Concerta: Uses, Side Effects, Dosages, & More

What Is Concerta Used to Treat?

Concerta is FDA-approved for ADHD for children, adolescents, and adults.² An FDA-approved drug means it has been proven in randomized controlled clinical trials to be safe and effective for a certain use. Concerta also has off-label uses. An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.

Concerta may have off-label uses for lack of interest or concern in Alzheimer’s disease,³ fatigue in adults with cancer, ⁴ depression in older people,⁵ and cognitive performance or memory.⁶ A doctor may prescribe a stimulant like Concerta in your treatment, potentially first if you are having symptoms throughout the day that impact your productivity.

Concerta is FDA-approved to treat:²

• Attention-deficit hyperactivity disorder (ADHD) for children age 6 and older, adolescents, and adults up to age 65

Concerta may also be used off-label (non-FDA-approved) for treating:^{3, 4, 5, 6,}

• Lack of interest or concern in Alzheimer’s disease
• Fatigue in adults with cancer
• Depression in older people
• Thought performance or memory

Who Should Not Take Concerta?

You should not take Concerta for ADHD if you have certain health conditions, are less than 6 years old, or have taken certain medications recently.² Conditions include serious heart issues, uncontrolled mental health issues or seizures, or pregnancy or breastfeeding. You may need to avoid taking Concerta or take it with caution if you have Reynaud’s phenomenon, blurry vision, or abnormal blood cell levels, as Concerta can make these worse.

People who may need to avoid taking Concerta include:²

• People younger than 6 years old
• Women who are pregnant or breastfeeding
• People who are allergic to methylphenidate or other components of Concerta
• People with uncontrolled anxiety, tension, agitation, aggression, or Bipolar disorder
• People with tics or a family history of Tourette’s syndrome
• People with glaucoma
• People who have taken a monoamine oxidase inhibitor (MAOI) in the past 14 days
• People with serious structural heart abnormalities, heart disease, serious heart rhythm abnormalities, heart artery disease, or other serious heart problems
• People with uncontrolled seizures
• People who are unable to swallow tablets whole

Concerta Dosages for FDA-Approved Treatment

Concerta dosages can vary for each individual. Your dose may differ from others for various reasons, including your age or the severity of your symptoms.² The usual starting dose for children and adolescents is 18 mg once daily, while adults may have a starting dose of 18 mg or 36 mg once daily. For adolescents and adults, the maximum dose is 72 mg per day, while the maximum dose for children is 54 mg per day.

Concerta Forms & Strengths

Concerta for ADHD comes as extended-release tablets of 18 mg, 27 mg, 36 mg, and 54 mg.² The right strength for you is determined by the disorder being treated, your age, and the severity of your symptoms. Doses may vary because your body may absorb more or need more to feel better. Concerta begins working after about 1 hour and reaches its full effects within the next 5-9 hours.

Concerta is available in the following forms and strengths:²

• 18 milligrams (mg) extended-release oral tablet
• 27 mg extended-release oral tablet
• 36 mg extended-release oral tablet
• 54 mg extended-release oral tablet

You should always take your medications as prescribed. Take Concerta daily in the morning with liquid with or without food.² Concerta has a delivery system that delivers part of the medication immediately, followed by another release of the medication later in the day. So, take your medication early enough for it to wear off in time.

How Should I Take Concerta?

Again, it is important to take your medications as prescribed. Concerta tablets should be taken in the morning with or without food.² If it has an effect on your appetite, eat breakfast before you take your dose. Take it whole with 8 ounces of liquid. Do not chew, divide, or crush it. Concerta is an extended-release formulation, so crushing it could be very dangerous.

What Happens If I Miss a Dose of Concerta?

If you miss a dose of Concerta, take it as soon as you remember unless the timing is closer to your next dose. If so, wait until the next dose and take it as prescribed. It’s important not to stop taking Concerta abruptly or try to catch up with extra doses. Serious side effects can occur if you take too much or too little at a time.

