It is an extended-release form of methylphenidate hydrochloride, a medicine used to manage Attention Deficit Hyperactivity Disorder (ADHD). It works on areas of the brain that are under-active in ADHD to help improve attention, focus, and impulse control. Because it is extended-release, each tablet is taken once daily in the morning and releases medicine throughout the day.

What it is and what it is used for

Active ingredient and class

Active ingredient: Methylphenidate hydrochloride
Medicine class: Central nervous system stimulant (acts on certain brain pathways involved in attention and behaviour)

Uses (indications)

Treatment of Attention Deficit Hyperactivity Disorder (ADHD).
The leaflet states methylphenidate improves activity in under-active parts of the brain to support attention span, concentration, and reduce impulsive behaviour.

How it works

In ADHD, some brain pathways that manage attention and self-control can be less active. Methylphenidate increases signalling in these pathways. In everyday terms, it helps the “brakes” and “focus circuits” in the brain perform better so you can concentrate longer, resist impulsive actions, and organise tasks more effectively. The extended-release tablet releases the medicine gradually to support symptom control during the day after a single morning dose.

Who should NOT use this medicine

Do not take CONTRAMYL XR if any of the following apply:

Allergy: You are allergic (hypersensitive) to methylphenidate or any ingredients in the tablet.
Eye conditions: Glaucoma (raised pressure in the eye).
Adrenal tumour: Phaeochromocytoma.
Recent or current MAOI use: You are taking, or have taken within the past 14 days, a monoamine oxidase inhibitor (MAOI) antidepressant.
Thyroid disorders.
Eating disorders: Conditions such as anorexia nervosa or other anorexic disorders.
Serious mood or mental health problems, including:
- Psychopathic or borderline personality disorder
- Schizophrenia or abnormal thoughts/visions
- Severe mood problems, such as suicidal thoughts, severe depression, or mania
- Type I bipolar disorder (severe and episodic) that is not well-controlled
Heart and blood vessel problems:
- Current or past heart disease, heart attack, chest pain, heart failure, arrhythmias, or congenital heart defects
- Very high blood pressure or narrowing of blood vessels (can cause limb pain)
- History of stroke, brain blood-vessel problems (aneurysm, vasculitis), or blocked vessels
Tourette’s syndrome: Personal or family history of Tourette’s (uncontrolled speech/body movements).
Liver or kidney function disorders.
Age: Under 6 years.
Pregnancy or breastfeeding: Do not use (see section on Pregnancy and Breastfeeding).
If unsure, speak to your doctor or pharmacist before use.

Warnings and precautions (Read before use)

Before starting or while taking CONTRAMYL XR, let your healthcare provider know if any of the following apply. Your doctor may monitor you more closely, adjust your dose, or decide this medicine is not suitable.

Growth and development

Children: Long-term use of stimulants can slow growth and weight gain. If a child is not growing or gaining weight as expected, treatment should be reviewed and may be stopped.
Duration in children/adolescents: Safety and effectiveness for long-term use beyond 12 months have not been systematically evaluated.
Adults: Starting treatment or routine continuation beyond 18 years has not been established; your doctor will review the ongoing need regularly.
Elderly: Use in those over 65 years has not been established and is not recommended.

Heart and circulation

Tell your doctor if you have any heart condition or a family history of sudden unexplained death.
High blood pressure or cerebrovascular disorders require caution.
Report symptoms such as chest pain, fainting, shortness of breath, or irregular heartbeat immediately.

Neurological and mental health

Hemiplegic cerebral palsy: May be used under specialist supervision.
Mental health changes: Tell your doctor if you experience or have a history of:
- Aggression, hostility, or worsening aggression
- Hallucinations, delusions, or paranoia
- Feeling agitated, anxious, tense, depressed, or guilty
- Mood swings or bipolar symptoms
- Suicidal thoughts
Tics/Tourette’s: Can worsen or appear; inform your doctor if you develop repeated movements or sounds.
Seizures/epilepsy or abnormal EEG: Use with caution; report any seizures.
Substance use: If you have ever abused or been dependent on alcohol, prescription medicines, or street drugs, discuss this with your doctor. Chronic abuse of methylphenidate can lead to tolerance and psychological dependence.
Stopping treatment: Should be gradual under medical supervision; stopping suddenly can cause return of symptoms or depression.

