excreted in the kidney.

How fast does it work and how long does it last?

It must be swallowed whole. It is has a slow ascending curve going in with about 22% methylphenidate delivery but most being delivered for the rest of the day.

What are the common side effects?

>60% of the patients may suffer from initial insomnia, appetite suppression, headaches, mild nausea, emotional lability as the medications are wearing off, a seriousness in attitude often seen as a perception of dysphoria, dry mouth, dry eyes, diarrhea, and gastric irritation. There are other side effects but they are not common.

Are there any specific major risk factors?

There are cardiovascular risk factors and possibility of sudden death IF there is a preexisting cardiac structural defect, a family history of a conduction problem and/or if the patient themselves had a sudden loss of consciousness that could only be explained by an erratic heart rate.

Can it be safely combined with other medications?

Yes, though it may potentiate the effects of similar agents including those that have a central effect on the brain (e.g. alcohol, cannabis, cocaine etc.)

If it doesn’t work, what should I do next?

Ask your doctor for guidance always but switching to another psychostimulant is usually successful. Some people just respond to another psychostimulant class, like dextro-amphetamine, better.

REPORT ABUSE

[Fochaosed]

If you have been switched from brand name to generic and you feel the effect of the generic is/was not as good, please ensure this gets reported to your government’s adverse effect register.

In Canada you can Google: medeffect canada vigilance adverse reaction
(currently accessible via shortcut: http://medeffect.ca  )
A form also resides on CADDAC website http://www.caddac.ca/cms/CADDAC_pdf/HCAdverseReactionForm.pdf
Unintended effect, health product abuse, overdose, interaction (including drug-drug and drug-food interactions) and unusual
lack of therapeutic efficacy are all considered to be reportable adverse reactions.

REPORT ABUSE

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