Concerta vs. Ritalin: similarities and differences
LAST UPDATED: Aug 12, 2021
6 MIN READ
HERE'S WHAT WE'LL COVER
Attention deficit hyperactivity disorder (ADHD) is a common behavioral condition that affects people of all ages. If you have ADHD, you may be wondering which available treatment options are the safest and most effective. It’s a good idea to talk with a healthcare professional who will listen to your concerns and recommend the best options for you.
Keep reading to learn about the differences and similarities between two medications commonly prescribed for ADHD: Concerta and Ritalin.
What are Concerta and Ritalin?
Concerta and Ritalin contain the same active ingredient—methylphenidate—a central nervous system (CNS) stimulant. The drug is called a stimulant because it speeds up brain activity. CNS stimulants work by increasing the availability of two brain chemicals: norepinephrine and dopamine (Farzam, 2021).
These medications treat ADHD in adults, adolescents, and children. ADHD is a behavioral condition that makes it very challenging to focus on everyday tasks. This condition may cause the following symptoms or behaviors (American Psychological Association, n.d.; Magnus, 2021):
Trouble concentrating or having a short attention span
Difficulty completing tasks
Trouble with fidgeting or sitting still
Being forgetful and disorganized
Frequently misplacing things
Trouble with impulsive behaviors, such as suddenly speaking or doing something without thinking about it first
Stimulant medications, including Concerta and Ritalin, are categorized as schedule II (two) controlled substances. According to the Drug Enforcement Administration, schedule II controlled substances are drugs with high abuse potential. Other examples of schedule II controlled substances are fentanyl, hydrocodone, and oxycodone. Taking these types of drugs, even as prescribed, can lead to psychological or physical dependence and addiction (DEA, n.d.).
What is Concerta?
Concerta is a brand-name medication. It contains the generic drug methylphenidate in an extended-release formulation. The Food and Drug Administration (FDA) first approved it in 2000. It’s a tablet that’s available in several strengths: 18 milligrams (mg), 27 mg, 36 mg, and 54 mg (Janssen, 2021).
Concerta (and its generic versions) are so-called osmotic extended-release tablets. They are designed to keep a steady amount of the drug in your bloodstream. A Concerta tablet releases its active ingredient into your body gradually over 5 to 9 hours, then its effects slowly wear off (Janssen, 2021). With extended-release drugs, the drug levels in the body stay more consistent, which comes with some advantages, including taking pills less often and fewer side effects. Extended-release medications may also help to reduce the potential for drug abuse.
Concerta is usually taken once per day in the morning, with or without food. Concerta tablets should not be crushed or cut. Be sure to take it exactly as prescribed by your healthcare professional (Janssen, 2021).
What is Ritalin?
Ritalin is the brand name for methylphenidate. Ritalin was originally FDA approved in 1955. It comes as an oral tablet and is available in 5 mg, 10 mg, and 20 mg tablets (Novartis, 2021).
Ritalin is an immediate-release tablet, which means it releases its active ingredient into your body all at once and is relatively short-acting. On average, the drug typically reaches its most potent effects in an adult’s body within 2.5–3 hours (within two hours for a child) before it begins to wear off (Novartis, 2021).
People who take Ritalin typically take it two or three times per day. The usual starting dosage of Ritalin is one tablet before breakfast and one tablet before lunch. The recommended timing for each dose is 30 to 45 minutes before a meal (Novartis, 2021).
The strength of your dosage may need to be adjusted after discussing it with your healthcare provider. It may take some trial and error to find the lowest dosage that works well for controlling your symptoms.
What are Concerta and Ritalin used to treat?
Concerta is approved to treat ADHD in children six years and older and adults up to age 65 (Janssen, 2021).
Ritalin is also approved to treat ADHD in adults and children (ages six years and older). In addition, Ritalin is approved to treat narcolepsy in adults. Narcolepsy is a brain condition that causes excessive daytime sleepiness. Taking CNS stimulants may help people with narcolepsy stay more alert during the day if other treatments aren’t effective (Novartis, 2021; Verghese, 2021).
Off-label (not FDA-approved) uses are similar for both Concerta and Ritalin since both drugs contain methylphenidate. These include (Verghese, 2021):
Fatigue (defined as lack of energy) in people with cancer
Depression in older adults (ages 65 years and older)
Apathy (defined as lack of motivation) in people with Alzheimer’s patients, a brain condition that affects memory and thinking and gets worse over time
In some cases, a healthcare provider may prescribe two ADHD medications to the same person to treat ADHD. For example, they may recommend that you take one Concerta 36 mg tablet every morning, with one Ritalin 10 mg tablet in mid- or late afternoon as needed. This is because some people complain that one morning dose of Concerta doesn’t give them enough control of their ADHD symptoms if they need to concentrate on work or homework later in the day or evening.