Side Effects of Concerta

Dry mouth, nausea, headaches, and dizziness may last a few weeks and then go away. These temporary effects may occur as your body adjusts to taking the medication. Side effects of Concerta can persist for as long as you take it due to the direct action of the medication. These side effects may include decreased appetite or weight, anxiety, and irritability.²

Common Side Effects of Concerta

Some common side effects of Concerta include decreased appetite or weight, anxiety, and trouble sleeping.² Commonly experienced side effects are often mild, though some may require immediate medical attention. Some side effects that may require immediate medical attention include severe nausea or weight loss, headaches, anxiety, and dizziness.

Common side effects of Concerta include:*²

• Nausea
• Decreased appetite or weight loss
• Issues sleeping
• Headaches
• Anxiety or irritability
• Increased sweating
• Dry mouth
• Feelings of dizziness

*All medications, including Concerta, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.

Serious Side Effects of Concerta

Serious side effects of Concerta may also occur due to the direct action of the medication. You may experience abuse or misuse from Concerta increasing levels of happiness quickly. Panic attacks or serious heart events can occur from increased heart activity. If you experience serious side effects, you may need to seek immediate medical care.

Serious side effects of Concerta may include:*²

• Abuse or misuse
• Seizures
• Panic attacks
• Hallucinations
• Serious heart events

*All medications, including Concerta, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.

Stimulant Withdrawal

Stimulant withdrawal is the physical dependence that occurs when your body gets used to a medication and needs time to adjust to you not taking the medication. Common symptoms of stimulant withdrawal include extreme fatigue and depression.² Other symptoms, such as poor concentration, headache, irritability, sweating, and increased appetite.⁷ If you experience withdrawal from Concerta, immediate medical care is required.

It’s important that you don’t abruptly stop taking your medication. To avoid withdrawal symptoms, you should talk with your doctor to develop a plan to taper off your medication slowly over time.

Allergic Reactions to Concerta

A severe allergic reaction to Concerta is similar to a reaction you could have to any medication. You may be allergic to Concerta if you are allergic to other formulations that contain methylphenidate or are allergic to any of the other ingredients in the medications.² Some ingredients include lactose, polyethylene glycol, and cellulose acetate.

Allergic reactions to Concerta may include:

• Hives
• Facial swelling
• Dizziness
• Difficulty breathing or speaking
• Anxiousness or confusion
• Fast or irregular heartbeat
• Clammy skin
• Wheezing

If you do experience an allergic reaction, seek immediate medical care. If you experience an anaphylactic reaction, such as difficulty breathing, go to the nearest emergency room. However, you may be able to try other stimulants, such as Adderall. You should talk with your prescriber before starting any new stimulant if you experienced an allergic medication to Concerta.

Concerta Warnings & Precautions

Concerta has many precautions that should be considered before use. It is not safe to use Concerta with alcohol or while pregnant or breastfeeding. Also, misuse or addiction, serious heart conditions, and impaired growth can occur.² You should consider medical attention if you experience severe side effects such as seizures, difficulty breathing with a rapid or irregular heart rate, severe eye pain, very high blood pressure, prolonged and painful erection, or severe psychiatric conditions.

Precautions for taking Concerta include:²

• Potential for misuse and addiction: Though rare when used correctly, Concerta has a risk of abuse.²
• Interactions with alcohol: Alcohol should not be consumed with ADHD medications. They can raise the risk of alcohol poisoning and seizures.

• Use while pregnant or breastfeeding: Concerta has been known to cause birth defects in animal studies, and it is unknown if it is safe to take while pregnant or breastfeeding.
• Allergic reactions: Like other drugs, you can have a severe allergic reaction to Concerta. The risk is rare, but if you do have one, you should seek immediate medical care.
• Seizures: Concerta can lower the threshold needed to have a seizure, making seizures more likely to occur.
• Priapism: Concerta can cause prolonged and painful erections when used long-term.
• Peripheral vasculopathy, including Raynaud’s phenomenon: Concerta should not be used in patients with poor blood circulation.
• Long-term suppression of growth: When taken long-term, Concerta can slow growth without growth rebound after discontinuation.
• Visual disturbances: Concerta can cause blurry vision.
• Potential for gastrointestinal obstruction: Concerta tablets are not broken down and therefore should not be given to patients with stomach or intestinal narrowing.
• Blood cell count monitoring: Blood levels should be monitored periodically with the long-term use of Concerta.

