Concerta 36 mg reviews

Concerta vs Vyvanse: Which ADHD Medication Is Best?

Both Concerta and Vyvanse are psychostimulants approved to treat ADHD, but there are differences.

The most notable difference is that Vyvanse is a prodrug. A prodrug is inactive until the body metabolizes it.

When Vyvanse is ingested, it’s broken down by enzymes into the drug dextroamphetamine and the amino acid l-lysine. At that point, the dextroamphetamine provides relief from ADHD symptoms.

Another major difference is Concerta’s delivery system. Concerta has absorption on the bottom and medication on the top.

As it passes through the gastrointestinal tract, it absorbs moisture, and as it expands it pushes medication out of the top. About 22 percent of the medication is delivered immediately and the remaining 78 percent is released over time.

Concerta is a brand name for methylphenidate HCl. It’s available as a tablet and lasts about 12 hours. It comes in doses of 18, 27, 36, and 54 milligrams. Concerta generic is also available.

Concerta is manufactured by Janssen Pharmaceuticals and was approved in August 2000 for ADHD. It’s also approved for narcolepsy.

Other brand names for methylphenidate include:

  • Aptensio
  • Daytrana
  • Ritalin
  • Metadate
  • Methylin
  • Quillivant

Vyvanse is a brand name for lisdexamfetamine dimesylate, a modified amphetamine mixture. It’s available as a capsule and as a chewable tablet. It lasts 10 to 12 hours and comes in doses of 20, 30, 40, 50, 60, and 70 milligrams.

Vyvanse is manufactured by Shire Pharmaceuticals and was approved in 2007 for ADHD and in 2015 for binge eating disorder.

Other brand names for modified amphetamine mixtures include:

  • Adderall (mixed amphetamine salts)
  • Adzenys (amphetamine)
  • Dyanavel (amphetamine)
  • Evekeo (amphetamine sulfate)

Concerta vs Vyvanse: Main Differences and Similarities

Concerta and Vyvanse are drugs that are used to treat attention deficit hyperactivity disorder (ADHD). They belong to a class of medications known as stimulants. Stimulants work by enhancing the effects of certain neurotransmitters in the brain. By increasing neurotransmitters such as dopamine and norepinephrine, a person with ADHD is able to improve their focus.

Concerta

Concerta is the brand name for methylphenidate. It is FDA approved to treat ADHD in affected individuals from age 6 up to 65 years old. Concerta is formulated as an extended-release tablet. 18 mg, 27 mg, 36 mg, and 54 mg oral tablets are available. After administration of Concerta, effects can last up to 12 hours.

Concerta tablets have two layers that allow it to produce effects quickly and over a longer period of time. Relief from ADHD symptoms can start within one hour after the first layer is dissolved. The second layer then releases the drug over 5 to 9 hours. This way a person can experience more consistent effects throughout the day.

Vyvanse

Vyvanse is the brand name for lisdexamfetamine. It is used to treat ADHD as well as moderate to severe binge eating disorder (BED) in adults. Vyvanse can be taken as a 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, or 70 mg oral capsule. It is also available as a 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, or 60 mg chewable tablet.

Unlike Concerta, Vyvanse is a prodrug for dextroamphetamine. In other words, it needs to be processed in the body to form the active ingredient. The effects of Vyvanse can be felt within 2 hours and last up to 14 hours.

Concerta vs Vyvanse Side by Side Comparison

Concerta and Vyvanse are similar medications with some unique differences. Due to their similar uses, it is important to be aware of their differing qualities as well. These similarities and differences can be found below.

Concerta Vyvanse
Prescribed For
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Attention Deficit Hyperactivity Disorder (ADHD)
  • Moderate to severe binge eating disorder (BED)
Drug Classification
  • Stimulant
  • Stimulant
Manufacturer
  • Janssen-Cilag
  • Shire US Inc.
Common Side Effects
  • Decreased appetite
  • Dry mouth
  • Headache
  • Nausea
  • Anxiety
  • Trouble Sleeping
  • Dizziness
  • Stomach ache
  • Weight loss
  • Irritability
  • Increased Sweating
  • Confusion
  • Agitation
  • Unusual moods or behavior
  • Allergic reactions
  • Decreased appetite
  • Anxiety
  • Anorexia
  • Weight loss
  • Diarrhea
  • Dizziness
  • Dry mouth
  • Irritability
  • Insomnia
  • Nausea
  • Vomiting
  • Stomach ache
  • Increased heart rate
  • Constipation
  • Jittery feeling
Is there a generic?
  • Yes
  • Methylphenidate hydrochloride
  • No generic available
Is it covered by insurance?
  • Varies according to your provider
  • Varies according to your provider
Dosage Forms
  • Oral tablet
  • Oral capsule
  • Oral tablet, chewable
Average Cash Price
  • $430 (per 30 tablets)
  • $341 (per 30 capsules)
SingleCare Discount Price
  • Concerta Price
  • Vyvanse Price
Drug Interactions
  • Guanethidine
  • Phenylbutazone
  • Antacids
  • Bupropion
  • Clonidine
  • Antihypertensives
  • Clomipramine
  • Desipramine
  • Dopamine agonists
  • Imipramine
  • MAO inhibitors
  • Phenobarbital
  • Phenytoin
  • Primidone
  • Anticoagulants
  • Anticonvulsants
  • Warfarin
  • Acetazolamide
  • Ammonium Chloride
  • Buspirone
  • Chlorpromazine
  • Ethosuximide
  • Fentanyl
  • Tryptophan
  • Hydrochlorothiazide
  • Lithium
  • Meperidine
  • Methenamine
  • MAO inhibitors
  • Quinidine
  • Reserpine
  • Ritonavir
  • Sodium acid phosphate
  • St. John’s Wort
  • Tramadol
  • Selegiline
  • Tricyclic antidepressants
Can I use while planning pregnancy, pregnant, or breastfeeding?
  • Concerta is in Pregnancy Category C. Consult a physician regarding taking Concerta while pregnant or breastfeeding.
  • Vyvanse is in Pregnancy Category C. Consult a physician regarding taking Vyvanse while pregnant or breastfeeding

Summary

Concerta and Vyvanse work similarly to treat ADHD in affected individuals. Vyvanse can also treat moderate to severe binge eating disorder. Both medications have similar side effects and drug interactions. For example, they should not be used with drugs called MAO inhibitors due to the possibility of increased blood pressure and sometimes, death.

