Is Taking An Extra Dose Of Methylphenidate Safe?

Answer

While I certainly can't recommend taking medication in a way in which it wasn't prescribed for you, especially a controlled substance like methylphenidate, I can give you some general guidance on the matter.

There are a few considerations to think through regarding wanting to take more than one dose of methylphenidate:

• What is the maximum dose that is safe to take in one day?
• Can you take more than one dose per day?
• What are the side effects of dosing more than once per day?
• Can your doctor prescribe more than one dose per day?

Let's answer all of these individually.

Maximum Daily Dose Of Methylphenidate For Adults

First and foremost, we want to make sure you are not exceeding the FDA-approved maximum daily dose of methylphenidate. Dosages above the maximum have not been well studied and put you at an increased risk of side effects.

Methylphenidate, a central nervous system stimulant, comes in a variety of forms, including:

• Ritalin (methylphenidate immediate-release)
• Concerta (methylphenidate extended-release)
• Adhansia XR (methylphenidate extended-release)
  
• Ritalin LA (methylphenidate extended-release)
• Methylin (methylphenidate immediate-release)
• Metadate CD (methylphenidate extended-release)
• Jornay PM (methylphenidate extended-release)
• QuilliChew ER (methylphenidate extended-release chewable)
• Quillivant XR (methylphenidate extended-release chewable)
• Relexxii (methylphenidate extended-release)
  
• Cotempla XR-ODT (methylphenidate extended-release chewable)

For adults, the maximum daily dose of methylphenidate varies somewhat by product:

• Adults: 100 mg/day PO for Adhansia XR; 72 mg/day for Concerta; Relexxii; 60 mg/day for all other oral formulations.

You don't mention in your question what form of methylphenidate you are taking, but, since you are asking about taking at most 60mg in one day, you are still within the FDA-approved maximum daily dosing limits for the drug.

Can You Take More Than One Dose Per Day?

It is not uncommon to need to take more than one dose of a stimulant as even extended-release versions of stimulants don't tend to last all day.

Immediate-release forms of methylphenidate last between four and six hours per dose, and you generally see them dosed one to two times daily, although I have even seen up to four times a day dosing.

If an individual requires more coverage than four to six hours, you'll generally see an extended-release form of methylphenidate prescribed. These are often only dosed once a day, as they last anywhere from 8-14 hours per dose, depending on the individual. It's not uncommon though, to see them dosed twice a day.

However, it is important to note that dosing an extended-release version of methylphenidate in the afternoon or later puts you at risk of insomnia since it may last until your bedtime hours. Instead, it is more common to have an extended-release version prescribed in the morning, and an immediate-release version added on in the afternoon as a 'booster' dose.

So, yes, methylphenidate can absolutely be dosed more than once a day, and there are a variety of ways it can be done.

If you consistently feel like the effects of the drug are wearing off too soon, ask your doctor about changing how you take the drug.

What Are The Side Effects Of Taking Methylphenidate More Than Once A Day?

The biggest risk with taking methylphenidate more than once a day, especially if the second dose is in the afternoon or evening, is insomnia. Taking higher doses than you are used to can also cause nervousness.

In fact, nervousness and insomnia are the most common side effects of methylphenidate and may occur with all formulations.

One study that is documented in the prescribing information for Jornay PM (methylphenidate extended-release) found that insomnia occurred in 33% to 41% of patients taking the drug, and that was with a morning dose.

As a general rule of thumb, you don't want to take an immediate-release version of methylphenidate within 6 hours of bedtime and an extended-release version 8-12 hours before bedtime. Doing so greatly increases your risk of having trouble sleeping.

Additionally, nearly all the side effects of methylphenidate are dose-related, meaning they occur more often as the dosage goes up. So, if you're asking what the side effects are of taking an extra dose, we can essentially say you are at a higher chance of them occurring in general versus lower doses.

Nevertheless, unless you make a habit of taking more than you are supposed, a one-time extra dose (within the dosing limits for the drug) will likely only increase the risk of short-term side effects like insomnia and nervousness. Some other common side effects that can occur with higher doses include headache, increased heart rate, nausea, and stomach cramps.

You can find out more about the drug's side effects on our drug detail page: Methylphenidate.

Can Your Doctor Prescribe More Than One Dose Per Day Of Methylphenidate?

Yes, as I mentioned in one of the above sections, it's common to prescribe the drug more than once a day, although there is no single way this is done that is applicable to everyone.

Drug choice and dosing of stimulants is highly individualized. You should talk to your doctor about how the drug is affecting you, and whether or not you think you need an adjustment in either drug, formulation, or strength.

Final Words

I hope you found this helpful.

I apologize for not being able to definitively say whether or not you can take another dose (adding 20mg of methylphenidate to 40mg) since I don't know how the drug was prescribed to you.

What I can say though, is that 60mg is within the FDA-approved maximum daily dose, and it's not uncommon to be prescribed to take methylphenidate more than once a day.

Taking a dose in the evening is likely to cause you trouble falling asleep, especially if you have not taken such a high dose before, so late at night. There likely are no long-term effects of a one-time extra dose, assuming you are taking an amount that is still within the recommended dosage range for the drug.

Good luck with your assignment!