(Date: January 2018. Version: 3)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

What is it?

Methylphenidate (Ritalin®, Concerta XL®, Equasym XL®, Medikinet XL®) is prescribed to treat attention deficit hyperactivity disorder (ADHD), and occasionally for narcolepsy (a rare sleep disorder where affected individuals suddenly fall asleep at inappropriate times throughout the day).

Is it safe to take methylphenidate in pregnancy?

When deciding whether or not to take methylphenidate during pregnancy it is important to weigh up the benefits of its use against the known or possible risks, some of which will depend on how many weeks pregnant you are.

This leaflet summarises the scientific studies relating to the effects of methylphenidate on a baby in the womb. It is advisable to consider this information before taking methylphenidate if you are pregnant. For some women, treatment with methylphenidate in pregnancy may be considered necessary. Your doctor is the best person to help you decide what is right for you and your baby.

What if I have already taken methylphenidate during pregnancy?

If you are taking any medicines it is always a good idea to let your doctor know that you are pregnant so that you can decide together whether you still need the medicines that you are on and to make sure that you are taking the lowest dose that works.

It is very important that you do not suddenly stop taking methylphenidate. Do not make any changes to your medication without first talking to your doctor.

Can taking methylphenidate in pregnancy cause my baby to be born with birth defects?

A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects.

Studies that together include around 3,400 women who took methylphenidate in early pregnancy do not show that their babies have a higher chance of birth defects overall, or of heart defects in general, than babies born to women not taking methylphenidate. Although one study did identify a possible increased chance of a specific, rare type of heart defect called a conotruncal defect following exposure to methylphenidate in early pregnancy, this was based on a small number of affected babies and requires confirmation with further research.

Can taking methylphenidate in pregnancy cause miscarriage?

Studies of around 760 women using methyphenidate in early pregnancy suggest that their chance of having a miscarriage may be up to double that of women not taking methyphenidate. However, research also suggests that women with untreated ADHD may be at increased risk of miscarriage, suggesting that this could be linked to the illness itself rather than to medicine used to treat ADHD. Further research is therefore required to determine whether treatment with methylphenidate in early pregnancy increases the chance of miscarriage.

Can taking methylphenidate in pregnancy cause preterm birth?

Two studies of a total of over 1,800 pregnancies with exposure to methyphenidate did not show an increased risk of preterm delivery compared to pregnancies with no methylphenidate exposure.

Can taking methylphenidate in pregnancy cause my baby to be small at birth (low birth weight)?

Two studies of a total of around 1,700 babies exposed in the womb to methylphenidate do not show that they have a greater chance of being smaller than expected for the stage of pregnancy at delivery compared to babies not exposed to methylphenidate.

Has taking methylphenidate in pregnancy been linked to other health problems in the child?

Withdrawal symptoms at birth (‘neonatal withdrawal’)
Withdrawal symptoms are thought to occur as the newborn baby’s body has to adapt to no longer getting certain types of medicines through the placenta.

Because methylphenidate has not been studied separately, there is no scientific information as to whether taking methylphenidate in pregnancy could cause a baby to experience withdrawal symptoms.

However, because methylphenidate works in a similar way similar to other medicines that are known to cause neonatal withdrawal, close monitoring of your baby for a few days after birth may be advised if you have taken methylphenidate in the weeks before delivery. 

Developmental delay, behavioural and psychological problems
A baby’s brain continues to develop right up until the end of pregnancy. It is therefore possible that taking certain medicines at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.

No studies have been carried out to look at whether there is an increased risk of learning and behavioural problems in children who were exposed to methylphenidate while in the womb.

Will my baby need extra monitoring during pregnancy?

If you have taken methylphenidate around the time of delivery, because of the risk of withdrawal symptoms in the baby, he/she may require extra monitoring after birth.

Are there any risks to my baby if the father has taken methylphenidate?

We would not expect any increased risk to your baby if the father took methylphenidate before or around the time you became pregnant.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from  

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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