Both Concerta and Vyvanse produce effects that can last for the whole day. However, Concerta is formulated as an extended-release tablet while Vyvanse is a prodrug. Because of their longer duration of effects, Concerta and Vyvanse are usually dosed once daily.

Concerta and Vyvanse are schedule II drugs that carry a potential for abuse and dependence. Therefore, the use of either drug needs to be monitored by a doctor. It is also important to discuss your overall condition with a doctor to determine the most appropriate medication.

What is Concerta (methyphenidate HCl)?

Concerta is a stimulant used to treat attention deficit hyperactivity disorder (ADHD) in adults, and children over 6. Stimulants influence the parts of the brain and central nervous system that control hyperactivity and impulses.

When did the U.S. Food and Drug Administration (FDA) approve methylphenidate?

Methylphenidate was first approved by the FDA in 1955 for the treatment of what was then referred to as hyperactivity.

Is there a generic version of Concerta available?

Yes, there are a generic methylphenidate extended-release versions available for purchase. The tablet dosages, however, may be different than those for Concerta.

Are there any major differences between Concerta and other stimulants used to treat ADHD?

There are a lot of similarities between stimulants used to treat ADHD. They are all habit-forming and classified as Schedule II controlled substances. Therefore, if you have a history of substance use problems, you should talk to your doctor about this before taking either medication. The major distinction is the different release formats of the medications. For example, Concerta is an extended release drug designed to last for 12 hours. Ritalin, meanwhile, comes in three formats: instant release (lasting 3-4 hours), sustained release (lasting 6-8 hours), and long-acting (lasting 8 hours).

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Can children take Concerta?

Children over age of 6 may be prescribed Concerta for ADHD. They should take the medication in the exact amount prescribed. It’s also important to tell your child’s doctor about other medication complications or past substance use history and to monitor their growth while on the medication.

How do you start Concerta therapy?

Talk to your doctor about whether you or your child are a good fit for the medication, and whether there are any medical conditions, mental health issues, or past substance use problems that might require a different medication. Also, monitor for potential side effects.

Are there potential interaction issues for people taking Concerta and any other drugs?

Do not take Concerta if you have taken an MAO inhibitor in the past two weeks, as a dangerous interaction effect could occur. There are also hundreds of drugs which are known to interact with Concerta in major, moderate, or mild ways, so let your doctor know what other medications you are taking before you begin taking the medication.

Are there any other medical conditions that would make someone ineligible for Concerta therapy?

You should not take Concerta if you have anxiety problems, glaucoma, or Tourette’s syndrome, or if you are allergic to the medication. Talk to your doctor if you or your child have heart problems, high blood pressure, seizures, stomach or esophagus problems, a history of mental illness, such as depression or bipolar disorder, or a history of substance use problems.

What is the typical dose that would be prescribed to someone taking Concerta?

Dosage typically starts at 18mg daily in the morning. The maximum recommended daily dose is 72 mg. Tablets come in dosage strengths of 18, 27, 36, and 54 mg. However, it’s important to talk to your doctor and not adjust dosage without their recommendation.

How long does it take for Concerta to work?

Concerta will begin working with the first dose, typically within an hour. The drug is designed to last for 12 hours.

What do I do if I miss a dose?

Take the dose of Concerta when you remember, but skip the missed dose if it already or almost evening. You should never take extra doses of the medication to make up for missed doses.

What are Concerta’s physical side effects?

Common side effects of Concerta can include:

  • headache
  • nausea
  • decreased appetite
  • insomnia
  • dizziness
  • weight loss
  • increase sweating
  • dry mouth.

Children who take Concerta may experience a temporary slowing in their rate of growth. If you experience major side effects, report them to your doctor immediately and stop using the medication. Major side effects can include increased blood pressure, heart attack, other heart problems, stroke, blurred vision, circulation problems, prolonged or painful erections, seizures, and blockage of the small intestine, stomach, or esophagus. You can also report them to the FDA at 1-800-FDA-1088 or online.

Are there any possible psychiatric side effects that come from taking Concerta?

People who take Concerta may experience irritability and anxiety as common side effects. Concerta can also cause or worsen symptoms of mental illness, such as hallucinations, and it may increase aggressive behavior among children or teens.

Is it safe for a woman who is pregnant, about to become pregnant, or nursing to take Concerta??

There have been no human pregnancy studies on the effects of Concerta. It is not known whether the drug can be transferred via breast milk in small amounts or harm a baby. Therefore, talk to your doctor if you are pregnant, planning to become pregnant, or are nursing, before you take Concerta.

Can symptoms occur if Concerta is discontinued?

Because Concerta is a stimulant, people can feel sluggish or drowsy as the drug begins to wear off. Many people however, do not experience withdrawal symptoms unless they have been abusing the drug in high doses. Withdrawal symptoms can also include depressed mood, increased appetite, confusion, irritability, lower blood pressure and forgetfulness. It’s important to eat healthy, exercise, and have a consistent sleep routine to help alleviate withdrawal symptoms.

