Ritalin (methylphenidate) is a prescription drug used to treat ADHD and narcolepsy. Ritalin can interact with alcohol, other medications, and some supplements. For example, it can interact with certain antidepressants, including sertraline (Zoloft).
Ritalin comes as an oral tablet and an extended-release oral capsule called Ritalin LA. (“Extended release” means the drug is released slowly into your body over a long period of time.)
Ritalin is used in adults and certain children to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Ritalin LA is used in certain children to treat ADHD.
Unless otherwise noted, this article uses “Ritalin” to describe both forms of the drug.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Ritalin’s possible interactions. And for more information about Ritalin, including details about its uses, see this article.
Before you start taking Ritalin, 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. (To learn whether Ritalin interacts with herbs or vitamins and supplements, see the “Are there other interactions with Ritalin?” section below.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The table below lists drugs that may interact with Ritalin. Keep in mind that this table does not include all drugs that may interact with Ritalin. For more information about some of these interactions, see the “Drug interactions explained” section below.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| selective serotonin reuptake inhibitors (SSRIs) | • sertraline (Zoloft) • fluoxetine (Prozac) • escitalopram (Lexapro) | can increase the risk of serotonin syndrome from SSRIs |
| serotonin-norepinephrine reuptake inhibitors (SNRIs) | • venlafaxine (Effexor XR) • desvenlafaxine (Pristiq) • duloxetine (Cymbalta) | can increase the risk of serotonin syndrome from SNRIs |
| monoamine oxidase inhibitors (MAOIs)* | • selegiline (Emsam, Zelapar) • isocarboxazid (Marplan) • linezolid (Zyvox) | can increase the risk of very high blood pressure from MAOIs |
| glucagon-like peptide-1 receptor (GLP-1) agonists | • semaglutide (Ozempic, Wegovy, others) • dulaglutide (Trulicity) • exenatide (Byetta, Bydureon BCise) | can make GLP-1 agonists less effective |
| beta-blockers | • propranolol (Hemangeol, Inderal LA, others) • metoprolol (Lopressor, Toprol XL, others) • nadolol (Corgard) | can make beta-blockers less effective |
| sulfonylureas | • glimepiride (Amaryl) • glipizide (Glucotrol XL) • glyburide (Diabeta, Glynase) | can make sulfonylureas less effective |
| warfarin (Jantoven) | — | can increase the risk of side effects from warfarin |
| bupropion (Wellbutrin SR, Wellbutrin XL, others) | — | can increase the risk of seizures from Ritalin and bupropion |
| pioglitazone (Actos) | — | can make pioglitazone less effective |
| risperidone (Risperdal, Rykindo, others) | — | can increase the risk of uncontrolled muscle movements with risperidone |
* To learn more about this interaction, see the “When should I avoid Ritalin?” section below.
Certain health conditions or other factors could raise your risk of harm if you take Ritalin. In such cases, your doctor may not prescribe Ritalin for you. These are known as contraindications. The list below includes Ritalin’s contraindications.
If you take an MAOI: If you take an MAOI, your doctor may not prescribe Ritalin for you. MAOIs are antidepressant drugs prescribed for depression and other conditions.
Taking Ritalin with an MAOI may lead to very high blood pressure, which could be life threatening.
Examples of MAOIs include:
- selegiline (Emsam, Zelapar)
- isocarboxazid (Marplan)
- linezolid (Zyvox)
Due to this risk, your doctor will not prescribe Ritalin until at least 14 days have passed since your last dose of the MAOI.
If you have questions about Ritalin and MAOIs, talk with your doctor or pharmacist.
If you’ve had an allergic reaction: If you’ve had an allergic reaction to Ritalin or any of its ingredients, your doctor likely won’t prescribe Ritalin for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.
Before you start taking Ritalin, talk with your doctor if either of the factors above apply to you. Your doctor can determine whether Ritalin is safe for you to take.
If you drink alcohol, talk with your doctor before consuming it while taking Ritalin. Alcohol and Ritalin work in opposite ways. Each may hide the other’s effects in your body. This means that drinking alcohol while taking Ritalin could make it hard to tell whether Ritalin is working for your condition. Likewise, taking Ritalin could make it hard to know the amount of alcohol you’ve consumed.
You should not drink alcohol during Ritalin LA treatment. Ritalin LA is an extended-release drug,* and combining it with alcohol could cause most of the drug to be released into your body soon after you take it. This could lead to side effects such as dry mouth and excessive sweating.
If you have other questions about alcohol and Ritalin, talk with your doctor or pharmacist.
* “Extended-release” means the drug is released slowly into the body over a long period of time.