Gastrointestinal and swallowing

If you have narrowing or blockage of the gut or oesophagus, or difficulty swallowing or swallowing whole tablets, tell your doctor. Tablets must not be chewed, crushed, or divided.

Laboratory and screening tests

Drug testing: Methylphenidate may cause positive results in substance tests, including in sport.

Sexual health

Prolonged, painful erections can occur; seek medical help if this happens.

Concomitant medicines

Serotonergic antidepressants (including SSRIs and tricyclics) may raise the risk of serotonin syndrome (confusion, restlessness, sweating, shivering, muscle jerks, fast heartbeat). Seek urgent care if these occur.
Clonidine or other centrally acting alpha-2 agonists: Long-term safety in combination has not been evaluated.
Dopaminergic medicines such as antipsychotics may interact.
Blood pressure medicines and blood thinners may require monitoring.

Alcohol and surgery

Alcohol: Do not drink alcohol while taking CONTRAMYL XR; alcohol can worsen side effects and some foods/medicines may contain alcohol.
Surgery/anaesthesia: Do not take CONTRAMYL XR on the day of surgery if a certain type of anaesthetic will be used, as it may cause a sudden rise in blood pressure. Tell your doctor and anaesthetist in advance.

Driving and using machines

The medicine may cause dizziness, drowsiness, or visual disturbances. Only drive or use machinery when you know how it affects you.

Note: CONTRAMYL XR contains sucrose and may affect blood sugar control in people with diabetes. If you have been told you have sugar intolerance, consult your doctor before use.

Pregnancy, planning pregnancy, and breastfeeding

Pregnancy: Do not use if you are pregnant or think you may be pregnant unless your doctor decides the benefits outweigh the risks; it may be harmful to the baby.
Breastfeeding: Methylphenidate can pass into breast milk; your doctor will help decide whether to breastfeed or take this medicine, but not both.

If any of the above applies, or you are planning pregnancy, speak to your doctor or pharmacist before use.

Interactions

Always tell your doctor or pharmacist about all medicines you take, including over-the-counter products, traditional or complementary remedies, and alcohol use.

Do not combine with:

MAOIs (monoamine oxidase inhibitors) or within 14 days of stopping an MAOI, due to risk of dangerous blood pressure increases.

Use with caution and medical advice:

Antidepressants: Tricyclics and SSRIs—risk of serotonin syndrome (confusion, restlessness, sweating, shivering, muscle jerks, fast heartbeat). Seek urgent help if these occur.
Antiepileptics: Phenobarbitone, phenytoin, primidone—your doctor may monitor levels or seizure control.
Blood thinners: e.g., warfarin and other anticoagulants/antiplatelets—monitoring may be needed.
Blood pressure medicines: Agents that raise or lower blood pressure may interact; your doctor may adjust doses or monitor BP.
Clonidine and other centrally acting alpha-2 agonists: Long-term safety with methylphenidate is not established.
Dopaminergic medicines, including antipsychotics: Potential interactions with effects on dopamine pathways.
Alcohol: Avoid alcohol as it can worsen side effects.

Surgery: Inform your doctor/anaesthetist in advance; omit dose on the day of certain anaesthetics due to blood pressure risks.

How to take (Step-by-step)

Important: Always take CONTRAMYL XR exactly as your doctor prescribes. Do not share it with anyone else.

