My headline sounds pretty stupid, but I didn't come up with a better one :eyebrow:

Just one quick question:

My package insert (concerta) says you should definitely take if AFTER breakfast. It's stated a couple times. Only if you take it after breakfast you avoid peeks and only that way it's evenly released. That's at least what the package insert says..
But I eat at night SO much and SO late (I eat between midnight- 4 o'clock really big meals) that there's no way that I could eat when I get up.

I know it's a bad habit but I wasn't "able" to quit it for the last 15 years, so I think I never will.

So is it ok if I take Concerta on an empty stomach? I usually eat about 4 hours after I took it and then I eat a LOT when it wears off.

So basically I'm not following the directions on Concerta. That means I don't use/take it the way I should!

That probably causes a peek short after I take it and a reduced effect the next hours, right?

You probably wonder why I ask and if I can't answer this question myself, but since I've always taken it without breakfast, I just know this effect and don't know how else it would/could be.. :confused:


Thanks for any help.

I have the same crummy habit myself Katy :o try a protein shake or a smoothie in the AM before Concerta. Gag it down if you have to ;) it works for me!

Crazy

Hi Katy,
My daughter takes her concerta on an empty stomache and goes back to sleep. This is because during the summer I let her sleep in past when I go to work. Her doctor and the information we have does not indicate an issue with food other than a concern for stomache upset. I am curious about the differences between what you have in the package insert and what is at the concerta info site:
http://www.concerta.net/html/concerta/hcp/prescribing_info.jsp?
and found the full prescribing info, it says there is no evidence of dose dumping with or without food:
http://www.concerta.net/active/mccus/en_US/html/concerta/utilities/patient_info.pdf#zoom=100

At the end of the prescribing info is the patient infor that says to take before or after breakfast.

Does your package insert have some kind of issue version and/or date on it? I would like to contact the manufacturer about the descrepancy. I try to keep up to date on these things, and would like to get an explanation from them.
thanks,
vickie

I thought the advice was to take Concerta and wait 30 minutes before you eat something. Wake up..take it..go to the bathroom...make breakfast...eat. If you are very quick, include a shower before making breakfast. Truly, it is not a big deal.

I'll look up what the p.i. exactly says later tonight and let you know!

@crazy:
If I eat any fruits (like smoothie) for some reason it lessens the effect of methylphenidate- no matter when I eat the fruits. So I don't eat any fruits nor do I drink any fruit juice as long as the concerta is acting. Fruits like banana are ok but not any sour fruits.

Did any of you make similar experiences?

I heard that you shouldn't eat/drink any fruit or sth with citric acid right before or right after taking methylphenidate. But I lose the drug's effect no matter at what time I eat fruits (even hours after I've taken Concerta) !

Any idea why?
Maybe because Concerta constantly releases methylphenidate (instead of all at once like Ritalin does) ?

Katy,

The citric acid issue is really related to amphetamine as the former affects how the latter is absorved. It does not (at least officially) apply to methylphenidate.

I take it on an empty stomach every day. I can't eat in the mornings, never have been able to, so I don't eat for about 4 hours after taking it. I haven't noticed any odd effects. Everything feels pretty smooth to me release wise. When I had my dose increases I did have a few days of nausea, that was relieved with food, but that has subsided as well.

Katy,

The citric acid issue is really related to amphetamine as the former affects how the latter is absorved. It does not (at least officially) apply to methylphenidate.Yes and no, Snap. The outer shell of Concerta is made up of IR methylphenidate; ascorbic acid from citrus fruits can slow down the absorption of IR. ;) Sorry Katy, the Kid and I are allergic to citrus fruits, so there is no orange juice in our smoothies. Avoid citrus until the IR has been processed, IMO (and I had a truly rotten experience with milk and Metadate CD, so my smoothies made that experience worse)...our smoothies include yogurt, and non-citrus fruits like strawberries, peaches and pears.


HTH.

Crazy

Oh well, Crazy...my Concerta paper from the pharmacy does not mention that!
I guess I'm covered by having said that the citric acid issue does not "officially" apply to methylphenidate! :-)

Thanks.

Oh well, Crazy...my Concerta paper from the pharmacy does not mention that!
I guess I'm covered by having said that the citric acid issue does not "officially" apply to methylphenidate! :-)

Thanks.It's OK Snap...mine did not say that either!! I found it out when I was flipping on that Metadate excursion. I had to whine and beg for that little bit of info (thanks Sis!) and it seems to only apply to the IR type of methylphenidate anyway :confused: weird huh?

