Ritalin LA (methylphenidate) is a long-acting prescription medication for the treatment of ADHD (attention-deficit hyperactivity disorder). Many patients on Ritalin LA are children, which is concerning because it can have serious side effects like growth delays, seizures, psychiatric disorders, cardiovascular events, priapism (erection lasting 4 hours or more), and permanent sexual dysfunction.
What is Ritalin LA?
Ritalin LA (“long-acting”) was introduced to the market as a reformulation of Ritalin SR (“short-release”). Both are made by the same manufacturer, Novartis Pharmaceuticals. Ritalin LA was approved in June 2002. Each capsule contains methylphenidate — 50% short-acting beads and 50% long-acting beads. The medication is designed to work for 6-8 hours, which helps children avoid taking it during the school day.
Ritalin LA and Long-Lasting Erections
In December 2013, the U.S. Food and Drug Administration (FDA) required Novartis to place a warning about the risk of priapism from Ritalin LA. According to the Prescribing Information:
“Prolonged and painful erections, sometimes requiring surgical intervention, have been reported with methylphenidate products in both pediatric and adult patients. Priapism was not reported with drug initiation but developed after some time on the drug, often subsequent to an increase in dose.”
According to the FDA Drug Safety Communication, there were 15 cases of priapism reported in patients on methylphenidate, including 12 cases in children, with ages ranging from 8 to 33 years old. Some patients were hospitalized, including two who needed surgery.
FDA Recommendation for Priapism in Children on Ritalin LA
Priapism can occur in males of any age on Ritalin LA. Children on Ritalin LA may not recognize symptoms of priapism or they may be too embarrassed to tell an adult. This could delay treatment until serious tissue damage has occurred, resulting in lifelong erectile dysfunction.
The FDA recommends: “All male patients and their caregivers should be taught the signs and symptoms of priapism and the importance of seeking immediate medical treatment if it occurs.”
Ritalin LA Cardiovascular Risk Information
Ritalin LA is a stimulant medication that may increase blood pressure and heart-rate. Therefore, all patients should be monitored for large increases in these side effects. Sudden death, heart attack, and stroke have been reported in adults taking stimulant drugs at usual doses for ADHD. Ritalin LA should not be used in children with heart defects, cardiomyopathy, heart rhythm abnormalities, or other risk-factors for deadly cardiovascular events.
Cardiovascular risks of Ritalin LA:
- Hypertension (high blood pressure)
- Heart rhythm is fast, uneven, or pounding
- Cardiac arrhythmia or palpitations
- Cardiomyopathy
- Heart attack
- Stroke
- Sudden cardiac death
Ritalin LA Side Effects
Serious side effects of Ritalin LA:
- Slow growth (height and weight) in children
- Seizures
- Eyesight changes or blurred vision
- Priapism (prolonged and painful erections)
- Mental (psychiatric problems)
- New or worse aggression, hostility, bipolar illness, manic symptoms, etc.
- Circulation problems in fingers and toes
Common side effects of Ritalin LA:
- Headache
- Stomach ache
- Decreased appetite
- Trouble sleeping
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