Your healthcare professional can tell you more about what dosage of Concerta or Ritalin is appropriate for you.
Side effects of Concerta and Ritalin
Since both Concerta and Ritalin contain methylphenidate, they may cause some of the same side effects. But, since Concerta is an extended-release drug, some side effects are less frequent or milder than Ritalin. This is because extended-release medications are designed to provide your body with more consistent drug levels, and their effects wear off more gradually. For example, there were fewer reports of raised blood pressure and increased heart rate in clinical trials of Concerta, although these side effects are still possible.
Side effects of Concerta
The most common side effects reported with Concerta treatment include (Janssen, 2021):
Insomnia (trouble falling asleep or staying asleep)
Decreased body weight
Upper abdominal pain
Side effects of Ritalin
The most common side effects of Ritalin may include (Novartis, 2021):
Insomnia (trouble falling asleep or staying asleep)
Increased heart rate or heart palpitations
Increased blood pressure
Precautions before taking Concerta or Ritalin
The FDA requires stimulants, including Concerta and Ritalin, to carry several boxed warnings. Boxed warnings are the strongest type of FDA warnings, and they alert healthcare professionals and patients about risks that they should be aware of before starting treatment. These boxed warnings state (Novartis, 2021; Janssen, 2021):
CNS stimulants, such as methylphenidate, have a high potential for abuse and dependence.
Taking stimulants more than prescribed or for a non-legit purpose could result in dangerous effects, including life-threatening health problems such as heart attack or stroke.
Because of these risks, your doctor will monitor you after you start treatment to check for any signs of heart problems, such as increased blood pressure. They’ll work with you to adjust your dosage and treatment plan until they find the lowest dose that’s effective for you.
Also, tell your healthcare provider about your health history and any medical conditions before starting Concerta or Ritalin, including an eye condition called glaucoma, anxiety disorders, tics, or a family history of Tourette’s syndrome (Novartis, 2021; Janssen, 2021).
Since Concerta and Ritalin contain the same active ingredient, methylphenidate, they have the same drug interactions.
Blood pressure medications (antihypertensives)
Methylphenidate can reduce the effectiveness of blood pressure medications. Since methylphenidate can cause increased blood pressure as a possible side effect, the combination is not recommended unless you and your healthcare provider establish a plan to monitor your blood pressure closely.
Certain types of drugs used for anesthesia can increase the risk of high blood pressure with methylphenidate. If you have an upcoming surgery or medical procedure, ask your healthcare provider if and when you should temporarily stop taking Concerta or Ritalin.
People who take monoamine oxidase inhibitors (MAOIs), or took them recently, shouldn’t take methylphenidate because the combination can elevate your blood pressure dangerously high. Healthcare providers call this a hypertensive crisis, a medical emergency that can be life-threatening. Some examples of MAOIs include linezolid (Zyvox), an antibiotic, and selegiline (Eldepryl), a treatment for Parkinson’s disease, a nervous system disorder that usually causes tremors.
Other drug interactions
If you take a blood-thinner drug called warfarin (Coumadin), certain anti-seizure medications, or certain antidepressants, your healthcare provider may adjust the dosage of your medication to minimize the risk of drug interactions.
Before taking any new medications, including over-the-counter drugs or herbal supplements, consult your pharmacist or healthcare provider. They can guide you on avoiding drug interactions that could cause your medications to work less effectively or lead to side effects.
Similarities and differences of Concerta vs. Ritalin
We’ve given you a lot of information regarding the differences and similarities between these two stimulant medications. Here is a summary:
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
American Psychological Association. (n.d.). ADHD. Retrieved from https://www.apa.org/topics/adhd
Drug Enforcement Agency (DEA). (n.d.). Drug Scheduling. Retrieved from https://www.dea.gov/drug-information/drug-scheduling
Farzam, K., Faizy, R. M., & Saadabadi, A. (2021). Stimulants. [Updated May 28, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK539896/
Janssen Pharmaceuticals. (2021). Concerta (methylphenidate HCl) extended-release tablets CII. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/021121s044lbl.pdf
Magnus, W, Nazir, S, Anilkumar, A. C., et al. (2021). Attention deficit hyperactivity disorder. [Updated Jul 1, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK441838/
Novartis. (2021). Ritalin (methylphenidate hydrochloride) tablets, for oral use, CII. Ritalin-SR (methylphenidate hydrochloride extended-release) tablets, for oral use, CII. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/010187s093lbl.pdf
Verghese, C. & Abdijadid, S. (2021). Methylphenidate. [Updated May 4, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482451/