Crazy

Avoid citrus until the IR has been processed
How long does this approximately take?

But I lose the drug's effect no matter at what time I eat fruits, even hours after I've taken Concerta..

Isn't it constantly released?

Or if not, is it released twice: the first time right away and the second time after 4 hours?
This would mean you shouldn't eat/drink any citric acid around 4 hours later either, right?

Concerta instantly releases 22% of its methylphenidate content; the remaining amount is continuously released for about 6-7 more hours. It has an increasing release profile. It takes a while to kick in.

The following two meds have a flat release profile:

Metadate CD instantly releases 30% and then 70% about 4 hours later. Smoother initial kick than Concerta.

Ritalin LA instantly releases 50% and then the other 50% about 4 hours later. Stronger initial kick than both Concerta and Metadate CD. I still need to try this one.

Choose you poison... ;-)

Metadate CD instantly releases 30% and then 70% about 4 hours later. Smoother initial kick than Concerta.
Sorry once again Snap :o but I vehemently disagree! For me, Metadate results in a humongous IR rush, then nothing "helpful" 4 hours later. That's a good reason they say we all react differently, IMO. Metadate CD kicked me straight to the curb!

Crazy

@SnappyCloud:

Wow, great info! How do you know that exactly?
Do you also know "by chance" the release mechanism of Medikinet (also a longacting formula of methylphenidate)?
Metadate CD instantly releases 30% and then 70% about 4 hours later. Smoother initial kick than Concerta.
Why is it the initial kick of Metadate smoother than Concerta, if Concerta only releases 22% instantly but Metadate releases 30% instantly?

And does Metadate releases 70% all at once 4 hours later?
Isn't that an imbalance (why not 50-50) ?

Concerta instantly releases 22% of its methylphenidate content; the remaining amount is continuously released for about 6-7 more hours.Doesn't Concerta releases methylphenidate up to 10 hours?

Sorry for all these questions, I just realized I know less than I thought ;)

Thanks again!

And does Metadate releases 70% all at once 4 hours later?
Isn't that an imbalance (why not 50-50) ?

Doesn't Concerta releases methylphenidate up to 10 hours?

Sorry for all these questions, I just realized I know less than I thought ;)

Thanks again!Well, I am not Snap, but I do try to help, Katy! Metadate is a capsule composed of IR and LA beads at a 30% to 70% ratio because that works for some people. I seem to remember one of the Great Books (A Hallowell & Ratey, possibly?) stating that Metadate is teriffic for some and lousy for others. It was and is lousy for me. Might be great for others!

They like to say Concerta is releasing for up to 10 hours but you cannot tell that by me :rolleyes:. I had to stagger doses to get all-day relief from Concerta for a long time. Lately I can take my full-dose all at once in the AM. I do not understand why that works now and did not work before; I am just glad that it works.

HTH!

Crazy

Crazy and Kathy,

Sorry, never heard of Medikinet.

I get my info from the product websites, under physician info, etc. This type of information, by its nature, is based on statistical data. Outliers, like Crazy, are possible. Most people, however, will experience results that are more representative of the advertized mean figures. The websites will show you the release and plasma level charts.

I meant to say that concerta is initially slightly smoother than metadate cd - My second Concerta of the day is obviously wearing out.

Yes, Metadate CD releases the remaining 70% in one shot, about four hours later. YMMV, as Crazy mentioned.

Some people react better to one of the three release profiles.

Concerta is not necessarily releasing for 10 hours. What happens is that during the last 4 hours or so you are still getting the decreasing effect of the last amount released. Furthermore, Concerta releases at an increasing rate. Lately I have thought that I don't want that feature so I want to try Ritalin LA (50-50). I am getting relaxed and sleepy, like when I started taking it. The relaxation is good, but my concentration is suffering. On Adderal XR, the relaxation is less, but the concentration is better - FOR ME!

@ Snappy & Crazy:
Thanks for your info.

I'm currently taking Medikinet and it's suppossed to be released the same way as Concerta. But I feel that it wears off after around 4-5 hours after taking it and then around half an hour later it feels like sth is released again. So that would be the 50-50. :confused:

Strange is that I get irritable and moody after around 4-5 hours (after taking it) but when it all wears off (around 10 hours later) I get all of a sudden extremely tired but not irritable..