Interactions With Concerta

Concerta can interact with various substances that act in similar ways or enhance Concerta’s effects.³ It can interact with alcohol, some seizure and anti-blood clotting medications, antidepressants, allergy medications, and antipsychotic medications. The effects can risk seizures, substance abuse, high blood pressure crisis, serotonin syndrome, bleeding, and tremors. These side effects can be serious and require medical attention.

Substances you should avoid while taking Concerta include:²

• Alcohol: Alcohol should not be consumed with ADHD medications. When combined, they can enhance the effects of each other and risk substance abuse, seizures, coma, or death.
• Tricyclic antidepressants (TCAs): Concerta may inhibit the metabolism of TCAs, increasing their concentration. The combination can risk serotonin syndrome, a rare but dangerous reaction when serotonin levels are too high.
• Monoamine oxidase inhibitors (MAOIs): Concerta and MAOIs can risk high blood pressure crises if combined.
• Selective serotonin reuptake inhibitors (SSRIs): Another substance Concerta may increase drug levels of includes SSRIs. The combination can also risk serotonin syndrome.
• Anticonvulsants, e.g., phenobarbital, phenytoin, and primidone: Concerta may also increase anticonvulsant levels. The combination may risk seizures, coma, or death.
• Anti-blood clotting drugs: Another substance that Concerta increases concentrations of includes anti-blood clotting drugs. Concerta with anti-blood clotting drugs can risk bleeding or hemorrhages.
• Vasopressors: Vasopressors you may use include phenylephrine for congestion or epinephrine for severe allergic reactions. Concerta should be used with caution with these, as the combination can increase blood pressure.
• Risperidone: The combination of Concerta with risperidone can risk tremors or jerky, involuntary movements. These movements can be dangerous if they involve your tongue, so signs of movement should be monitored.

Can You Overdose on Concerta?

It is possible to overdose on Concerta.² Signs and symptoms of an overdose on Concerta include vomiting, agitation, muscle twitching, seizures, confusion, or hallucinations. Other signs include heart palpitations, fast heart rate, irregular heart rhythm, and high blood pressure. Additional symptoms include fever, pupil dilation, excessive sweating, or headache. If you suspect you have an overdose, seek medical care immediately.

What Should You Do If You Take Too Much Concerta?

If you have taken too much Concerta, call 911 or the Poison Control Center immediately. Try not to eat or drink anything to keep the airway open in case a seizure occurs. It is best to try to stay calm, as Concerta can raise your heart’s function, and stress can make this worse.

Questions to Ask Your Healthcare Provider About Concerta

You may be interested in learning about Concerta if you think you have trouble concentrating on tasks or being present in conversations. Ask their doctor, psychiatrist, and therapist if Concerta is right for you and when you will start to feel better. Online psychiatry services may be a good option if you need to change prescribers.

Questions to ask your care team about Concerta:

• How long will it take for me to adjust to taking Concerta?
• Am I at risk for more severe symptoms if I am already taking other mental health medications?
• What is the best dosage to ensure fewer side effects?
• When should I reach out to you if I am experiencing sexual side effects?
• Is there anything I should tell my therapist about this new medication?
• Do you think my symptoms are caused by other mental health conditions, such as anxiety or depression?
• What other ADHD medications are available?
• Are there supplements that I can take for ADHD?
• Will Concerta be covered by my insurance?
• How often should I see you for checkups while taking Concerta?
• What should I do if I am unsure whether ADHD medications are right for me?
• Does my medical history increase my risk of side effects?
• How long can I expect side effects to last?
• How can I compare ADHD medications, such as Ritalin vs Concerta or Focalin?
• Are there discounts or coupons for Concerta to help me save money on my prescription?

In My Experience

In my experience, Concerta is a common medication taken for ADHD that is generally well tolerated. If you do experience side effects, ask your doctor about potentially lowering your dose or trying a different medication for ADHD. It’s important to talk to your doctor about this topic and follow their guidance because Concerta can have serious side effects if not taken correctly or when discontinued.