Concerta Interactions: Alcohol, Medications, and Others

Concerta (methylphenidate) is a prescription drug that’s used to treat attention deficit hyperactivity disorder (ADHD) in certain adults and children. Like other drugs, Concerta may have interactions.

Some interactions occur because one substance causes another substance to have a different effect than expected. For example, sometimes alcohol, another drug, or a supplement can affect how a drug acts in your body. Interactions can also occur if you have certain health conditions.

Keep reading to learn about Concerta’s possible interactions. And for more information about Concerta, including details about its uses, see this article.

Certain health conditions or other factors could raise your risk of harm if you take Concerta. In such cases, your doctor may not prescribe Concerta. These are known as contraindications. The list below includes contraindications of Concerta.

If you have Tourette syndrome or tics. If you or a family member has Tourette syndrome or tics, your doctor may not prescribe Concerta. With Tourette syndrome, you have tics. These are repetitive and uncontrollable movements or sounds. But tics aren’t always caused by Tourette syndrome.

Concerta could worsen symptoms in people who have Tourette syndrome or tics. So if you have one of these conditions, your doctor may recommend a treatment other than Concerta.

If you have anxiety or agitation. If you have severe anxiety or agitation, your doctor may not prescribe Concerta. The drug could worsen symptoms in people who have one of these conditions.

If you have anxiety or agitation, talk with your doctor before taking Concerta. They can recommend a different treatment option for you.

If you have glaucoma. If you have glaucoma, your doctor may not prescribe Concerta. Glaucoma is typically caused by a buildup of pressure in the eye. Over time, this pressure may lead to vision loss.

Concerta may increase your blood pressure, which can further raise the pressure in your eye. As a result, Concerta may worsen your glaucoma.

If you have glaucoma, your doctor will likely recommend a different treatment for your condition.

If you take monoamine oxidase inhibitors (MAOIs). Taking Concerta with MAOIs may cause a hypertensive crisis. (MAOIs are a type of antidepressant drug.)

With a hypertensive crisis, you have a severe and rapid increase in blood pressure. This can lead to dangerous effects such as kidney failure, heart attack, or stroke.

Examples of MAOIs that can interact with Concerta include:

• methylene blue (ProvayBlue)
• linezolid (Zyvox)
• selegiline (Emsam)
• phenelzine (Nardil)
• isocarboxazid (Marplan)

Due to this risk, doctors aren’t likely to prescribe Concerta with an MAOI. If you’re taking this kind of drug, your doctor will recommend that you do not start Concerta treatment right away. They’ll likely have you wait until at least 14 days have passed since your last dose of the MAOI.

If you have questions about Concerta and MAOIs, talk with your doctor.

If you’ve had an allergic reaction. If you’ve had an allergic reaction to Concerta or any of its ingredients, your doctor will likely not prescribe Concerta. This is because taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better options for you.

Before you start taking Concerta, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Concerta is safe for you to take.

It may not be safe to drink alcohol during Concerta treatment.

Concerta isn’t known to interact with alcohol. But Concerta may hide the effects of alcohol on your body, and vice versa. This happens because of the way each works.

Both Concerta and alcohol affect your central nervous system (CNS). (The CNS regulates activities such as thinking and breathing.)

Concerta stimulates your CNS, so the drug might make you feel more awake or alert. But alcohol depresses (slows down) your CNS. This can make you feel less awake or alert. When Concerta and alcohol are taken together, you may not notice the effects of either substance on your body.

Keep in mind that Concerta has a boxed warning about the risk of drug dependence. This risk affects people who have or have had alcohol use disorder. For details, see “Boxed warning” at the top of this article.

Before you start taking Concerta, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The chart below lists drugs that may interact with Concerta. Keep in mind that this chart does not include all drugs that may interact with Concerta. For more information about some of these interactions, see the “Drug interactions explained” section below.

* To learn more about this interaction, see the “When should I avoid Concerta?” section above.

Learn more about certain drug interactions that can occur with Concerta.

Interaction with seizure drugs

Taking Concerta with seizure drugs could make seizure drugs less effective than usual. In addition, taking these medications together could increase the risk of side effects from seizure drugs. Seizure drugs are used to treat conditions that cause seizures, such as epilepsy.

Examples of seizure medications include:

• phenobarbital
• phenytoin (Dilantin)
• primidone (Mysoline)

What could happen

Concerta can lower the seizure threshold. This means the drug can increase the risk of seizures, particularly for people who already have them. As a result, seizure drugs may be less effective than usual.

Concerta may also keep the body from breaking down certain seizure drugs as it should. This can increase the level of a seizure drug in your body and raise your risk of side effects from the drug.

What you can do

Before taking Concerta, tell your doctor if you have seizures or take any seizure drugs. They’ll tell you whether it’s safe to take Concerta. If they tell you it’s safe, they may adjust the dosage of your seizure drug. Doing so can help the seizure drug be more effective while also reducing your risk of side effects.