What should I do if I overdose on Concerta?

An overdose of Concerta could be fatal, so seek immediately help or call the Poison Help Line at 1-800-222-1222 if you overdose. Overdose symptoms can include headache, vomiting, palpitations, agitation, tremors, cardiac arrhythmias, hyperreflexia, muscle twitching, euphoria, sweating, hypertension, confusion, hallucinations, delirium, flushing, hyperpyrexia, tachycardia, mydriasis, dryness of mucous membranes, convulsions, and coma.

Is Concerta habit-forming?

Concerta is a Schedule II controlled substance and can be habit-forming, as users may develop a tolerance to the drug over time. Make sure that you keep track of the medication and never take more than prescribed. It is illegal to give or sell the medication to others. Talk to your doctor if you have a past history of substance dependence before you begin Concerta Therapy.

How much does Concerta cost?

Thirty 36 mg tablets of Concerta cost approximately $180.00

Are there any disadvantages to Concerta?

The biggest disadvantage of Concerta is that it is habit-forming. If you have a history of abusing substances or have a history of substance use in your family, then the drug may not be right for you. Also, common side effects such as slowed growth in children, decreased appetite, dizziness, nervousness, and headaches may outweigh the benefits.

DISCLAIMER: The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. This article mentions drugs that were FDA-approved and available at the time of publication and may not include all possible drug interactions or all FDA warnings or alerts. The author of this page explicitly does not endorse this drug or any specific treatment method. If you have health questions or concerns about interactions, please check with your physician or go to the FDA site for a comprehensive list of warnings.

Article Sources Last Updated: Nov 25, 2018

What are the Effects of Concerta on the Body?

Concerta, known generically as methylphenidate, is a stimulant mainly used to treat attention deficit hyperactivity disorder (ADHD). It can help you focus and provide a calming effect, but it’s a powerful drug that should be taken with caution.

The effects of Concerta on the body

Concerta is a central nervous system stimulant. It is available by prescription and is often prescribed as part of a total treatment plan for ADHD. Concerta is also used to treat a sleep disorder called narcolepsy. The medication is categorized as a schedule II controlled substance because it can be habit-forming.

Tell your doctor if you have any pre-existing health conditions or if you take any other medications. It’s important to follow your doctor’s instructions when taking this medication. Continue to see your doctor regularly and report all side effects right away.

This medication has not been studied in children younger than 6 years old.

Central nervous system (CNS)

Concerta has a direct impact on the central nervous system. Stimulants like Concerta allow norepinephrine and dopamine levels to rise slowly and steadily, by preventing the neurons from reabsorbing them. Norepinephrine and dopamine are neurotransmitters that are naturally produced in your brain. Norepinephrine is a stimulant and dopamine is linked to attention span, movement, and feelings of pleasure.

You may find it easier to focus and get organized with the right amount of norepinephrine and dopamine. In addition to increasing your attention span, you may be less likely to act impulsively. You may also gain more control over movement, so sitting still may be more comfortable.

Your doctor will probably start you out with a low dose. If necessary, the dose can be increased gradually until you achieve the desired results.

All medications have the potential to cause side effects and Concerta is no exception. Some of the more common CNS side effects are:

  • blurry vision or other changes to your eyesight
  • dry mouth
  • sleep difficulties
  • dizziness
  • anxiety or irritability

Some of the more serious side effects are seizures and psychotic symptoms such as hallucinations. If you already have behavior or thought problems, Concerta may make them worse. In some cases, this medication can cause new psychotic symptoms in children and teenagers. If you are prone to seizures, Concerta may aggravate your condition.

You should not take this medication if you:

  • are overly anxious or easily agitated
  • have tics, Tourette syndrome, or a family history of Tourette syndrome
  • have glaucoma

Some children experience slowed growth while taking Concerta, so your doctor may monitor your child’s growth and development.

Concerta may cause dopamine levels to rise quickly when taken in very high doses, which can result in a euphoric feeling, or a high. Because of that, Concerta can be abused and can lead to dependence.

Furthermore, high doses may increase the activity of norepinephrine and can lead to thought disorders, mania, or psychosis. Tell your doctor if you have a history of substance abuse, including alcohol abuse or alcoholism. If you experience new or worsening emotional symptoms, call your doctor right away.

Stopping Concerta suddenly can result in withdrawal. Symptoms of withdrawal include trouble sleeping and fatigue. Withdrawal increases your risk of developing severe depression. If you want to stop taking this medication, speak to your doctor, who can help you taper off.

Circulatory/cardiovascular system

Stimulants may cause circulation problems. Poor circulation can cause the skin on your fingers and toes to turn blue or red. Your digits may also feel cold or numb. They may be extra sensitive to temperature, or even hurt.

Concerta can increase your body temperature and cause excessive perspiration.

Use of stimulants can increase your risk of high blood pressure and increased heart rate. It can also raise your risk of stroke or heart attack. Heart-related problems can occur in people who have pre-existing heart defects or problems. Sudden death has been reported in children and adults with heart problems.

Digestive system

Taking Concerta can decrease your appetite. This may lead to weight loss. If you do eat less, make sure the foods you eat are nutrient rich. Ask your doctor if you should take dietary supplements. You may develop malnutrition and associated problems if you abuse this drug for a long time.

Some people experience abdominal pain or nausea when taking Concerta.

Serious digestive system side effects include blockage of the esophagus, stomach, or intestines. This is more likely to be a problem if you already have some narrowing in your digestive tract.

Reproductive system

In males of any age, Concerta can cause a painful and long lasting erection. This condition is called priapism. If this happens, it’s important to seek medical attention. Priapism can cause permanent damage if left untreated.