Do you have any idea how this could be explained?

Katy,

Let's try to solve the riddle once and for all. Please look at the picture shown by this link

http://commons.wikimedia.org/wiki/Image:Methylphenidat_medikinet.jpg

and tell me if that is what you are taking. If so, those are tablets. Concerta capsules use a unique patented release mechanism developed at MIT and I doubt that a foreign company has legally or ilegally copied it.

I am about to conclude that you are taking a biphasic formulation similar to ritalin la. In your case, given the reactions that you describe, Concerta might in fact be a drug to have your doc let you try. I think the citric acid issue is only secondary; what you might need is the sustained release!

Please let us know!

Snappy.

TY Snap, this has been puzzling me too! As far as I know, Concerta is unique in its release mechanism, too. This is what Concerta looks like:

http://www.drugs.com/pdr/images/pills/p05321b1.jpg

I presume they are considered tablets since the outer shell is made up of methylphenidate, not gel like a capsule.


Crazy

Actually, Crazy, my bottle says tablets - and very hard ones at that.
They are shaped like capsules, but cannot be opened and sprinkled on food.

They have three phases of release: inmediate (IR), then a second chamber (more medicine than the first release) opens up due to contact with water in the stomach and, finally, the third chamber (more medicine than the second chamber) opens up. The theoretical effect (hehe) is to provide a sustained and increasing plasma concentration in "statistically normal" subjects. :-) BTW, I personally don't like to be normal, in most cases.

My bottle says the same thing Snap, tablets.

Concerta uses osmotic pressure to deliver methylphenidate HCl at a controlled rate. The system, which resembles a conventional tablet in appearance, consists of an osmotically active trilayer core surrounded by a semipermeable membrane with an immediate-release drug overcoat.

Sooooo, according to my doctor, as he explained it to The Kid, the outer shell (IR) dissolves and enters the bloodstream immediately, exposing the core's first chamber. The ER is released and remains in the bloodstream, while the second chamber has that lovely laser-drilled hole and the teeny-tiny spongelike compressed thingie (well he was explaining to a kid LOL) and as the sponge absorbs stomach fluids it slowly pushes more of the ER into the stomach. Upshot? Very smooth experience.

So far, so good, and it has been smooth IMO. Of course that core is indigestible, which bugs The Kid but not me :rolleyes: and it just figures she is able to, ahem, SEE the indigestible results from time to time? Not me though.

Crazy

theoretical effect (hehe) is to provide a sustained and increasing plasma concentration in "statistically normal" subjects. :-) What exactly does that mean :eyebrow: ? :)

Thank you again for these helpful information!

I am about to conclude that you are taking a biphasic formulation similar to ritalin la. Do you know if people usually develop a tollerance to Concerta sooner than to biphasic formulation like ritalin la?

Oh, I forget: I take the Medikinet retard (it also comes as a just "Medikinet" formula)
What I take is a capsule.

Katy,

I was just making fun of the fact that actual results are sometimes different, as pointed out by Crazy.

Don't worry too much about the details, the practical application is: provide a sustained and increasing plasma concentration.

So, what have you concluded you are actually taking?

Katy,

Then it seems you are taking something like metadate cd or ritalin la, probably the latter. Sorry, I don't know about the tolerance difference.

I was just making fun of the fact that actual results are sometimes different, as pointed out by Crazy.

Don't worry too much about the details, the practical application is: provide a sustained and increasing plasma concentration.

So, what have you concluded you are actually taking?Thanks Snap, the humor was appreciated :D and I do not mind being an outlier. As soon as Katy lets us know what it is she is taking we can proceed with that, if we know.

I agree with the don't worry thing. This is my anaology for that...

I do not have to understand the chemical reactions by which pudding is made. I either have pudding, or I don't. It does not matter what "flavor" of pudding I am making (type of med). If I have pudding, that's good enough for me. That's my proof; the proof is in the pudding.

Crazy

Ok, I searched the internet for Medikinet retard's release mechanism (kind of hard too find for my meds and also not explained in the package insert) and that's what I found:

If you take Medikinet retard AFTER breakfast the maximum concentration level is reached after about 2 hours. Afterwards you reach the so called "plateau phase" for the next 3-4 hours. Within this plateau phase at least 75% of the max. concentration is released.
The half life/half value time of Medikinet retard is around 3,2 hours (for adults).