When to take: Once daily in the morning.
How to take: Swallow the tablet whole with a glass of water.
- Do not chew, crush, or divide the tablet.
- The tablet has score lines but they are not designed for splitting the dose; do not break and take at different times.
With food: You may take with or without food.
Dose adjustments: Your doctor will typically start low and increase gradually to find the right dose.
Duration of treatment: Your doctor will advise how long to continue and will review regularly, especially in children/adolescents and adults over 18.

Missed dose:

If you forget a dose, skip it and take your next dose at the usual time the following morning.
Do not take a double dose.

Overdose:

If you or someone else takes too much, contact a doctor, pharmacist, poison control centre, or the nearest hospital immediately.

Stopping treatment:

Do not stop suddenly without medical advice. Stopping abruptly can lead to return of symptoms or depression. Your doctor may reduce the dose gradually before stopping.

Practical tips

Take at the same time each morning.
Keep tablets in the original container, tightly closed, and out of children’s reach.
Do not alter the tablet (no chewing/crushing/splitting).

Dosing table

Not specified in the source. Your doctor will individualise the dose and may adjust it gradually.

Possible side effects

Like all medicines, CONTRAMYL XR can cause side effects, although not everybody gets them. Some side effects require urgent medical attention.

Serious—seek urgent help and stop the medicine (go to the nearest casualty/emergency department)

Severe allergic reactions: Anaphylaxis, sudden swelling of the skin, throat, or tongue with difficulty breathing, skin peeling, widespread rash or purplish-red patches.
Neuroleptic Malignant Syndrome-like reaction: Sudden high fever, very high blood pressure, severe convulsions.
Heart problems: Disturbed or fast heartbeat, palpitations, fainting, shortness of breath, signs of heart attack or sudden cardiac issues.
Stroke or other serious brain blood vessel problems.
Seizures (fits), including grand mal.
Severe mental changes: Psychosis (seeing/hearing things not there), mania, suicidal thoughts or attempts, severe confusion.
Severe circulation issues: Cold, numb fingers/toes that change colour (white → blue → red) (Raynaud’s phenomenon).
Liver problems: Abnormal liver function, liver enzyme elevations, or signs of severe liver injury (including hepatic coma).
Prolonged, painful erections.

These are serious and may need immediate medical treatment.

Common (reported frequently)

Infections: Throat inflammation, upper respiratory or sinus infections.
Appetite and growth: Decreased appetite, weight loss, and reduced height gain with prolonged use in children.
Sleep and mood: Insomnia, nervousness, rapid mood changes, aggression, agitation, anxiety, depression, irritability, mood swings, reduced sexual interest, panic attacks, teeth grinding.
Nervous system: Dizziness, movement difficulties, sensation of movement, tingling feelings, tension headache.
Eyes: Focusing difficulties.
Blood pressure: High blood pressure.
Breathing and throat: Cough, mouth/throat pain.
Gut: Stomach pain, diarrhoea, nausea, vomiting, dry mouth, indigestion.
Skin and hair: Rash, itching, hives-like raised areas, hair loss.
Muscles and joints: Joint pain, muscle tightness, spasms or cramps.
General: Fatigue, jitteriness, low energy, thirst.
Tests: Raised ALT (a liver enzyme) on blood tests.

Less common (reported less frequently)

Blood: Anaemia, low white cells (leucopenia), low platelets (thrombocytopenia)—may increase risk of infections and bruising/bleeding.
Tics: Worsening or new tics.
Speech/behaviour: Excessively rapid speech, increased responsiveness, sedation, tremor.
Vision: Blurred vision, dry eyes, double vision, difficulties focusing.
Vascular and skin: Hot flushes, excessive sweating, macular rash.
Gut and urinary: Constipation, blood in urine.
Hormonal: Breast swelling in men.
Chest: Chest pain.
Blood cell reductions: Decrease in red cells, white cells, and platelets.

Frequency not known

Pancytopenia (decrease in all types of blood cells).
Migraine, dilated pupils (mydriasis), restricted jaw movement, fever, erectile dysfunction, urinary frequency or incontinence.

Post-marketing

Nosebleeds.