SIDE EFFECTS

The following are discussed in more detail in other sections of the labeling:

  • Drug Dependence
  • Hypersensitivity to Methylphenidate
  • Agitation
  • Glaucoma
  • Tics
  • Monoamine Oxidase Inhibitors
  • Serious Cardiovascular Events
  • Psychiatric Adverse Events
  • Seizures
  • Priapism
  • Long-Term Suppression of Growth
  • Visual Disturbance
  • Potential for Gastrointestinal Obstruction
  • Hematologic Monitoring

The most common adverse reaction in double-blind clinical trials ( > 5%) in pediatric patients (children and adolescents) was abdominal pain upper. The most common adverse reactions in double-blind clinical trials ( > 5%) in adult patients were decreased appetite, headache, dry mouth, nausea, insomnia, anxiety, dizziness, weight decreased, irritability, and hyperhidrosis .

The most common adverse reactions associated with discontinuation ( ≥ 1%) from either pediatric or adult clinical trials were anxiety, irritability, insomnia, and blood pressure increased .

The development program for CONCERTA® included exposures in a total of 3906 participants in clinical trials. Children, adolescents, and adults with ADHD were evaluated in 6 controlled clinical studies and 11 open-label clinical studies (see Table 3). Safety was assessed by collecting adverse events, vital signs, weights, and ECGs, and by performing physical examinations and laboratory analyses.

Table 3: CONCERTA® Exposure in Double-Blind and Open-Label Clinical Studies

Patient Population N Dose Range
Children 2216 18 to 54 mg once daily
Adolescents 502 18 to 72 mg once daily
Adults 1188 18 to 108 mg once daily

Adverse events during exposure were obtained primarily by general inquiry and recorded by clinical investigators using their own terminology. Consequently, to provide a meaningful estimate of the proportion of individuals experiencing adverse events, events were grouped in standardized categories using MedDRA terminology.

The stated frequencies of adverse events represent the proportion of individuals who experienced, at least once, a treatment-emergent adverse event of the type listed. An event was considered treatment-emergent if it occurred for the first time or worsened while receiving therapy following baseline evaluation.

Throughout this section, adverse reactions are reported. Adverse reactions are adverse events that were considered to be reasonably associated with the use of CONCERTA® based on the comprehensive assessment of the available adverse event information. A causal association for CONCERTA® often cannot be reliably established in individual cases. Further, because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in clinical trials of another drug and may not reflect the rates observed in clinical practice.

The majority of adverse reactions were mild to moderate in severity.

Commonly Observed Adverse Reactions In Double-Blind, Placebo-Controlled Clinical Trials

Adverse reactions in either the pediatric or adult double-blind adverse reactions tables may be relevant for both patient populations.

Children And Adolescents

Table 4 lists the adverse reactions reported in 1% or more of CONCERTA®-treated children and adolescent subjects in 4 placebo-controlled, double-blind clinical trials.

Table 4: Adverse Reactions Reported by ≥ 1% of CONCERTA®-Treated Children and Adolescent Subjects in 4 Placebo-Controlled, Double-Blind Clinical Trials of CONCERTA®

System/Organ Class
Adverse Reaction
CONCERTA®
(n=321) %
Placebo
(n=318) %
Gastrointestinal Disorders
Abdominal pain upper 6.2 3.8
Vomiting 2.8 1.6
General Disorders and Administration Site Conditions
Pyrexia 2.2 0.9
Infections and Infestations
Nasopharyngitis 2.8 2.2
Nervous System Disorders
Dizziness 1.9 0
Psychiatric Disorders
Insomnia* 2.8 0.3
Respiratory, Thoracic and Mediastinal Disorders
Cough 1.9 0.9
Oropharyngeal pain 1.2 0.9
*Terms of Initial insomnia (CONCERTA®=0.6%) and Insomnia (CONCERTA®=2.2%) are combined into Insomnia.

The majority of adverse reactions were mild to moderate in severity.

Adults

Table 5 lists the adverse reactions reported in 1% or more of CONCERTA®-treated adults in 2 placebo-controlled, double-blind clinical trials.

Table 5: Adverse Reactions Reported by ≥ 1% of CONCERTA®-Treated Adult Subjects in 2 Placebo-Controlled, Double-Blind Clinical Trials*

System/Organ Class
Adverse Reaction
CONCERTA®
(n=415) %
Placebo
(n=212) %
Cardiac Disorders
Tachycardia 4.8 0
Palpitations 3.1 0.9
Ear and Labyrinth Disorders
Vertigo 1.7 0
Eye Disorders
Vision blurred 1.7 0.5
Gastrointestinal Disorders
Dry mouth 14.0 3.8
Nausea 12.8 3.3
Dyspepsia 2.2 0.9
Vomiting 1.7 0.5
Constipation 1.4 0.9
General Disorders and Administration Site Conditions
Irritability 5.8 1.4
Infections and Infestations
Upper respiratory tract infection 2.2 0.9
Investigations
Weight decreased 6.5 3.3
Metabolism and Nutrition Disorders
Decreased appetite 25.3 6.6
Anorexia 1.7 0
Musculoskeletal and Connective Tissue Disorders
Muscle tightness 1.9 0
Nervous System Disorders
Headache 22.2 15.6
Dizziness 6.7 5.2
Tremor 2.7 0.5
Paresthesia 1.2 0
Sedation 1.2 0
Tension headache 1.2 0.5
Psychiatric Disorders
Insomnia 12.3 6.1
Anxiety 8.2 2.4
Initial insomnia 4.3 2.8
Depressed mood 3.9 1.4
Nervousness 3.1 0.5
Restlessness 3.1 0
Agitation 2.2 0.5
Aggression 1.7 0.5
Bruxism 1.7 0.5
Depression 1.7 0.9
Libido decreased 1.7 0.5
Affect lability 1.4 0.9
Confusional state 1.2 0.5
Tension 1.2 0.5
Respiratory, Thoracic and Mediastinal Disorders
Oropharyngeal pain 1.7 1.4
Skin and Subcutaneous Tissue Disorders
Hyperhidrosis 5.1 0.9
* Included doses up to 108 mg.

