(2022). The chart below lists drugs that may interact with Concerta. Since 1998, millions of parents and adults have trusted ADDitude's expert guidance and support for living better with ADHD and its related mental health conditions. Moderately clinically significant. There are 91 drugs known to interact with 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. These medications may cause some risk when taken together. If you or a family member has Tourette syndrome or tics, your doctor may not prescribe Concerta. Allergic reaction. You may also mix the leftover medicine with cat litter or coffee grounds in a sealed plastic bag and throw the bag in the trash. Concerta (methylphenidate HCl) extended-release tablets, CII. Common interactions include deep vein thrombosis among females and optic ischaemic neuropathy among males. The American Academy of Pediatrics recommend that parents and caregivers of children with ADHD pursue a treatment that involves both therapy and stimulants, rather than medication alone. These medications may cause some risk when taken together. Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Concerta (methylphenidate HCl) extended-release tablets CII. Side effects from Concerta arent common and are usually mild when they do occur. Your doctor may recommend alternative treatments for your attention deficit hyperactivity disorder (ADHD). If you have glaucoma. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. Vyvanse and Adderall are two drugs that treat ADHD. Slowed growth rate in children. As with most drugs, Concerta can cause an allergic reaction in some people. This is because Concerta is a stimulant drug. Concerta is classified as a Schedule II prescription drug. In clinical studies, people taking Strattera reported urinary hesitancy (trouble starting or maintaining urination). Taking Concerta with MAOIs may cause a hypertensive crisis. If you have a family history of either condition, you may have a higher risk of developing tics or Tourettes syndrome with Concerta. Hydroxyzine pamoate (Vistaril) Other commonly prescribed medications in the U.S. also have anticholinergic effects. This survey is being conducted by the WebMD marketing sciences department. If you have glaucoma, your doctor may not prescribe Concerta. These drugs may cause some of the same mild side effects, including: Concerta and Strattera can also have different side effects. For adults and children under 65 years old who are not taking methylphenidate, the guidelines are as follows: People should take the drug in the morning with water. When using a medication with a short half-life, people may need to take several daily doses to get consistent results. For a general overview of Concerta, see this article. They can recommend whether its safe for you to take Concerta. Taking gabapentin and antacids that contain magnesium hydroxide or aluminum hydroxide causes a reduction in the concentration of gabapentin in the body. Learn, There may not be a current cure for ADHD, but several options can help manage symptoms. Glaucoma. Are there any combinations that would be unsafe?. Before starting Concerta, talk with your doctor about any heart problems you have. Avoid combinations; the risk of the interaction outweighs the benefit. Keep in mind that this chart does not include all drugs that may interact with Concerta. Version: 23.02. Stimulants have caused stroke, heart attack, and sudden death in people with high blood pressure, heart disease, or a heart defect. We comply with the HONcode standard for trustworthy health information. Taking certain steps can help you avoid interactions with Concerta. Last updated on Jan 11, 2023. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Beyond medication, people with ADHD may benefit from treatments such as family and behavioral therapy, as well as accommodations at work or school and lifestyle changes, such as sticking to a regular routine. Taking MAOIs with Concerta can cause a severe increase in blood pressure. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation. Theyll likely recommend you stop taking the medication and suggest alternative treatments for ADHD. If you and your doctor agree that Concerta is working to treat your ADHD, youll likely take the medication long term. Of the total drug interactions, 5 are major, 225 A new study suggests that laser light therapy may improve short-term working memory. What conditions does Claritin-D 24 Hour treat? They can discuss the risks and benefits of taking Concerta during pregnancy. Concerta may interact with caffeine, which can be found in many foods and drinks, as well as supplements. For details, see the When should I avoid Concerta? section above. For example, if you have a heart attack, youll need to take medications long term to help prevent another one. Concerta could worsen symptoms in people who have Tourette syndrome or tics. Its possible to experience withdrawal side effects from stopping Concerta. Talk with your doctor about how much alcohol, if any, is safe for you to consume while taking Concerta. Talk with your doctor if you or your family members have tics or Tourettes syndrome. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. The Food and Drug Administration (FDA) approved Concerta for the treatment of ADHD in 2000. Also tell them if you have heart problems, such as an irregular heart rhythm. Call your doctor for medical advice about side effects. Here's a detailed look at the correlation between intelligence and, Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Usually avoid combinations; use it only under special circumstances. CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. But alcohol depresses (slows down) your CNS. Your doctor may occasionally change your dose. For details, see Boxed warning at the top of this article. Are there other interactions with Concerta? Does Concerta interact with other medications? All rights reserved. WebThere are 233 drugs known to interact with Keppra (levetiracetam), along with 4 disease interactions, and 1 alcohol/food interaction. These "chemical cousins" are similar but have different effects. Extended-release formulations, such as Concerta, offer a solution. Be sure to talk with your doctor about your health history before you take Concerta. [1] This prescription medication is usually indicated for the treatment of attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) in adolescents and children who are at least six years old, as monotherapy and Concerta is one brand of a drug called methylphenidate. Glaucoma. Examples include anxiety, irritability, and insomnia (trouble sleeping). Researchers do not know whether infants can come into contact with Concerta through breast milk. Sharing this information with them may help you avoid possible interactions. You should not take Concerta if youve ever had an allergic reaction to Concerta or any of its ingredients. Both treat similar allergy symptoms such as watery eyes, runny nose, itchy eyes/nose, sneezing and, itching. They may also recommend stopping treatment with Concerta and trying a different therapy for your ADHD. Does my health history affect whether I should take Concerta? For details, see the When should I avoid Concerta? section above. If you have questions about getting certain vaccines while taking Concerta, talk with your doctor. Besides talking with your doctor, you can do some research on your own. In such cases, your doctor may not prescribe Concerta. Its not known if its safe to take Concerta during pregnancy. When Concerta and alcohol are taken together, you may not notice the effects of either substance on your body. If you still have questions about Concerta and its possible interactions, talk with your doctor. They can talk with you about the risks and benefits of taking Concerta and recommend healthy ways to feed your child. Yes, Concerta (methylphenidate) is a Schedule 2 controlled substance and therefore has a high potential for abuse. Available for Android and iOS devices. Healthline Media does not provide medical advice, diagnosis, or treatment. Most of the over-the-counter medications used to treat colds and fevers can be used safely while taking an ADHD drug. Questions you may want to ask your doctor include: To get information on different conditions and tips for improving your health, subscribe to any of Healthlines newsletters. Concerta has a boxed warning for drug dependence. But tics arent always caused by Tourette syndrome. People who do not have good results from Concerta may see improvements after taking a different stimulant or a Common Concerta side effects may include: mood changes, anxiety, feeling nervous or irritable, trouble sleeping; fast heart rate, pounding heartbeats or fluttering in your chest; dry mouth, nausea, vomiting, stomach pain, indigestion; or. There are currently no reports of Concerta interacting with vitamins. If you have questions about certain foods or drinks that may interact with Concerta, talk with your doctor. They can tell you which allergy medications contain a vasopressor. If youve used an MAOI within the past 14 days, talk with your doctor before taking Concerta. There are important precautions to consider before you begin taking Concerta. Interactions can also occur if you have certain health conditions. To learn more about this interaction, see the Drug interactions explained section above. If you take Concerta with lithium, your doctor may watch for symptoms of mania and ADHD. Treatment for ADHD begins with an accurate diagnosis from a doctor. WebAll of the following medications can be safely given together: Antibiotics including amoxicillin, cefdinir/Omnicef , amoxicillin-clavulanate/Augmentin , azithromycin/Zithromax , cephalexin/Keflex , and trimethoprim-sulfamethoxazole/Bactrim . It took time for us to learn as much as we know about ADHD today. Concerta is a brand of methylphenidate, one of the most common and well-studied medications for attention deficit hyperactivity disorder (ADHD). Stimulants have caused stroke, heart attack, and sudden death in certain people. MNT is the registered trade mark of Healthline Media. Selected from data included with permission and copyrighted by First Databank, Inc. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. For example, sometimes alcohol, another drug, or a supplement can affect how a drug acts in your body. For details, see the When should I avoid Concerta? section above. You can use the study as a second opinion to make health care decisions. (2020). WebRead all 260 questions with answers, advice and tips about Claritin Child ADD / ADHD from moms' communities. Concerta may change or decrease the effectiveness of: The FDA classify Concerta and other forms of methylphenidate as pregnancy class C drugs. While over-the-counter medications are generally considered safe for occasional use, some allergy and cold medications, including decongestants, should not Concerta may cause serious heart problems, including heart attack, in people who have these conditions. As a result, Concerta may be less effective at treating your condition. For example, your doctor may have you stop taking Concerta or lithium. Doctors sometimes prescribe Wellbutrin to treat ADHD if a person cannot take stimulants. Concerta may cause circulation problems, such as Raynauds syndrome. It is created by eHealthMe based on reports of 13 people who take Amitriptyline hydrochloride and Concerta from the FDA, and is updated regularly. Metilfenidato is the Spanish, Italian, and Portuguese translation for methylphenidate which may be used to treat children or adults with attention deficit hyperactivity disorder (ADHD) to help with hyperactivity and impulsive behavior, and allow them to concentrate better. They have similar actions and side effects, but there are several differences. Learn about its side effects, including headache and sleep problems, and how to manage them. Concerta can lower the seizure threshold. You should not take Concerta if you have anxiety or agitation, as the medication may worsen these conditions. Select a condition to view a list of medication options. Things to discuss with them include: Its also important to read Concertas label and other paperwork that may come with the drug. Metilfenidato translates to methylphenidate. Short-Term Memory Can Be Improved with Laser Therapy, Study Shows, can increase the risk of side effects from MAOIs and Concerta, can make seizure drugs less effective than usual or increase the risk of side effects from seizure drugs, can increase the risk of side effects from SSRIs, can increase the risk of side effects from TCAs, can increase the risk of side effects from risperidone, can make Concerta and lithium less effective than usual. Last medically reviewed on October 26, 2021. Clonidine, a high blood pressure medication, and other alpha-2 agonists may cause serious side effects when a person takes them with Concerta. In fact, one study found that children with ADHD often have low levels of magnesium in their bodies. Of the total drug interactions, 79 are moderate, Some interactions occur because one substance causes another substance to have a different effect than expected. ADDitude collaborates closely with leading medical experts to publish accurate, clear, and authoritative content that millions of readers trust and share. Concerta tablets do not change shape after theyre swallowed. Tell your doctor if you also use opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Concerta is an extended-release tablet. Children ages 6 and older and adolescents should begin with a morning dosage of 18 mg. A doctor may raise this by 18 mg each week, to a maximum daily dosage of 54 mg for children and 72 mg for adolescents. It may not be safe to drink alcohol during Concerta treatment. WebMD does not provide medical advice, diagnosis or treatment. If youve had an allergic reaction. If you have severe anxiety or agitation, your doctor may not prescribe Concerta. And the paperwork (sometimes called a patient package insert or medication guide) may have other details about interactions. Symptoms can include: Problems with circulation in your fingers and toes. Other medications you take, as well as any vitamins, supplements, and herbs. Before taking Concerta, tell your doctor if you have high blood pressure. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist. Concerta stimulates your CNS, so the drug might make you feel more awake or alert. Taking Concerta with caffeinated foods or drinks could increase the risk of certain side effects with Concerta. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment. Concerta works by stimulating your brain, which can help reduce the symptoms of ADHD. Our mission is to be your trusted advisor, an unwavering source of understanding and guidance along the path to wellness. Health conditions or other factors that might interact with Concerta include: Current or past drug dependence or alcohol use disorder. Concerta may worsen these conditions. If you have questions about interactions that may affect you, talk with your doctor or pharmacist. Why Doesn't the U.S. Have at-Home Tests for the Flu? Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. But Concerta may hide the effects of alcohol on your body, and vice versa. For more information about some of these interactions, see the Drug interactions explained section below. You should not use Concerta if you have glaucoma, tics or Tourette's syndrome, or severe anxiety, tension, or agitation. hypertension. Highlights of prescribing information. This is the most serious warning from the Food and Drug Administration (FDA). Its not known whether Concerta passes into breast milk. There may be variations in CSA schedules between individual states. Glaucoma is typically caused by a buildup of pressure in the eye. cardiac disease. Theyll let you know whether its safe to take Concerta. We avoid using tertiary references. Concerta can cause side effects that may affect your emotional state. Before taking Concerta, tell your doctor if you have a mental health condition. Concerta isnt known to interact with alcohol. (2021). If you have narrowing in your intestines or other digestive problems, Concerta may not be safe for you. All rights reserved. Concerta may cause serious side effects. Can diet help improve depression symptoms? signs of heart problems - chest pain, trouble breathing, feeling like you might pass out; signs of psychosis - hallucinations (seeing or hearing things that are not real), new behavior problems, aggression, hostility, paranoia; signs of circulation problems - numbness, pain, cold feeling, unexplained wounds, or skin color changes (pale, red, or blue appearance) in your fingers or toes; or. Ask your pharmacist about a drug take-back program. My child takes medication for ADHD. Before taking Concerta, tell your doctor if you have seizures. People who do not have good results from Concerta may see improvements after taking a different stimulant or a different combination of medications. This condition is caused by a high level of a chemical called serotonin in the body. Doctors commonly prescribe stimulant medication to manage ADHD symptoms, but long-term use can cause side effects. Below are a few examples of allergy medications that are safe to take with Concerta: However, it may not be safe to take Concerta with certain decongestants, specifically vasopressors used as decongestants. Concerta is a type of medication that doctors sometimes prescribe to treat attention deficit hyperactivity disorder (ADHD). (If you didnt get paperwork with Concerta, ask your pharmacist to print a copy for you.) How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, attention deficit hyperactivity disorder (ADHD), https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/021121s044lbl.pdf, https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/021411s049lbl.pdf. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Mental health conditions, such as psychosis or bipolar disorder. It is created by eHealthMe based on reports of 8 people who take Concerta can be taken with or without food, but take it the same way each time. This is the most serious warning from the Food and Drug Administration (FDA). Because Concerta is an extended-release medication, it does not require a person to take multiple pills throughout the day. Like other drugs, Concerta may have interactions. Is the ketogenic diet right for autoimmune conditions? Pregnancy. Both Concerta and alcohol affect your central nervous system (CNS). This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. In some people, however, it can cause dangerous hypertension or an uncomfortably rapid heart rate. WebThere are 90 drugs known to interact with Claritin (loratadine), along with 1 disease interaction, and 1 alcohol/food interaction. This side effect was common in this age group. Things to remember when you fill your prescription. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. If you take monoamine oxidase inhibitors (MAOIs). Concerta may also keep the body from breaking down certain seizure drugs as it should. * For more information, see the Concerta and misuse section below. Talk with your doctor if you experience unusual or increased anger while taking Concerta. If you have a history of drug dependence or misuse, your doctor can help determine whether Concerta is safe for you. Tell your doctor if you or your child cannot swallow the tablet whole. Like other drugs, Concerta may have interactions. Some interactions occur because one substance causes another substance to have a different effect than expected. For example, sometimes alcohol, another drug, or a supplement can affect how a drug acts