Learn more about certain drug interactions that can occur with Ritalin.
Interaction with SSRIs
Ritalin can interact with SSRIs. These are antidepressant drugs prescribed for depression and other mental health conditions.
Examples of SSRI medications include:
- sertraline (Zoloft)
- fluoxetine (Prozac)
- escitalopram (Lexapro)
What could happen
Taking Ritalin with an SSRI can raise your risk of serotonin syndrome as a side effect of the SSRI.
Serotonin syndrome is caused by a high level of a chemical called serotonin in the body. This condition can result in symptoms such as very high body temperature, very high blood pressure, and confusion. In severe cases, serotonin syndrome can be life threatening.
What you can do
Your doctor will determine whether it’s safe for you to take Ritalin with an SSRI.
If you take these drugs together, your doctor may prescribe a lower dose of the SSRI for you. This may help reduce your risk of serotonin syndrome. It’s important that you do not take a higher dose of either medication than your doctor prescribes.
If you take Ritalin with an SSRI, tell your doctor right away if you have symptoms of serotonin syndrome. But if your symptoms seem severe or life threatening, call 911 or a local emergency number. Your doctor or emergency care personnel will recommend how to manage this condition.
If you have questions about taking Ritalin with an SSRI, talk with your doctor or pharmacist.
Interaction with pioglitazone
Ritalin can interact with pioglitazone (Actos), which is used to treat type 2 diabetes.
What could happen
Ritalin may increase your blood sugar, and pioglitazone helps manage blood sugar levels. So taking these drugs together could make pioglitazone less effective.
What you can do
Your doctor will determine whether it’s safe for you to take Ritalin with pioglitazone.
If you take these drugs together, your doctor may ask you to check your blood sugar more often than usual. They’ll review your blood sugar levels and determine whether your pioglitazone dosage needs to be adjusted.
If you have questions about taking Ritalin with pioglitazone, talk with your doctor or pharmacist.
Interaction with risperidone
Ritalin can interact with risperidone (Risperdal, Rykindo, others). This drug is used to treat schizophrenia and other mental health conditions.
What could happen
Risperidone may cause uncontrolled muscle movements. Taking Ritalin and risperidone together can increase this risk, especially when the dosage of either drug is changed.
With these uncontrolled muscle movements, you may have symptoms such as restlessness, tremors, or muscle cramps.
What you can do
Your doctor will determine whether it’s safe for you to take Ritalin and risperidone together.
If you take these drugs together, your doctor will closely monitor you for any uncontrolled muscle movements. If you have symptoms of uncontrolled muscle movements, tell your doctor right away. They’ll advise you on how to manage your symptoms and may recommend stopping treatment with either drug if necessary.
If you have questions about taking Ritalin with risperidone, talk with your doctor or pharmacist.
Ritalin 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 Ritalin.
Does Ritalin interact with supplements?
Ritalin may interact with caffeine supplements. Among other uses, these supplements are taken to help people stay awake.
Taking Ritalin with caffeine supplements could increase the risk of certain side effects from Ritalin. Examples include insomnia (trouble sleeping) and feeling irritable or nervous.
Before you start taking Ritalin, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible Ritalin interactions with supplements.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Ritalin interactions with herbs
Ritalin may interact with St. John’s wort, which is used to ease symptoms of depression and other conditions.
Taking Ritalin with St. John’s wort can increase the risk of serotonin syndrome from St. John’s wort.
Serotonin syndrome is caused by a high level of a chemical called serotonin in the body. This condition can result in symptoms such as very high body temperature, very high blood pressure, and confusion. In severe cases, serotonin syndrome can be life threatening.
For this reason, it’s important to check with your doctor or pharmacist before taking St. John’s wort with Ritalin. They’ll likely recommend alternative treatments for your condition.
Ritalin and vitamins
There are currently no reports of Ritalin interacting with vitamins. But this doesn’t mean that such 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 treatment with Ritalin.
Does Ritalin interact with food?
Ritalin may interact with caffeine, which can be found in many drinks, foods, and supplements.* Examples include tea, coffee, chocolate, and some soft drinks.
Taking Ritalin with caffeinated drinks or foods could raise your risk of certain side effects from Ritalin. Examples include insomnia and feeling irritable or nervous.
If you have questions about certain drinks or foods that may interact with Ritalin, talk with your doctor.
* To learn more, see the “Does Ritalin interact with supplements?” section above.
Does Ritalin interact with vaccines?
There are currently no reports of Ritalin interacting with vaccines. If you have questions about receiving certain vaccines during your Ritalin treatment, talk with your doctor.
Does Ritalin interact with lab tests?