The majority of ADRs were mild to moderate in severity.

Other Adverse Reactions Observed In CONCERTA® Clinical Trials

This section includes adverse reactions reported by CONCERTA®-treated subjects in double-blind trials that do not meet the criteria specified for Table 4 or Table 5 and all adverse reactions reported by CONCERTA®-treated subjects who participated in open-label and postmarketing clinical trials.

Blood and Lymphatic System Disorders: Leukopenia

Eye Disorders: Accommodation disorder, Dry eye

Vascular Disorders: Hot flush

Gastrointestinal Disorders: Abdominal discomfort, Abdominal pain, Diarrhea

General Disorders and Administrative Site Conditions: Asthenia, Fatigue, Feeling jittery, Thirst

Infections and Infestations: Sinusitis

Investigations: Alanine aminotransferase increased, Blood pressure increased, Cardiac murmur, Heart rate increased

Musculoskeletal and Connective Tissue Disorders: Muscle spasms

Nervous System Disorders: Lethargy, Psychomotor hyperactivity, Somnolence

Psychiatric Disorders: Anger, Hypervigilance, Mood altered, Mood swings, Panic attack, Sleep disorder, Tearfulness, Tic

Reproductive System and Breast Disorders: Erectile dysfunction

Respiratory, Thoracic and Mediastinal Disorders: Dyspnea

Skin and Subcutaneous Tissue Disorders: Rash, Rash macular

Vascular Disorders: Hypertension

Discontinuation Due To Adverse Reactions

Tics

In a long-term uncontrolled study (n=432 children), the cumulative incidence of new onset of tics was 9% after 27 months of treatment with CONCERTA®.

In a second uncontrolled study (n=682 children) the cumulative incidence of new-onset tics was 1% (9/682 children). The treatment period was up to 9 months with mean treatment duration of 7.2 months.

Blood Pressure And Heart Rate Increases

In the laboratory classroom clinical trials in children (Studies 1 and 2), both CONCERTA® once daily and methylphenidate three times daily increased resting pulse by an average of 2 to 6 bpm and produced average increases of systolic and diastolic blood pressure of roughly 1 to 4 mm Hg during the day, relative to placebo. In the placebo-controlled adolescent trial (Study 4), mean increases from baseline in resting pulse rate were observed with CONCERTA® and placebo at the end of the double-blind phase (5 and 3 beats/minute, respectively). Mean increases from baseline in blood pressure at the end of the double-blind phase for CONCERTA® and placebo-treated patients were 0.7 and 0.7 mm Hg (systolic) and 2.6 and 1.4 mm Hg (diastolic), respectively. In one placebo-controlled study in adults (Study 6), dose-dependent mean increases of 3.9 to 9.8 bpm from baseline in standing pulse rate were observed with CONCERTA® at the end of the double-blind treatment vs. an increase of 2.7 beats/minute with placebo. Mean changes from baseline in standing blood pressure at the end of double-blind treatment ranged from 0.1 to 2.2 mm Hg (systolic) and 0.7 to 2.2 mm Hg (diastolic) for CONCERTA® and was 1.1 mm Hg (systolic) and -1.8 mm Hg (diastolic) for placebo. In a second placebo-controlled study in adults (Study 5), mean changes from baseline in resting pulse rate were observed for CONCERTA® and placebo at the end of the double-blind treatment (3.6 and -1.6 beats/minute, respectively). Mean changes from baseline in blood pressure at the end of the double-blind treatment for CONCERTA® and placebo-treated patients were -1.2 and -0.5 mm Hg (systolic) and 1.1 and 0.4 mm Hg (diastolic), respectively .

Postmarketing Experience

The following additional adverse reactions have been identified during postapproval use of CONCERTA®. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency:

Blood and Lymphatic System Disorders: Pancytopenia, Thrombocytopenia, Thrombocytopenic purpura

Cardiac Disorders: Angina pectoris, Bradycardia, Extrasystoles, Supraventricular tachycardia, Ventricular extrasystoles

Eye Disorders: Diplopia, Mydriasis, Visual impairment

General Disorders: Chest pain, Chest discomfort, Drug effect decreased, Hyperpyrexia, Therapeutic response decreased

Hepatobiliary disorders: Hepatocellular injury, Acute hepatic failure

Immune System Disorders: Hypersensitivity reactions such as Angioedema, Anaphylactic reactions, Auricular swelling, Bullous conditions, Exfoliative conditions, Urticarias, Pruritus NEC, Rashes, Eruptions, and Exanthemas NEC

Investigations: Blood alkaline phosphatase increased, Blood bilirubin increased, Hepatic enzyme increased, Platelet count decreased, White blood cell count abnormal

Musculoskeletal, Connective Tissue and Bone Disorders: Arthralgia, Myalgia, Muscle twitching, Rhabdomyolysis

Nervous System Disorders: Convulsion, Grand mal convulsion, Dyskinesia, Serotonin syndrome in combination with serotonergic drugs

Psychiatric Disorders: Disorientation, Hallucination, Hallucination auditory, Hallucination visual, Mania, Logorrhea, Libido changes

Reproductive System and Breast Disorders: Priapism

Skin and Subcutaneous Tissue Disorders: Alopecia, Erythema

Vascular Disorders: Raynaud’s phenomenon

Read the entire FDA prescribing information for Concerta (Methylphenidate Extended-Release Tablets)

The Effects of Concerta Use

Withdrawal Treatment

Concerta withdrawal treatment can be difficult and uncomfortable. Those detoxing from Concerta may experience the following withdrawal symptoms:

  • Depression and suicidal ideation.
  • Manic states.
  • Cravings.
  • Fatigue.
  • Foggy thinking.
  • Headaches.
  • Nausea.
  • Increased thirst and appetite.
  • Sleep changes and weight changes.
  • Problems concentrating without the drug.