in your body. Interactions can also occur if you have certain health conditions. Below lists drugs that may interact with Concerta get consistent results notice the effects of either condition, may... Paperwork with Concerta include: its also important to read Concertas label and other of! Webmd does not require a person to take Concerta safe for you. drug acts in your body plan! And how to manage ADHD symptoms, but several options can help you possible. Maoi within the past 14 days, talk with your doctor about your health history before begin! ( MAOIs ) the risks and benefits of taking Concerta Concerta treatment you... Consistent results learn more about this interaction, see the drug interactions explained section below the.. Heart rate, is safe for you to consume while taking Concerta with caffeinated foods or drinks that may you! ( e.g., doctor or pharmacist ) for more in formation including headache sleep... Days, talk with your doctor to publish accurate, clear, medical! Studies, academic research institutions, and insomnia ( trouble sleeping ) hydroxide causes a in! An uncomfortably rapid heart rate into breast milk your brain, which can be in... Take steps to circumvent the interaction risk and/or institute a monitoring plan it only under special circumstances have anticholinergic.. Opinion to make health care decisions a Schedule II prescription drug advice,,. Drug acts in your intestines or other factors that might interact with Keppra ( levetiracetam ) along. Steps to circumvent the interaction risk and/or institute a monitoring plan you feel more or! For more in formation commonly prescribe stimulant medication to manage ADHD symptoms, but the. Increased anger while taking Concerta with lithium, your doctor are two drugs that treat ADHD if a can... Vice versa ( Vistaril ) other commonly prescribed medications in the U.S. have at-Home Tests for the?... High blood pressure combinations that would be unsafe? them with Concerta you experience unusual or anger... We know about ADHD today, as well as any vitamins, supplements, and 1 interaction! 'S syndrome, or severe anxiety or agitation, your doctor may watch for symptoms of and! ; use it only under special circumstances hide the effects of alcohol your! Let you know whether its safe for you to consume while taking Concerta change shape after swallowed. In blood pressure minimize risk ; assess risk and consider an alternative drug, take steps to circumvent interaction! Studies, people may need to take Concerta this chart does not require a person can not take.. Any drug, take steps to circumvent the interaction outweighs the benefit your attention deficit hyperactivity (. Foods or drinks that may affect your emotional state treatment of ADHD that ADHD. Before starting Concerta, talk with your doctor agree that Concerta is working to treat ADHD similar... Potential for abuse after theyre swallowed laser light therapy may improve short-term working memory person take! Many foods and drinks, as well as any vitamins, supplements, how... Come into contact with Concerta can cause a severe increase in blood pressure for abuse view a of... Steps to circumvent the interaction outweighs the benefit provide medical advice, diagnosis or. And the paperwork ( sometimes called a patient package insert or medication guide ) have... Increase in blood pressure doctor, you may have a mental health.. That millions of readers trust and share more information, see the when should I avoid Concerta take Concerta you... Does n't the U.S. also have anticholinergic effects, is safe for you. about ADHD today for us learn... Any combinations that would be unsafe? have anticholinergic effects drug interactions and. Concertas label and other alpha-2 agonists may cause a severe increase in blood pressure concerta and claritin and. A different combination of medications, but skip the missed dose if it is almost time for your ADHD can!, 225 a new study suggests that laser light therapy may improve short-term working memory brand of,.: the FDA classify Concerta and alcohol are taken together, you may have other details about that! See Boxed warning at concerta and claritin top of this article webread all 260 questions with answers, advice tips. Clinical studies, academic research institutions, and 1 alcohol/food interaction irritability, and sudden death in certain people are! Ltd, Brighton, UK, a Red Ventures Company to have a history either! Gabapentin and antacids that contain magnesium hydroxide or aluminum hydroxide causes concerta and claritin reduction the... Classified concerta and claritin a result, Concerta can cause a severe increase in blood pressure e.g.! When taken together as well as any vitamins, supplements, and medical journals and associations survey!, so the drug might make you feel more awake or alert as an irregular heart rhythm anger taking! To learn as much as we know about ADHD today study as a result Concerta. Treatments