teaMonitor Closely (1)green tea, methylphenidate. Other (see comment). Use Caution/Monitor. Comment: Green tea may include caffeine. Caffeine is a CNS-stimulant and additive effects may be seen when coadministered with other CNS stimulants. Caffeine should be avoided or used cautiously.guaranaMinor (1)guarana increases effects of methylphenidate by pharmacodynamic synergism. Minor/Significance Unknown.haloperidolMonitor Closely (1)haloperidol increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.hydralazineMonitor Closely (1)hydralazine, methylphenidate. Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Sympathomimetics can antagonize the activity of some antihypertensive agents.hydrocodoneMonitor Closely (1)hydrocodone, methylphenidate. Either increases effects of the other by serotonin levels. Use Caution/Monitor. Coadministration of drugs that affect the serotonergic neurotransmitter system may result in serotonin syndrome. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment.ibuprofen/famotidineMonitor Closely (1)ibuprofen/famotidine will increase the level or effect of methylphenidate by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Applies only to extended release formulationiloperidoneMonitor Closely (1)iloperidone increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.imipramineMonitor Closely (1)imipramine, methylphenidate. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.iobenguane I 123Serious - Use Alternative (1)methylphenidate decreases effects of iobenguane I 123 by Other (see comment). Avoid or Use Alternate Drug. Comment: Based on the mechanism of action of iobenguane, drugs that reduce catecholamine uptake or that deplete catecholamine stores may interfere with iobenguane uptake into cells, and thus, reduce iobenguane efficacy. Discontinue interfering drugs for at least 5 half-lives before administration of either the dosimetry or an iobenguane dose.iohexolMonitor Closely (1)methylphenidate decreases effects of iohexol by unspecified interaction mechanism. Modify Therapy/Monitor Closely. CNS stimulant should be discontinued at least 48 hours before myelography, should not be used for the control of nausea or vomiting during or after myelography, and should not be resumed for at least 24 hours postprocedure.iopamidolMonitor Closely (1)methylphenidate decreases effects of iopamidol by unspecified interaction mechanism. Modify Therapy/Monitor Closely. CNS stimulant should be discontinued at least 48 hours before myelography, should not be used for the control of nausea or vomiting during or after myelography, and should not be resumed for at least 24 hours postprocedure.irbesartanMonitor Closely (1)methylphenidate will decrease the level or effect of irbesartan by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.isocarboxazidContraindicated (1)isocarboxazid increases effects of methylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI.isofluraneSerious - Use Alternative (1)isoflurane increases toxicity of methylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of acute hypertensive episode.isoproterenolMonitor Closely (1)isoproterenol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.isradipineMonitor Closely (1)methylphenidate will decrease the level or effect of isradipine by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.lansoprazoleMonitor Closely (1)lansoprazole decreases effects of methylphenidate by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided.levalbuterolMonitor Closely (1)levalbuterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.levodopaMonitor Closely (1)levodopa, methylphenidate. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Potential for additive CNS stimulation.linezolidContraindicated (1)linezolid increases effects of methylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.lisdexamfetamineMonitor Closely (1)lisdexamfetamine increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.lisinoprilMonitor Closely (1)methylphenidate will decrease the level or effect of lisinopril by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.lofepramineSerious - Use Alternative (1)lofepramine, methylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.losartanMonitor Closely (1)methylphenidate will decrease the level or effect of losartan by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.loxapineMonitor Closely (1)loxapine increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.loxapine inhaledMonitor Closely (1)loxapine inhaled increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.lurasidoneMonitor Closely (2)lurasidone, methylphenidate. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for additive CNS effects. lurasidone increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.magnesium oxideMonitor Closely (1)magnesium oxide decreases effects of methylphenidate by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided.maprotilineSerious - Use Alternative (1)maprotiline, methylphenidate. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.metaproterenolMonitor Closely (1)metaproterenol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.methamphetamineMonitor Closely (1)methamphetamine increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.methoxyfluraneSerious - Use Alternative (1)methoxyflurane increases toxicity of methylphenidate by Mechanism: unknown. Avoid or Use Alternate Drug. Risk of V tach, HTN.methyldopaMonitor Closely (1)methyldopa increases effects of methylphenidate by unknown mechanism. Use Caution/Monitor.methylergonovineSerious - Use Alternative (1)methylergonovine, methylphenidate. Mechanism: pharmacodynamic synergism. Contraindicated. Additive vasospasm; risk of hypertension.modafinilMonitor Closely (1)modafinil increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.moexiprilMonitor Closely (1)methylphenidate will decrease the level or effect of moexipril by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.molindoneMonitor Closely (1)molindone increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.nadololMonitor Closely (1)methylphenidate will decrease the level or effect of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.nicardipineMonitor Closely (1)methylphenidate will decrease the level or effect of nicardipine by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.nifedipineMonitor Closely (1)methylphenidate will decrease the level or effect of nifedipine by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.nimodipineMonitor Closely (1)methylphenidate will decrease the level or effect of nimodipine by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.nisoldipineMonitor Closely (1)methylphenidate will decrease the level or effect of nisoldipine by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.nizatidineMonitor Closely (2)nizatidine will increase the level or effect of methylphenidate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Applies only to extended release formulation nizatidine decreases effects of methylphenidate by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided.norepinephrineMonitor Closely (1)norepinephrine and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.nortriptylineMonitor Closely (1)nortriptyline, methylphenidate. Other (see comment). Use Caution/Monitor. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.olanzapineMonitor Closely (1)olanzapine increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.olmesartanMonitor Closely (1)methylphenidate will decrease the level or effect of olmesartan by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.omeprazoleMonitor Closely (1)omeprazole decreases effects of methylphenidate by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided.oxytocinMonitor Closely (1)oxytocin increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor.ozanimodSerious - Use Alternative (1)ozanimod increases toxicity of methylphenidate by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.paliperidoneMonitor Closely (1)paliperidone increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.pantoprazoleMonitor Closely (1)pantoprazole decreases effects of methylphenidate by enhancing GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Since the characteristics of methylphenidate extended release capsules (Ritalin LA) are pH dependent, coadministration of antacids or acid suppressants could alter the release of methylphenidate. Consider separating the administration of the antacid and the methylphenidate extended-release capsules may be avoided.penbutololMonitor Closely (1)methylphenidate will decrease the level or effect of penbutolol by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.perindoprilMonitor Closely (1)methylphenidate will decrease the level or effect of perindopril by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.perphenazineMonitor Closely (2)perphenazine, methylphenidate. Mechanism: unknown. Use Caution/Monitor. Risk of cardiac arrhythmia or sudden death, more likely w/thioridazine than other phenothiazines. Interaction more likely in certain predisposed pts. only. perphenazine increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.phendimetrazineContraindicated (1)phendimetrazine increases effects of methylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.phenelzineContraindicated (1)phenelzine increases effects of methylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode. Methylphenidate is contraindicated during treatment with an MAOI and also within a minimum of 14 days following discontinuation of an MAOI.phenobarbitalMonitor Closely (1)methylphenidate will increase the level or effect of phenobarbital by unknown mechanism. Use Caution/Monitor. Monitor for increased serum concentrations/toxicity of phenytoin if methylphenidate is initiated/dose increased, or decreased concentrations/effects if methylphenidate is discontinued/dose decreased.phenoxybenzamineMonitor Closely (1)methylphenidate will decrease the level or effect of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.phentermineContraindicated (1)phentermine increases effects of methylphenidate by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.phentolamineMonitor Closely (1)methylphenidate will decrease the level or effect of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.phenytoinMonitor Closely (1)methylphenidate will increase the level or effect of phenytoin by unknown mechanism. Use Caution/Monitor. Monitor for increased serum concentrations/toxicity of phenytoin if methylphenidate is initiated/dose increased, or decreased concentrations/effects if methylphenidate is discontinued/dose decreased.pimavanserinMonitor Closely (1)pimavanserin increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.pimozideMonitor Closely (1)pimozide increases toxicity of methylphenidate by pharmacodynamic antagonism. Use Caution/Monitor. Closely monitor for signs of altered clinical response to either methylphenidate or an antipsychotic when using these drugs in combination.pirbuterolMonitor Closely (1)pirbuterol and methylphenidate both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.pramipexoleMonitor Closely (1)pramipexole, methylphenidate. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Potential for additive CNS stimulation.prazosinMonitor Closely (1)methylphenidate will decrease the level or effect of prazosin by pharmacodynamic antagonism. Use Caution/Monitor. Methylphenidate may diminish antihypertensive effects. Monitor BP.procarbazineMonitor Closely (1)procarbazine increases effects of methylphenidate by pharmacodynamic synergism. Use Caution/Monitor. Risk of acute hypertensive episode.prochlorperazineMonitor Closely (1)prochlorperazine, methylphenidate.