Concerta Effects question 6

The duration of the withdrawal process really depends on the length of the addiction and the individual’s body chemistry. Typically, stimulant withdrawal can last from one to two weeks. Withdrawal symptoms can be mild or severe and can occur anywhere inside this window of time.

NOTE: It is smart to detox under close medical supervision, such as in a rehab facility, because of the risk of depression during withdrawal and the possibility that underlying mental disorders may be revealed during the detox process.

If you or someone that you love is dealing with Concerta substance abuse issues, you don’t have to wait for things to change on their own. You can get help. Give us a call at 1-888-744-0069Who Answers?. We can help you to find a specialized rehab center that fits your specific personal needs.

Last updated on December 3, 2018 2018-12-03T23:30:02+00:00 Finding the perfect treatment is only one phone call away!

Is Methylphenidate Anything Like Cocaine?

Methylphenidateis the active ingredient in two major drugs used to treat attention deficit hyperactivity disorder (ADHD): Ritalin and Concerta. Ritalin is the immediate-release form of methylphenidate, whereas Concerta is the extended-release form of the drug.

Methylphenidate is classified as a central nervous system stimulant or psychostimulant medication. It is a Schedule II controlled substance. Methylphenidate also has other medicinal uses that include treating narcolepsy and addressing other conditions, such as promoting wakefulness and helping with appetite control or weight loss.

Cocaine (benzoylmethylecgonine) is a substance that is processed from the coca plant. It is also classified as a central nervous system stimulant drug and still has some medicinal uses, particularly as an anesthetic for dental surgery. Although cocaine is most often recognized as an illicit drug, it is actually a controlled substance in the same category as methylphenidate because of its potential medicinal uses. Unlike methylphenidate, cocaine is not prescribed to private individuals; instead, its use is limited to clinics and hospitals.

Are Methylphenidate and Cocaine Alike?

Drugs that are classified in the same category (psychostimulants or central nervous system stimulants) share numerous similarities, or they would not be classified in the same general category.

On a very basic level, all psychostimulants affect the functioning of the nervous system, such that they speed up its functioning. The general effects of these drugs include increasing attention, boosting awareness, amplifying energy, lessening appetite, and reducing the need for sleep. Thus, the simple answer to the question is that the drugs are alike in some respects; however, further elaboration is needed before assuming that children who are taking methylphenidate are taking cocaine.

A brief summary follows based on the information from the books Cocaine and Other Stimulants and Drugs, Society & Human Behavior.

  • Structure: Methylphenidate and cocaine share similar chemical properties.
  • General mechanism of action: Methylphenidate and cocaine exert their stimulant effects by elevating dopamine levels in the brain in a very similar fashion, mainly by blocking the ability of the neurons in the central nervous system to reabsorb dopamine once it is released by blocking the reuptake of dopamine.
  • Similarities: Because of their similar chemical structure and similar mechanism of action, it is possible to study the effects of either drug by looking at the actions of the other. Researchers can study the basic principles of action associated with cocaine use in animals by using methylphenidate and vice versa.
  • Tolerance: Both of the drugs can produce significant tolerance, meaning that after taking the drug for a while, a person’s system will adjust to the effects of the drug. They will need more of the drug to get the same effects that they previously achieved with smaller doses.
  • Physical dependence: Both of the drugs can produce physical dependence (first tolerance, then a withdrawal syndrome) that is pretty similar in its presentation. In fact, the American Psychiatric Association (APA) lists the diagnostic criteria for the development of a stimulant use disorder (abuse or addiction to stimulants), intoxication associated with stimulant use, and the withdrawal from stimulant medications as applying to all stimulant medications because abuse of the drugs in this category and their withdrawal syndrome are so similar that they share the same characteristics.
  • Abuse: Both drugs can be abused. When methylphenidate is abused, the pills are often crushed and snorted or mixed with water and injected. Cocaine is often snorted, smoked, or injected.
  • Side effects: Side effects of the drugs are similar when the drugs are taken in similar quantities and through similar methods of administration. Abuse of any drug increases the potential for side effects, including effects that would normally be rare when the drug is used in a manner consistent with its prescribed use. For instance, few people taking medicinal cocaine experience hallucinations and delusions, whereas hallucinations and delusions as a result of chronic cocaine abuse are not uncommon. Likewise, individuals who snort large amounts of methamphetamine are more prone to develop hallucinations and paranoia; however, children and adults using methylphenidate for the treatment of ADHD and according to its prescribed purposes rarely have these issues.

Is Methylphenidate Safer than Cocaine?

It appears that the effects of cocaine are experienced more rapidly in the brain than the effects of methylphenidate, although snorting methylphenidate in the matter that cocaine is snorted increases its onset of action. Despite the method of use, methylphenidate appears to be eliminated from the system a bit more slowly than cocaine, making it less likely to produce physical dependence than cocaine.

The level of euphoria that is obtained with medicinal doses of methylphenidate is negligible (comparable to the use of coffee). When abused in larger amounts and in a manner similar to cocaine, the drug will produce similar effects, which is why methylphenidate is a controlled substance.