There are currently no reports of Ritalin interacting with lab tests. If you have questions about having certain lab tests during your treatment with Ritalin, talk with the healthcare professional ordering the test.
Does Ritalin interact with cannabis or CBD?Cannabis (commonly called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Ritalin. Taking Ritalin with cannabis products may lead to heart-related side effects. Examples include increased heart rate or blood pressure.
Before you start treatment with Ritalin, 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 Ritalin. Before taking Ritalin, talk with your doctor about your health history. They’ll determine whether Ritalin is right for you.
Health conditions or other factors that might interact with Ritalin include:
Certain mental health conditions: Ritalin may worsen certain mental health conditions, such as psychosis and bipolar disorder. Before starting Ritalin treatment, tell your doctor about any mental health conditions you have. They can determine whether Ritalin is a safe treatment option for you.
Heart conditions, including high blood pressure: Before starting Ritalin treatment, tell your doctor if you have high blood pressure. The drug may worsen this condition. In addition, Ritalin may cause life threatening heart problems in people who have an irregular heart rhythm, cardiomyopathy, and other heart conditions.
If you have a heart condition or high blood pressure, talk with your doctor about whether Ritalin is right for you.
Circulation problems: Ritalin may worsen circulation problems, including Raynaud phenomenon. Before starting Ritalin treatment, tell your doctor about any circulation problems you have. They can determine whether Ritalin is a safe option for you.
Tourette syndrome or tics: Ritalin may worsen Tourette syndrome or tics in people with either condition. (Tics are uncontrollable sounds or movements often related to Tourette syndrome.) If you have Tourette syndrome or tics, your doctor can determine whether Ritalin is a safe treatment option.
Glaucoma: Ritalin may increase the pressure inside your eye, which could worsen glaucoma. Before starting Ritalin treatment, tell your doctor if you have glaucoma. They’ll decide whether to prescribe Ritalin or a different treatment for you.
Substance use disorder: Ritalin has a boxed warning about the risk of misuse and addiction. This risk may be higher for people with substance use disorder. For details, see the “Boxed warning” section at the top of the article.
Pregnancy: It’s not known whether Ritalin is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Ritalin.
If you do take Ritalin while pregnant, consider enrolling in the drug’s pregnancy registry. This registry collects details about pregnancy issues reported with Ritalin. To learn more, talk with your doctor or call 866-961-2388.
Breastfeeding: It’s not known whether it’s safe to take Ritalin while breastfeeding. The drug may pass into breast milk, but it isn’t known whether the drug causes side effects in a child who is breastfed.
If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Ritalin or any of its ingredients, your doctor will likely not prescribe Ritalin. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Find answers below to some frequently asked questions about Ritalin and possible interactions.
What is the best antidepressant to take with Ritalin? For example, can you take Ritalin and sertraline together?
It depends. Ritalin can interact with certain antidepressants, including sertraline (Zoloft). For more details, see “Interaction with SSRIs” under the “Drug interactions explained” section above.
The best antidepressant to take with Ritalin depends on certain factors, such as your overall treatment plan and the effects of the possible interaction. Your doctor can recommend a Ritalin and antidepressant combination that’s safe for you.
What drugs should you not take with Ritalin?
Whether Ritalin can be taken with other drugs depends on the possible interaction, what effect it may cause, and your doctor’s advice. Some drugs should not be taken with Ritalin, while others may be taken with caution.
For example, doctors typically won’t prescribe Ritalin with MAOIs (a type of antidepressant) due to the risk of very high blood pressure. For details, see the “When should I avoid Ritalin?” section above.
But doctors may prescribe Ritalin with other medications while being cautious about the possible interaction.
For instance, taking Ritalin with bupropion (Wellbutrin SR, Wellbutrin XL, others)* can increase the risk of seizures from either drug. But doctors may still prescribe them together. To minimize the risk of seizures, doctors typically start with a low dose of bupropion and gradually increase it over time.
If you have other questions about drugs you should not take with Ritalin, talk with your doctor or pharmacist.
* Bupropion is an antidepressant drug used for depression and other conditions.
Taking certain steps can help you avoid interactions with Ritalin. 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 Ritalin treatment.
It’s also important to understand Ritalin’s
If you have trouble reading or understanding this information, your doctor or pharmacist can help.
Taking Ritalin exactly as prescribed can also help prevent interactions.
If you still have questions about Ritalin and its possible interactions, talk with your doctor.
Questions you may want to ask your doctor include:
- Does my Ritalin dosage affect my risk of interactions?
- Do other treatments for ADHD and narcolepsy have similar interactions to Ritalin?
- Do any of my health conditions interact with Ritalin?
To learn more about Ritalin, see these articles:
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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.