Interaction with vasopressors

Taking Concerta with vasopressors can increase the effect of vasopressors. Certain vasopressors are used in emergencies to increase blood pressure when it’s dangerously low. Others are used to relieve allergy and cold symptoms.

Examples of vasopressor medications include:

• pseudoephedrine (Sudafed)
• phenylephrine (Sudafed PE)
• midodrine (Orvaten)

What could happen

Concerta and vasopressors may increase your blood pressure when taken individually. Taking Concerta with a vasopressor can increase blood pressure even more. This increases the effect of the vasopressor.

What you can do

If you take Concerta with a vasopressor, your doctor will watch your blood pressure closely. If your blood pressure increases, they’ll recommend how to manage it. For example, your doctor may have you stop taking Concerta or the vasopressor.

Interaction with lithium

Taking Concerta with lithium (Lithobid) could make both drugs less effective than usual. Lithium is a mood stabilizer. It’s used to treat bipolar disorder.

What could happen

Concerta may worsen mania in people with bipolar disorder. With mania, you have moments of feeling extremely excited and energetic that affect your daily life. Lithium is used to treat bipolar disorder, which may cause mania. By worsening mania, Concerta could make lithium less effective at treating this condition.

Concerta works by stimulating your brain, which can help reduce the symptoms of ADHD. Lithium may lessen this stimulant effect. As a result, Concerta may be less effective at treating your condition.

What you can do

If you take Concerta with lithium, your doctor may watch for symptoms of mania and ADHD. If you have symptoms of either condition, they’ll recommend ways to manage it. For example, your doctor may have you stop taking Concerta or lithium.

Concerta may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Concerta.

Does Concerta interact with supplements?

Before you start taking Concerta, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

Taking Concerta with caffeine supplements could increase the risk of certain side effects with Concerta. Examples include anxiety, irritability, and insomnia (trouble sleeping).

Before taking Concerta, tell your doctor about any caffeine supplements you take. They may suggest alternatives to Concerta or caffeine supplements.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Concerta interactions with herbs

Concerta may interact with St. John’s wort. This herb is thought to ease symptoms of depression and other conditions.

Taking Concerta with St. John’s wort may increase your risk of serotonin syndrome. This condition is caused by a high level of a chemical called serotonin in the body. Serotonin syndrome can result in symptoms such as confusion, nausea, and vomiting.

Before taking Concerta, be sure to tell your doctor if you’re taking St. John’s wort. They can advise you on whether it’s safe to take Concerta with this herb.

If you take Concerta with St. John’s wort, watch for possible symptoms of serotonin syndrome. Tell your doctor if you have these symptoms. They can tell you how to treat this condition.

But if your symptoms seem severe or life threatening, call 911 or your local emergency number right away.

Concerta and vitamins

There are currently no reports of Concerta interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products during Concerta treatment.

Does Concerta interact with food?

Concerta may interact with caffeine, which can be found in many foods and drinks, as well as supplements.* Examples include coffee, tea, some soft drinks, and chocolate.

Taking Concerta with caffeinated foods or drinks could increase the risk of certain side effects with Concerta. Examples include anxiety, irritability, and insomnia (trouble sleeping).

If you have questions about certain foods or drinks that may interact with Concerta, talk with your doctor.

* For more information, see the “Does Concerta interact with supplements?” section above.

Does Concerta interact with vaccines?

There are currently no reports of Concerta interacting with vaccines. If you have questions about getting certain vaccines while taking Concerta, talk with your doctor.

Does Concerta interact with lab tests?

There are currently no reports of Concerta interacting with lab tests. If you have questions about getting specific lab tests while taking Concerta, talk with your doctor.

Does Concerta interact with cannabis or CBD?

A small study found that cannabis (commonly called marijuana) may interact with Concerta. But more research is needed to determine whether cannabis and cannabis products, such as cannabidiol (CBD), interact with this drug.

Before you start treatment with Concerta, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Concerta. Before taking Concerta, talk with your doctor about your health history. They’ll determine whether Concerta is right for you.

Health conditions or other factors that might interact with Concerta include:

Current or past drug dependence or alcohol use disorder. Concerta has a boxed warning about the risk of drug dependence. This risk affects people who are dependent on drugs or have had alcohol use disorder at one time. For details, see “Boxed warning” at the top of this article.

Tourette syndrome or tics. If you have Tourette syndrome or tics, your doctor may not prescribe Concerta. For details, see the “When should I avoid Concerta?” section above.

Anxiety or agitation. If you have severe anxiety or agitation, your doctor may not prescribe Concerta. For details, see the “When should I avoid Concerta?” section above.

Glaucoma. If you have glaucoma, your doctor may not prescribe Concerta. For details, see the “When should I avoid Concerta?” section above.

Allergic reaction. If you’ve had an allergic reaction to Concerta or any of its ingredients, your doctor will likely not prescribe Concerta. For details, see the “When should I avoid Concerta?” section above.