Thus, unless children who use methylphenidate products for the treatment of ADHD are given large doses of the drug in a manner similar to the way cocaine is abused, the comparisons and statements that children being treated for ADHD are becoming “drug addicts” is not well founded. In fact, there is a substantial body of research that indicates that when children are treated for ADHD with stimulant medications, the risk of them developing later substance abuse issues is significantly decreased as opposed to being increased.

Prescription medications are designed to address specific types of disorders. Many prescription medications that have useful medicinal properties are abused, and this is an unfortunate ramification of the development of pharmaceuticals for the treatment of serious disorders and diseases.

Even though they share similar properties and can be abused, there is very little chatter that the drugs codeine and heroin are the same thing. Likewise, even though methylphenidate and cocaine share similar properties, they are not the same drug. Methylphenidate and even cocaine can be useful medicinally, but when abused, they can produce serious issues for people.

Methylphenidate and cocaine share numerous similarities, but they are not the same substance.

Is There a Difference between Concerta and Ritalin?

Central nervous system stimulants are the most commonly prescribed medications to treat attention deficit hyperactivity disorder (ADHD). Concerta and Ritalin both contain the same active ingredient, the psychostimulant methylphenidate.

Despite these drugs being classified as stimulant medications, when administered to children and adults with ADHD, they have a calming and stabilizing effect. It is hypothesized that people diagnosed with ADHD have different levels of resting brain activity than people without ADHD; the levels of resting brain activity in these people are lower than they are for people without ADHD. When the stimulant medication is given to people with ADHD, it increases the resting level of brain activity to a more functional level. As a result, they are able to pay attention and do not need to engage in impulsivity and hyperactivity as a form of self-medication.

Because both Concerta and Ritalin contain the same active chemical (methylphenidate), they are listed in the same controlled substance category (Schedule II) and essentially treated the same according to authorities in terms of illicit possession and misuse of the drugs. Both drugs have the potential for abuse and the development of physical dependence.

The Basic Differences between Concerta and Ritalin

The basic difference between Concerta and Ritalin is in the way the methylphenidate is released and how long the individual needs to wait before taking the drug again.

Concerta is an extended-release form version of methylphenidate. When taken, the methylphenidate is released slowly over time, and it is active for 10–12 hours. Concerta is typically taken in the morning, and there is no need for the person to take it again until the next day (unless the person takes it again in the evening). Because Concerta is an extended-release drug, the available dosages are typically higher for Concerta than they are for immediate-release drugs like Ritalin.

Ritalin is the short-acting form of methylphenidate. It requires frequent dosing throughout the day in order to experience its effects. When taken, the methylphenidate is released immediately, and its effects last for 4–6 hours in most cases. Thus, a child in school would need to take another dose of the medication around lunchtime and then again later in the day for the medication to remain active.

There are more extended-release and sustained-release forms of Ritalin available on the market now, and these are essentially the same as Concerta regarding how they work and the need for dosing. Because Ritalin is released immediately and its effects are felt quickly, it is also approved for the treatment of the sleep disorder narcolepsy.

Side Effects

The side effect profile of Concerta and Ritalin is similar because they contain the same active ingredient. Side effects can include:

  • Gastrointestinal issues, such as stomach pain, nausea, vomiting, and loss of appetite
  • Cardiovascular issues (which are rare), including increased blood pressure and heartbeat irregularities
  • Dry mouth, dizziness, headache, and jitteriness or anxiety
  • Blurry vision, skin rash, sweating, tingling or numbness in the hands or feet
  • Irritability, aggressiveness, and hallucinations (rare)
  • Problems with sleep, particularly when the drug is taken in the late afternoon or evening

Because Concerta is an extended-release version of methylphenidate, side effects may not be as severe as they would be with Ritalin.

Reports of delayed growth in children taking methylphenidate products are related to the medication’s side effect of interfering with the sleep cycle in many children. Typically, when children are given a “medication holiday” and taken off the medication over the summer months, the individual’s growth cycle catches up. However, modern uses of methylphenidate products and understanding when to use the drug have eliminated much of the issue with disturbed sleep patterns in children and with growth cycle problems.

Potential Abuse

Both Concerta and Ritalin are potential drugs of abuse. When methylphenidate products are abused, the pills are typically ground up and snorted, or mixed with water and injected. This negates the extended-release properties of Concerta, and the medication is delivered to the brain much more quickly than it would be if taken in pill form.

Abuse of methylphenidate products occurs across all generations, but it is more likely to occur in younger individuals who are in college or who work in very demanding and high-performance jobs. The use and abuse of methylphenidate products to assist with weight loss is more often observed in females than males, whereas the abuse of methylphenidate to assist with studying for school or performance on the job is more often observed in males.

Withdrawal

All methylphenidate products have the potential to produce both tolerance and withdrawal symptoms in individuals who use them on a regular basis. Abusers of methylphenidate are more likely to develop significant tolerance and withdrawal symptoms than individuals who use the medication for medical reasons and under the supervision of a physician.

The withdrawal process from methylphenidate products is similar to the withdrawal syndrome associated with other stimulants. Symptoms include:

  • Lethargy and fatigue
  • Sleep problems, such as insomnia or excessive sleeping (hypersomnia)
  • Increased appetite and/or weight gain
  • Very vivid and unpleasant dreams
  • Irritability, hyperactivity, or lethargy
  • Feeling as if one is moving in slow motion
  • Apathy, depression, decreased mood, or mood swings
  • Significant cravings to use stimulants

Treatment for withdrawal typically involves managing the specific symptoms via medications and using Cognitive Behavioral Therapy and stress management. The withdrawal syndrome associated with methylphenidate products is not physically damaging in the same way that withdrawal from alcohol can be fatal, but individuals may become emotionally distraught and are at risk for impulsive behaviors or poor judgment. Some individuals may experience dehydration as a result of appetite loss and lethargy, and this can lead to serious complications.