What to do:

Mild effects (e.g., reduced appetite, headache): speak to your doctor or pharmacist if troublesome or persistent.
Severe or worrying symptoms (especially those listed under Serious): stop the medicine and seek urgent medical help.

Storage and disposal

Keep out of the reach and sight of children.
Store at or below 25 °C.
Keep the container tightly closed and in the original container until use.
Do not store in a bathroom.
Do not use after the expiry date (EXP) shown on the carton (last day of the month indicated).
Return any unused or expired tablets to your pharmacist. Do not dispose of medicines in toilets, drains, or household waste.

What the medicine contains

Active ingredient: Methylphenidate hydrochloride—available as 18 mg, 27 mg, 36 mg, 54 mg prolonged-release tablets.
Key excipient information:
- Contains sucrose (sugar)—see exact amounts below; important for people with diabetes or sugar intolerance.
- Other formulation components include common tablet and coating excipients such as hypromellose, ethylcellulose, hydroxypropylcellulose, talc, triethyl citrate, carmellose sodium, microcrystalline cellulose, magnesium stearate, colloidal silica, and film-coating systems (e.g., Opadry® II with polyvinyl alcohol, macrogol, talc, titanium dioxide and iron oxides).
Sugar content per tablet:
- 18 mg: Sucrose 10,013 mg
- 27 mg: Sucrose 15,024 mg
- 36 mg: Sucrose 20,027 mg
- 54 mg: Sucrose 30,040 mg

Warning: The high sucrose content may affect blood glucose control.

Pack information and appearance

Pack size: Bottles of 30 tablets (HDPE bottles with child-resistant, tamper-evident caps and desiccant).
Appearance by strength:
- 18 mg: Yellowish to yellow, round, biconvex, film-coated.
- 27 mg: Yellow, oblong, biconvex, film-coated, with break scores on both sides (not for dose splitting).
- 36 mg: White to off-white, oblong, biconvex, film-coated, with break scores on both sides (not for dose splitting).
- 54 mg: Reddish to red, oblong, biconvex, film-coated, with break scores on both sides (not for dose splitting).

Practical FAQs

Can I drink alcohol while taking CONTRAMYL XR?
No. Do not drink alcohol, as it can worsen side effects. Remember that some foods and medicines may contain alcohol.

Can my child under 6 years take CONTRAMYL XR?
No. It should not be given to children under 6 years because safety and effectiveness have not been established.

Will this medicine affect growth?
In children, long-term use has been associated with reduced weight and height gain. If growth is not as expected, treatment should be reviewed and may be stopped.

Can I drive or use machines?
This medicine can cause dizziness, drowsiness, or visual disturbances. Only drive or use machinery when you know how it affects you.

What if I miss a dose?
Skip the missed dose and take the next dose at the usual time the next morning. Do not take a double dose.

Can CONTRAMYL XR affect drug screening tests?
Yes. It may cause positive results in substance testing, including tests used in sport.

Should I stop the medicine before an operation?
Tell your doctor/anaesthetist. Do not take your tablet on the day of surgery if a certain anaesthetic is being used, as it may cause a sudden rise in blood pressure.

Can I take it with food?
Yes. It can be taken with or without food.

May I split, crush, or chew the tablet?
No. Swallow whole with water. Even though some tablets have break scores, they are not intended for splitting into separate doses or for chewing/crushing.

Is it safe in pregnancy or breastfeeding?
Do not use if you are pregnant or breastfeeding unless your doctor decides otherwise. Methylphenidate may harm the baby and can pass into breast milk.

Are there important medicine interactions?
Yes. Do not take with MAOIs (or within 14 days of stopping an MAOI). Use caution with SSRIs, tricyclics, antiepileptics, warfarin, blood pressure medicines, clonidine/alpha-2 agonists, antipsychotics, and alcohol. Always tell your doctor about all medicines you use.

CONTRAMYL XR : Uses,Side Effects,Warnings,Precautions