It's also emphasized that the retardation is not guaranteed any more if you take Medikinet with empty stomach.


What kind of wonders me is that the half life is only 3,2 hours :confused:
I always felt that the Medikinet retard is working up to 10hours for me, 9 hours almost for sure.. (the effect get's a little less after around 8 hours but still kind of working).
So 3,2 hours seems a little short..:eyebrow:

What do you think now :faint: ?

What do you think now :faint: ?
Katy, I think you are way over-thinking this stuff. Talk to your pharmacist, get an explanation, and ask for the physician insert. That's what they are paid to do.
I have several big questions

why is it so necessary to know all this stuff? Please help my brain understand.
will knowing this stuff make a difference in your treatment?
Will your health improve?
Does it make any difference if you take it on empty or full? I take it and see no dif.
Do you have problems taking concerta, should you take a different one?
What does your doctor say?
Have you asked your doc?
Could you please state your specific reasons for inquiring please?
Why not contact the pharaceutical company-they have PhD chemists who can answer your questions better than any of us possibly could?
Please splain Lucy, I am confused, bewildered, and perplexed. And feel like this thread has no focus or purpose.
Thanks, RADD

ADDF is no substitute for a physician or pharmacist's advice. Good point RADD! If I personally was this confused I would be speed-dialing the doc.

Crazy :cool:

http://cellar.org/images/moresmilies/pyth.gif and now, for something completely off topic...


I find the term Medikinet retard's release mechanism to be quite funny for some reason.
Medikinet retard is working up to 10 hours
This sounds so politically incorrect. And like they should pay overtime. :D Sorry, I just see humor in strange places, at strange times, in strange ways.

My husband used to make non-analytical field analysis tablets. Why do I tell you this? I don't know. The tablet making process is quite fascinating tho.

RADD, in need of a humor fix. House cleaning numbs my mind. Life is way to short to not have a wee bit of laughter.

http://i3.photobucket.com/albums/y92/kzrainbow/lmao.jpg

I had the same response to those phrases myself RADD. My Go Go Gadget Impulse Controller must have been working well that day.

Crazy :cool:

I was just trying to figure out which long acting formula might be the best for me/my daily routine. That's why I wanted to know more about the "release mechanism" of the different stimulants.
I'm always curious, don't ask me why, I've no clue :)

Medikinet retard's release mechanism Yeah, you're right that sounds pretty funny, not to say kind of retarded :D

As long as curiosity does not kill the Kat, its all good.


Crazy :cool:

I was just trying to figure out which long acting formula might be the best for me/my daily routine. That's why I wanted to know more about the "release mechanism" of the different stimulants.
I'm always curious, don't ask me why, I've no clue :)

Yeah, you're right that sounds pretty funny, not to say kind of retarded :D
Katy,

You responded to a previous post with a lot of grace. Congratulations! I understant that when we are new at this, sometimes we have so many questions and we need empathy and a receptive environment.

I totally agree with the poster that you were almost obsessing (I do that all the time), but contrary to the intentions of the poster, I felt like the Inquisition was conducting a trial. :)

Best wishes and talk to your doc.
Snappy

@SnappyCloud:
You responded to a previous post with a lot of grace. Congratulations! Thank you, I appreciate that. I try my best.

you were almost obsessing (I do that all the time) Yeah, I'm definetely the obsessive ADHD type, but only if sth really interests me unfortunately, not the stuff I should do instead. I told myself not to post for the next few month because I've so much stuff to do and always "lose" so much time with reading/writing in this forum..

Katy that was mighty graceful. If you are the obsessive type of ADHD, then please label me the "wildly hilarious" type :o and when my impulsivity gets the best of me, well, let's just say that I am not laughing AT you...I am just sort of laughing NEAR you.

I felt a bit grilled myself by all the questions, but I believe that's my own failing because I do try to help others as best I am able. When I cannot do that or appear to be failing, I feel like such a loser, and that's all my issues. Has nothing to do with you!

You get to obsess as long as I get to be hilarious...deal?

Crazy :cool: (virtual handshake extended)

When I cannot do that or appear to be failing, I feel like such a loser, and that's all my issues. Has nothing to do with you!
You did a pretty good job! A learned a lot from you (ADHD wise..) ;)

You get to obsess as long as I get to be hilarious...deal?
Deal :) !