In rare cases, individuals withdrawing from chronic stimulant abuse have been known to experience hallucinations (seeing, hearing, or otherwise experiencing things that are not really there) and other psychotic effects, such as delusions (significant paranoia). This appears to be associated with the development of psychosis as a result of heavy stimulant abuse or having a previous diagnosis of a mental disorder. In most instances, hallucinations and delusions that occur during withdrawal can be treated and will eventually resolve in chronic stimulant abusers.

Concerta vs Adderall: Main Differences and Similarities

Concerta and Adderall are two prescription medications used in the management of attention deficit hyperactivity disorder (ADHD). They are both classified as CNS stimulants which work by increasing the number of neurotransmitters, such as dopamine and norepinephrine, in the brain. This leads to increased brain activity and allows an individual with ADHD to focus or stay alert. While both drugs are in the same classification of medications, they exhibit differences in their indications and modes of action.

Concerta, also known as methylphenidate, is a drug that mainly works by blocking the reuptake of stimulant neurotransmitters so that their effects can last longer. Concerta is readily absorbed in the body following oral administration. The average time to peak concentrations range between 6 and 10 hours. Concerta is extensively metabolized into an inactive metabolite called PPAA which is excreted into the urine. However, renal clearance is not considered an important part of its overall clearance. Doses of Concerta come in tablets with milligram strengths of 18, 27, 36, and 54 usually given once daily.

Adderall

Adderall contains a mix of amphetamine salts such as dextroamphetamine and levoamphetamine. Adderall differs from Concerta in that it works by directly increasing the production of stimulant neurotransmitters, which may lead to a higher potential for abuse. Adderall is metabolized in the liver and eliminated through renal clearance. Consequently, hepatic and renal impairment may affect how long the drug stays in the body. Dosage forms for Adderall come in immediate release oral tablets of 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, and 30 mg. Extended release capsules are also available in similar strengths.

Concerta vs Adderall Side by Side Comparison

While Concerta and Adderall are both stimulants used to treat ADHD, they also exhibit differences that make one more appropriate than the other depending on individualized needs. These differences can be examined more closely in the table below:

Concerta Adderall
Prescribed For
  • ADHD
  • Narcolepsy
  • ADHD
  • Narcolepsy
Drug Classification
  • Stimulant
  • Stimulant
Manufacturer
  • Janssen-Cilag
  • Shire US Inc.
Common Side Effects
  • Decreased appetite
  • Dry mouth
  • Headache
  • Nausea
  • Anxiety
  • Trouble sleeping
  • Dizziness
  • Stomach ache
  • Weight loss
  • Irritability
  • Increased sweating
  • Confusion
  • Agitation
  • Unusual moods or behavior
  • Allergic reactions
  • Decreased appetite
  • Nervousness
  • Anxiety
  • Sweating
  • Muscle spasms
  • Twitching
  • Stomach ache
  • Seizures
  • Dry mouth
  • Trouble sleeping
  • Nausea
  • Vomiting
  • Diarrhea
  • Allergic reactions
Is there a generic?
  • Yes
  • Methylphenidate Hcl Er
  • Yes
  • Amphetamine-dextroamphetamine
Is it covered by insurance?
  • Varies according to your provider
  • Varies according to your provider
Dosage Forms
  • Oral capsule
  • Oral tablet
  • Oral chewable tablet
  • Oral solution
  • Oral capsule
  • Oral tablet
Average Cash Price
  • $430 (per 30 tablets)
  • $622 (per 100 tablets)
SingleCare Price
  • Concerta Discount
  • Adderall Discount
Drug Interactions
  • Guanethidine
  • Phenylbutazone
  • Antacids
  • Bupropion
  • Clonidine
  • Antihypertensives
  • Clomipramine
  • Desipramine
  • Dopamine agonists
  • Imipramine
  • MAO inhibitors
  • Phenobarbital
  • Phenytoin
  • Primidone
  • Warfarin
  • Acetazolamide
  • Ammonium Chloride
  • Buspirone
  • Chlorpromazine
  • Ethosuximide
  • Fentanyl
  • Glutamic acid
  • Guanethidine
  • Haloperidol
  • Hydrochlorothiazide
  • Lithium
  • Meperidine
  • Methenamine
  • MAO inhibitors
  • Phenobarbital
  • Phenytoin
  • Propoxyphene
  • Quinidine
  • Reserpine
  • Ritonavir
  • Sodium acid phosphate
  • St. John’s Wart
  • Tramadol
  • Tryptophan supplement
  • Antacids / Proton pump inhibitors
  • Antihypertensives
  • Tricyclic antidepressants
Can I use while planning pregnancy, pregnant, or breastfeeding?
  • Concerta is in Pregnancy Category C. Consult a physician regarding taking Concerta while pregnant or breastfeeding.
  • Adderall is in Pregnancy Category C. Consult a physician regarding taking Adderall while pregnant or breastfeeding.

Concerta and Adderall are both commonly used stimulant medications. Because they are both schedule II drugs according to DEA classification, their use is highly regulated. While they may share similarities in indications, they each work in different ways. For this reason, Adderall, for instance, may have more potential to interact with other medications. Dosage forms are also important considerations in deciding which treatment is best for certain conditions. Since Concerta is the extended release formulation of methylphenidate, it is primarily dosed as once per day. While Adderall also has an extended release formulation, it is primarily available as an immediate release tablet.

When evaluating these medications, it is always important to discuss your treatment options with a physician. Because of the abuse potential of these medications, it is highly recommended to only use these medications under the supervision of a healthcare provider.

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