Seizures. Concerta can increase the risk of seizures, particularly for people who already have them. Before taking Concerta, tell your doctor if you have seizures. They’ll let you know whether it’s safe to take Concerta.

Mental health conditions, such as psychosis or bipolar disorder. Before taking Concerta, tell your doctor if you have a mental health condition. This includes psychosis or bipolar disorder. Concerta may worsen these conditions. Your doctor can tell you whether Concerta is the right treatment option for you.

Circulation problems. If you have circulation problems, tell your doctor before starting Concerta treatment. Concerta may cause circulation problems, such as Raynaud’s syndrome. Taking this drug while you have circulation problems could worsen your condition. Your doctor can help determine whether it’s safe to take Concerta.

Heart problems, including high blood pressure. Before taking Concerta, tell your doctor if you have high blood pressure. Also tell them if you have heart problems, such as an irregular heart rhythm. Concerta may cause serious heart problems, including heart attack, in people who have these conditions.

If you have heart problems or high blood pressure, your doctor may not prescribe Concerta.

Problems with your esophagus, intestines, or stomach. Concerta tablets do not change shape after they’re swallowed. For this reason, these tablets could block the intestines of people who have certain digestive problems. Examples of such problems include peritonitis and short bowel syndrome.

Before starting Concerta treatment, tell your doctor if you have any problems with your esophagus, intestines, or stomach. They can recommend whether it’s safe for you to take Concerta.

Pregnancy. It’s not known whether Concerta is safe to take while pregnant. If you’re pregnant or planning to become pregnant, talk with your doctor. They can discuss the risks and benefits of taking Concerta during pregnancy.

Breastfeeding. It’s not known whether Concerta passes into breast milk. And it’s not known if the drug causes side effects in a child who’s breastfed. If you’re breastfeeding or planning to do so, talk with your doctor about Concerta treatment during this time.

Find answers to some frequently asked questions about Concerta and possible interactions.

Can I take allergy medication with Concerta?

It depends. You can take certain allergy medications with Concerta, and you should use others with caution.

Allergies may cause a variety of symptoms. And several medications may be needed to manage all of the different symptoms allergies may cause.

Below are a few examples of allergy medications that are safe to take with Concerta:

• antihistamines, such as diphenhydramine (Benadryl) and loratadine (Claritin)
• pain relievers, such as aspirin and acetaminophen (Tylenol)
• corticosteroids, such as prednisone (Rayos) and methylprednisolone (Medrol)

However, it may not be safe to take Concerta with certain decongestants, specifically vasopressors used as decongestants. Examples of these medications include pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE). To learn more about this interaction, see the “Drug interactions explained” section above.

If you’re interested in treating allergies while taking Concerta, talk with your doctor or pharmacist. They can tell you which allergy medications contain a vasopressor.

Is it safe to take Concerta with other stimulant drugs, such as Adderall, Vyvanse, or phentermine?

It may not be safe to take Concerta with other stimulant drugs.

This is because Concerta is a stimulant drug. And taking Concerta with other stimulants could increase your risk of side effects from these medications. For this reason, your doctor isn’t likely to prescribe Concerta with other stimulants.

Examples of stimulant drugs include:

• amphetamine/dextroamphetamine (Adderall, Adderall XR)
• lisdexamfetamine (Vyvanse)
• phentermine (Adipex-P, Lomaira)
• dextroamphetamine (Dexedrine, Xelstrym)

If you have questions about Concerta and stimulants, talk with your doctor or pharmacist.

Does Concerta interact with magnesium?

No, Concerta isn’t known to interact with magnesium. It should be safe to take Concerta with supplements containing this mineral.

Certain supplements are sometimes taken to manage symptoms of attention deficit hyperactivity disorder (ADHD), which Concerta is used to treat. This is because having low levels of certain minerals in the body is thought to contribute to the symptoms of ADHD.

In fact, one study found that children with ADHD often have low levels of magnesium in their bodies. However, whether magnesium supplements are effective for treating ADHD is unknown.

To learn more about taking Concerta with magnesium, talk with your doctor.

Taking certain steps can help you avoid interactions with Concerta. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you start taking a new drug during your Concerta treatment.

It’s also important to read Concerta’s label and other paperwork that may come with the drug. You may see colored stickers on the label that describe interactions. And the paperwork (sometimes called a patient package insert or medication guide) may have other details about interactions. (If you didn’t get paperwork with Concerta, ask your pharmacist to print a copy for you.) If you have trouble understanding this information, your doctor or pharmacist can help.

Taking Concerta exactly as prescribed can also help prevent interactions.

If you still have questions about Concerta and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Should I tell you if I start taking a new medication or supplement during my Concerta treatment?
• If I take Concerta and have certain health conditions, will I be monitored more closely during treatment?
• Do other medications that treat my condition have similar interactions?

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.