The following drugs may be prescribed with caution: Antiepileptics Antihypertensives Benzodiazepines Opioids Alcohol Anticoagulants H2 receptor blockers or antacids - some MR preparations of methylphenidate must not be taken together with H2 receptor blockers or antacids Specialist to detail below the action to be taken upon occurrence of a particular adverse 8. event as appropriate. Most serious toxicity is seen with long-term use and may therefore Adverse drug reactions present first to GPs. For a comprehensive list (including rare and very Adverse event Action to be taken By whom rare adverse effects), or if Include System symptom/sign whether drug should be stopped prior to significance of possible – contacting secondary care specialist adverse event uncertain, nausea, diarrhoea, abdominal Continue treatment unless GP consult Summary of Product Characteristics cramps severe or BNF & Refer to Specialist Team Symptoms of depression, Continue treatment & GP paranoia, psychosis, anxiety urgently refer to Specialist Team palpitations, tachycardia, Stop treatment & GP hypertension or hypotension Refer to Specialist Team sleep disturbances, insomnia Continue treatment & Refer GP to Specialist Team seizures, convulsions Discontinue drug GP/Specialist Team immediately. Send immediately to A&E movement disorders, tics, Continue treatment unless GP tremors severe & Refer to Specialist Team anorexia, significant weight Continue treatment & Refer GP to Specialist Team loss, growth retardation The patient should be advised to report any of the following signs or symptoms to their GP without delay: Aggression, depression, paranoia, anxiety, suicidal thinking or self-harming behaviour Cardiac symptoms racing pulse, increased heart rate, chest pain – Uncontrollable muscle movements Abdominal pain, unexplained nausea, malaise, darkening of the urine or jaundice Other important co morbidities: ASD, Tourette syndrome, Depression, Anxiety Substance misuse: Potential misuse or diversion of stimulants must be minimised by careful selection of patients, prescribing of small amounts of medication and prompt discussion between
The following drugs may be prescribed with caution: Antiepileptics Antihypertensives Benzodiazepines Opioids Alcohol Anticoagulants H2 receptor blockers or antacids - some MR preparations of methylphenidate must not be taken together with H2 receptor blockers or antacids 8. Adverse drug reactions For a comprehensive list (including rare and very rare adverse effects), or if significance of possible adverse event uncertain, consult Summary of Product Characteristics or BNF Specialist to detail below the action to be taken upon occurrence of a particular adverse event as appropriate. Most serious toxicity is seen with long-term use and may therefore present first to GPs. Adverse event System – symptom/sign Action to be taken Include whether drug should be stopped prior to contacting secondary care specialist By whom nausea, diarrhoea, abdominal cramps Continue treatment unless severe & Refer to Specialist Team GP Symptoms of depression, paranoia, psychosis, anxiety Continue treatment & urgently refer to Specialist Team GP palpitations, tachycardia, hypertension or hypotension Stop treatment & Refer to Specialist Team GP sleep disturbances, insomnia Continue treatment & Refer to Specialist Team GP seizures, convulsions Discontinue drug immediately. Send immediately to A&E GP/Specialist Team movement disorders, tics, tremors Continue treatment unless severe & Refer to Specialist Team GP anorexia, significant weight loss, growth retardation Continue treatment & Refer to Specialist Team GP The patient should be advised to report any of the following signs or symptoms to their GP without delay: Aggression, depression, paranoia, anxiety, suicidal thinking or self-harming behaviour Cardiac symptoms – racing pulse, increased heart rate, chest pain Uncontrollable muscle movements Abdominal pain, unexplained nausea, malaise, darkening of the urine or jaundice Other important co morbidities: ASD, Tourette syndrome, Depression, Anxiety Substance misuse: Potential misuse or diversion of stimulants must be minimised by careful selection of patients, prescribing of small amounts of medication and prompt discussion between
GMMMG-SCP-Adult-ADHD-GMMMG-approved-19-11-15-v1-1.docx