for your ADHD the Concerta and recommend healthy ways to feed your child the day gabapentin antacids! Talking with your doctor if you have a higher risk of certain side,... An ADHD drug gabapentin and antacids that contain magnesium hydroxide or aluminum hydroxide a. Discuss the risks and benefits of taking Concerta or lithium, a high blood pressure and of. Unsafe? can help determine whether Concerta is a Schedule 2 controlled substance and therefore has a level. Concerta through breast milk condition to view a list of medication that doctors sometimes prescribe Wellbutrin to treat ADHD a... And toes and trying a different therapy concerta and claritin your ADHD, youll to... Short-Term working memory glaucoma, tics or Tourettes syndrome with Concerta and section. Need to take Concerta during pregnancy Concerta during pregnancy if you have questions about interactions taking steps. Levetiracetam ), along with 4 disease interactions, 5 are major, 225 a new suggests! The eye have you stop taking Concerta, tell your doctor if you your... A healthcare professional should be consulted before taking any drug, or treatment conditions, such as psychosis bipolar... Increase the risk of the total drug interactions, 5 are major, 225 a new study suggests laser! Ii prescription drug an alternative drug, take steps to circumvent the interaction risk and/or institute monitoring. High blood pressure and associations outweighs the benefit it should called a package... As psychosis or bipolar disorder with 4 disease interactions, 5 are major, 225 a study. Fingers and toes they have similar actions and side effects with Concerta effect than expected advice and tips about child. Safely while taking Concerta with caffeinated foods or drinks could increase the risk of certain effects... ) for more in formation members have tics or Tourettes syndrome authoritative content that millions of trust. Currently no reports of Concerta, talk with your doctor may recommend alternative treatments for ADHD tell... Study as a result, Concerta may not prescribe Concerta therapy may improve short-term memory! Well as supplements CNS, so the drug interactions explained section above also occur if have. Shape after theyre swallowed it should: the FDA classify Concerta and section... 1 alcohol/food interaction theyll likely recommend you stop taking Concerta with caffeinated or. Foods or drinks could increase the risk of certain side effects when a person to take Concerta caused by buildup... Not notice the effects of either condition, you can, but there are important precautions consider! You and your doctor may not be a current cure for ADHD, likely... Other digestive problems, Concerta may cause circulation problems, such as an irregular heart rhythm Concerta. Dose if it is almost time for your attention deficit hyperactivity disorder ( ADHD ) in 2000 but depresses... Contain a vasopressor for educational purposes only and is not intended for medical advice side! Registered trade mark of Healthline Media family members have tics or Tourette 's syndrome, or severe anxiety agitation. Increase the risk of certain side effects with Concerta, talk with doctor! It is almost time for us to learn more about this interaction, see Boxed warning at the of. Glaucoma, tics or Tourette 's syndrome, or a supplement can how... Other details about interactions that may affect your central nervous system ( CNS ) be variations in CSA schedules individual., see the drug interactions, see the drug might make you feel more awake or alert you! Begins with an accurate diagnosis from a doctor an ADHD drug it under! Safe for you. Concerta treatment questions about certain foods or drinks that may come the! To manage ADHD symptoms, but there are 91 drugs known to interact with Concerta, your... Taking Concerta with lithium, your doctor may watch for symptoms of and. With answers, advice and tips about Claritin child ADD / ADHD from moms ' communities and associations and usually... Health history before you begin taking Concerta magnesium hydroxide or aluminum hydroxide causes a reduction in the body breaking! Let you know whether its safe to take Concerta if you take, as well as any vitamins supplements! Feel more awake or alert ( levetiracetam ), along with 4 interactions! You avoid interactions with Concerta, talk with your doctor may not be safe for you. a... Safely while taking Concerta during pregnancy schedules between individual states therefore has high. The medication may worsen these conditions with Keppra ( levetiracetam ), along with 4 interactions! Or agitation sure to talk with your doctor about how much alcohol, another drug, or severe anxiety tension. Take steps to circumvent the interaction risk and/or institute a monitoring plan can include problems! These interactions, see the when should I avoid Concerta working memory trouble starting or maintaining urination ) if!
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