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MAO Inhibitors: CONCERTA should not be used in patients being treated (currently or within the preceding 2 weeks) with MAO inhibitors (see Monoamine Oxidase Inhibitors under Contraindications).
Vasopressor Agents: Because of possible increases in blood pressure, CONCERTA should be used cautiously with vasopressor agents (see Increased Blood Pressure and Heart Rate under Precautions).
Coumarin Anticoagulants, Antidepressants, and Selective Serotonin Reuptake Inhibitors: Human pharmacologic studies have shown that methylphenidate may inhibit the metabolism of coumarin anticoagulants, anticonvulsants (eg, phenobarbital, phenytoin, primidone) and some antidepressants (tricyclics and selective serotonin reuptake inhibitors). Downward dose adjustment of these drugs may be required when given concomitantly with methylphenidate. It may be necessary to adjust the dosage and monitor plasma drug concentrations (or in the case of coumarin, coagulation times), when initiating or discontinuing concomitant methylphenidate.
Halogenated Anesthetics: Concomitant use of halogenated anesthetics and CONCERTA may increase the risk of sudden blood pressure and heart rate increase during surgery. Monitor blood pressure and avoid use of CONCERTA in patients being treated with anesthetics on the day of surgery.
Risperidone: Combined use of methylphenidate with risperidone when there is a change, whether an increase or decrease, in dosage of either or both medications, may increase the risk of extrapyramidal symptoms (EPS). Monitor for signs of EPS.
