What is Methylphenidate ER (OSM): Uses, Warnings & Interactions

Updated May 30, 2025  •  Published Jul 9, 2022

Methylphenidate ER osmotic-release tablets (generic Concerta) use a controlled-release technology to provide a steady release of methylphenidate into the intestines for six to seven hours. The only indications a prescription is for osmotic-release tablets are the unusual dosage strengths or daily doses (54 mg rather than 40 mg). Not all generic versions work as well as Concerta, so ask the pharmacist if the version being purchased is “AB” rated.

Methylphenidate ER (OSM) overview

BRAND NAMES:

  • Concerta, Relexxii

Generic Names:

  • Methylphenidate HCl ER osmotic-release

Uses:

  • Treats ADHD

Therapeutic Classes:

  • Stimulant, central nervous system agent

Forms:

  • Extended-release tablet

How it’s taken:

  • By mouth

What is Methylphenidate ER (OSM) used for?

Methylphenidate ER osmotic-release treats the symptoms of attention deficit hyperactivity disorder (ADHD) in adults and children 6 years of age and older.

What form(s) does Methylphenidate ER (OSM) come in

  • Extended-release tablet 

    • 18 mg

    • 27 mg

    • 36 mg

    • 45 mg

    • 54 mg

    • 63 mg

    • 72 mg

What are common Methylphenidate ER (OSM) doses?

  • For ADHD: 

    • In adults and children 13 years of age and older: 18–72 mg tablet taken once per day in the morning

    • In adults and children 6–12 years of age: 18–54 mg tablet taken once per day in the morning

Find more information about Concerta dosage, forms, and strengths here.

Common Methylphenidate ER (OSM) prescriptions

  • Methylphenidate HCl ER (OSM)
    18mg tablet

  • Methylphenidate HCl ER (OSM)
    27mg tablet

  • Methylphenidate HCl ER (OSM)
    36mg tablet

  • Methylphenidate HCl ER (OSM)
    54mg tablet

  • Methylphenidate HCl ER (OSM)
    72mg tablet

  • Methylphenidate HCl ER (OSM)
    18mg tablet extended release

  • Methylphenidate HCl ER (OSM)
    27mg tablet extended release

  • Methylphenidate HCl ER (OSM)
    36mg tablet extended release

  • Methylphenidate HCl ER (OSM)
    54mg tablet extended release

How to take Methylphenidate ER (OSM)

  • Follow the prescriber’s instructions.

  • Please read the Medication Guide that comes with the medicine.

  • Take only one tablet daily.

  • Take each day’s dose in the morning.

  • Swallow the tablet whole with water or other liquid. Do not crush, break, or chew it.

  • Store methylphenidate ER osmotic-release tablets in a closed container at room temperature. Protect from humidity.

What to do if you miss a dose of Methylphenidate ER (OSM)

  • Ask the prescriber how to manage a missed dose.

  • As a general rule, a missed dose can be taken anytime in the morning.

    • Taking it later in the day may cause sleep problems in the evening.

Methylphenidate ER (OSM) contraindications

  • This medicine is not right for everyone. 

  • Do not use it if you have had an allergic reaction to methylphenidate.

Methylphenidate ER (OSM) warnings

  • Tell any doctor or other healthcare professional who treats you that you or your child is taking methylphenidate.

    • This drug may need to be stopped before surgery.

  • Methylphenidate tablets do not have refills. Monthly prescriptions require monthly visits with a healthcare provider to assess treatment and monitor the patient’s health. Keep all appointments.

  • Tell the prescriber if you are pregnant, breastfeeding, or if you have:

    • A history of heart problems 

    • A history of heart disease

    • A heart defect

    • High blood pressure

    • Circulation problems in the feet or legs

    • Eye problems, including glaucoma, high eye pressure, or farsightedness

    • Intestinal blockage or narrowing

    • A history of seizures

    • A history of abnormal brain wave tests (EEGs)

    • A personal or family history of psychiatric problems, including depression, bipolar disorder, or psychosis

    • Tourette syndrome, motor tics, or a family history of Tourette syndrome

    • Bouts of anxiety or agitation

    • A history of drug abuse or addiction

  • Methylphenidate can cause serious problems, including:

    • Serious heart or blood vessel problems, including heart attack or stroke

    • Circulation problems in the hands and feet

    • High blood pressure

    • Increased pressure in the eye

    • Glaucoma

    • Prolonged and painful erections

    • Growth suppression in children

  • This medicine can worsen underlying psychiatric issues like anxiety, mania, psychosis, or motor tics.

  • This medicine can cause dizziness or blurry vision. Avoid driving or other potentially hazardous activities until you understand this medicine’s effects.

  • Methylphenidate can be habit-forming. Do not use more than prescribed. Talk to the prescriber if the treatment does not seem to be working.

  • Methylphenidate is a federally controlled substance. Selling or giving this medicine to another person is hazardous and illegal.

Methylphenidate ER (OSM) interactions

  • Do not use methylphenidate if you are using or have used an MAO inhibitor (MAOI) within the past 14 days.

  • Tell the prescriber about all the prescription drugs, over-the-counter medications, and supplements being regularly taken, particularly:

    • Other stimulants

    • Blood pressure medications

    • Drugs that narrow blood vessels (vasopressors)

    • Blood thinners called coumarin anticoagulants (like warfarin)

    • Drugs that treat depression

    • The antipsychotic drug risperidone

  • Avoid drinking alcohol when taking extended-release methylphenidate. 

  • Tell other healthcare providers about methylphenidate before they prescribe new medications or schedule medical procedures that require inhaled anesthetics.

Methylphenidate ER (OSM) side effects

Serious side effects

Talk to a doctor if you notice any signs or symptoms of a possible serious side effect, including:

  • Feeling dizzy, lightheaded, or faint

  • Fast, slow, pounding, or uneven heartbeat

  • Chest pain that may spread, trouble breathing, nausea, unusual sweating

  • Elevated blood pressure

  • Numbness or weakness on one side of your body, sudden or severe headache, problems with vision, speech, or walking

  • New or worse behaviors, hearing voices, seeing or feeling things that aren’t there, other unusual thoughts or behaviors

  • Extreme energy or restlessness, confusion, agitation, unusual moods or behaviors

  • New or worsening tics

  • Seizures

  • Blurred vision, vision changes, eye pain

  • Numb, cold, pale, or painful fingers or toes

  • Unexplained wounds or sores on the fingers or toes

  • Slow growth or weight loss in children

  • Painful erection or an erection that lasts longer than four hours

  • Allergic reaction: Hives, rash, itching, swelling of the face, mouth, tongue, or throat, chest tightness, trouble breathing

Less serious side effects

  • Trouble falling or staying asleep

  • Appetite loss

  • Headache

  • Stomach pain

  • Dry mouth

Find more information about Concerta side effects here.

Sources:

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