Learn which medications and substances interact with Quillichew ER, including dangerous combinations to avoid and what to tell your doctor before starting.
Quillichew ER (methylphenidate extended-release chewable tablets) is a powerful medication that affects brain chemistry. When combined with certain other drugs, the effects can be unpredictable — and sometimes dangerous.
Understanding these interactions isn't just helpful; it could be lifesaving. This guide covers every major interaction you should know about.
If you're new to this medication, start with our overview of what Quillichew ER is and how it works.
This is the most dangerous interaction. Do not take Quillichew ER if you are currently using or have used an MAOI within the past 14 days.
MAOIs include:
Why it's dangerous: MAOIs prevent the breakdown of dopamine and norepinephrine. Quillichew ER blocks the reuptake of these same neurotransmitters. The combination can cause a hypertensive crisis — a sudden, severe spike in blood pressure that can lead to stroke, organ damage, or death.
Quillichew ER can raise blood pressure and heart rate. If you're taking medication to lower your blood pressure, Quillichew ER may reduce its effectiveness. Medications affected include:
Your doctor may need to adjust your blood pressure medication doses while you're on Quillichew ER.
Medications that raise blood pressure (like epinephrine, norepinephrine, or dopamine used in emergency settings) can have amplified effects when combined with Quillichew ER. Make sure any emergency medical team knows you take this medication.
Quillichew ER may slow down the metabolism of blood thinners like warfarin (Coumadin). This can increase the blood thinner's effect, raising the risk of bleeding. If you take warfarin, your doctor should monitor your INR (blood clotting levels) more closely after starting Quillichew ER.
Methylphenidate may affect how your body processes seizure medications, including:
Blood levels of these medications may increase, potentially leading to toxicity. Your doctor should monitor seizure medication levels if you start Quillichew ER.
Quillichew ER can inhibit the metabolism of tricyclic antidepressants (TCAs) like:
This can raise TCA blood levels and increase the risk of side effects like dry mouth, constipation, heart rhythm changes, and sedation.
If you're scheduled for surgery, tell your anesthesiologist that you take Quillichew ER. Combining it with halogenated anesthetics (like sevoflurane or desflurane) can cause a sudden increase in blood pressure during surgery. Your doctor may ask you to stop Quillichew ER before the procedure.
While not a formal drug interaction listed in the prescribing information, combining Quillichew ER with other stimulants — including high doses of caffeine — can increase side effects like:
If your child drinks energy drinks or you consume a lot of coffee, discuss this with your doctor.
Alcohol should be used with caution. While there is no specific interaction listed, alcohol can affect judgment and behavior, and combining it with a stimulant may mask the signs of intoxication, leading to dangerous situations.
Always tell your doctor about supplements and OTC medications, including:
Before your first prescription, make sure your doctor knows about:
For tips on finding the right prescriber, see our guide on finding a doctor who prescribes Quillichew ER.
Don't panic, and don't stop any medication on your own. Many of these interactions can be managed with:
Your doctor and pharmacist are your best resources. If you have concerns about a specific combination, bring it up at your next appointment.
If side effects from an interaction are bothering you, read our guide on managing Quillichew ER side effects.
Drug interactions are important, but so is actually getting your medication. If you're having trouble finding Quillichew ER due to the ongoing shortage, use MedFinder to check pharmacy stock online.
And if cost is a concern, don't miss our guide on saving money on Quillichew ER — including programs that can bring your co-pay down to as little as $25.
You focus on staying healthy. We'll handle the rest.
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