Drug Interactions, Kratom Guides

Is It Safe to Mix Kratom & Methylphenidate (Ritalin)?

Unfortunately, there is little we can definitively say about the interaction between methylphenidate and kratom.

Still, we can make educated guesses about what is likely to occur when attempting to mix kratom and methylphenidate — there’s plenty of scientific literature on the specifics of each compound. Combining these two is high risk because of the multiple ways these two can interact.

Medically reviewed by Dr. Devin Carlson

Last updated 5 months ago by Wade Paul

Is It Safe to Mix Kratom & Methylphenidate (Ritalin)?

Does Kratom Interact With Methylphenidate (Ritalin)?

Methylphenidate and kratom have a high risk of interacting with each other.

First, you have the chance of an agonistic interaction. Methylphenidate has psychoactive properties that can enhance the cognitive capacity of individuals, making it one of the first-line treatments against attention deficit hyperactivity disorder (ADHD).

When consumed in low doses, kratom offers psychoactive benefits that are quite similar. This is not surprising, as both kratom and methylphenidate are central nervous system stimulants. Using these two together can increase the stimulation, which can be dangerous.

However, kratom’s effects begin to alter, and it becomes sedative in more significant amounts, making an antagonistic interaction possible. Kratom could reduce the effects of methylphenidate, which can also be problematic or dangerous depending on why you’re taking it.

Many drugs are also metabolized by the same enzymes, leading to a medication staying in your body longer than it should or building up. In some cases, this can lead to overdose or severe side effects.

Methylphenidate is slightly different from other medications because it’s metabolized by carboxylesterase CES1A1 instead of CYP enzymes like many other drugs, including kratom [1].

The assumption used to be that drugs metabolized by CES1 or CES2 were not likely to cause an interaction with other drugs; however, current research shows that this metabolism plays an important role and could change the outcome [2].

Because of these three possible interactions, it’s best to avoid using kratom and methylphenidate together. Always talk to your doctor before combining them.

Methylphenidate Chart

Drug NameMethylphenidate
Trade NameRitalin, Aptensio, Concerta, Daytrana
ClassificationCNS Stimulant
CYP MetabolismPrimarily metabolized by CES1A1
Interaction With KratomAntagonistic, agonistic
Risk of InteractionHigh

Is it Safe to Take Kratom With Methylphenidate (Ritalin)?

No, kratom and stimulants shouldn’t be used together — there’s too high a risk of a drug interaction.

These two are relatively safe on their own, but increasing or decreasing the effects of methylphenidate, along with the uncertainty of how metabolism comes into play, makes it a dangerous mix.

What is Methylphenidate?

Methylphenidate is the drug more commonly known as Ritalin. It is classified as a central nervous system stimulant and only available as a prescription medication.

Methylphenidate is available for consumption in different preparations and in various forms, such as instant-release or extended-release. The precise mechanisms through which methylphenidate acts on the body are not entirely understood.

The FDA has classified methylphenidate as a Schedule II drug, which means it has a high potential for abuse, leading to physical or psychological dependence.

What is Methylphenidate Used for?

Methylphenidate has been approved as a prescription treatment for attention deficit disorder (ADD) and narcolepsy.

Around 70% of those who use methylphenidate see an improvement in their ADD symptoms [3]. There’s also evidence to suggest that children with ADD improve their lives significantly when treated with stimulants.

Nevertheless, there’s also counter-evidence that draws the efficacy of methylphenidate as a treatment for ADD and ADHD into question, arguing in part that ADD symptoms are over-diagnosed in the US [4].

Stimulants such as methylphenidate treat narcolepsy as they can improve measures of drowsiness and other related factors [5]. Narcolepsy is a sleep disorder that causes overwhelming drowsiness and sleep.

There are also several off-label uses for methylphenidate:

  • It’s used in treatment-resistant cases of bipolar disorder and major depressive disorder [6]
  • It may improve depression symptoms in stroke, cancer, and HIV patients [7]
  • Methylphenidate has been used to counter opioid-induced tiredness in cancer patients

What’s the Dose of Methylphenidate?

You should never trust generalized dosage recommendations over your doctor’s prescription when it comes to prescription medication.

Proper dosage will always differ according to several factors. The medicine comes in 5, 10, and 20 mg tablets for oral administration. Kids commonly start with 5 mg twice daily, increased if needed. Adults take 20-30 mg two or three times a day. Neither group should take more than 60 mg a day.

Methylphenidate’s duration of action varies:

  • Instant-release: 2-4 hours
  • Sustained-release: 3-8 hours
  • Extended-release: 8-12 hours

Finally, contrary to popular belief, taking methylphenidate with a meal might actually speed up absorption [8].

Generic & Brand Name Versions

Methylphenidate is available under the following brand names:

  • Ritalin
  • Ritalin SR
  • Ritalin LA
  • Aptensio XR
  • Concerta
  • Daytrana
  • Metadate
  • Metadate CD
  • Metadate ER
  • Methlyn
  • Quillivant XR
  • QuilliChew Er

What Are the Side Effects of Methylphenidate

Methylphenidate — like all other prescription drugs — can cause side effects. It can also cause fatalities, which is unlikely if you take proper care, though overdose is common [9].

The most common side effects for methylphenidate are [10]:

  • Appetite loss
  • Dry mouth
  • Anxiety
  • Nausea
  • Insomnia
  • Abdominal pain
  • Weight loss
  • Akathisia
  • Irritability
  • Dyskinesia
  • Lethargy
  • Palpitations
  • Changes in blood pressure
  • Tachycardia

According to the FDA, there is also potential for more serious adverse effects like:

  • Sudden cardiovascular events
  • Emergence of manic symptoms
  • Priapism
  • Stroke
  • Myocardial infarctions

Additionally, it is known that methylphenidate has considerable addiction potential. People popularly use it without a prescription for off-label uses such as studying. There are also several reports of people ingesting acute doses for recreational purposes.

What is Kratom?

Kratom is an all-natural psychoactive substance that has recently been making waves in the United States due to its ability to reduce pain and provide energy.

It is derived from the leaves of a tropical evergreen tree known as the Mitragyna speciosa — a species native to several countries in Southeast Asia. Indigenous people there have been harvesting and using the kratom plant’s benefits for centuries.

Kratom has seen some bad headlines because — like the vast majority of drugs — it does have the potential for harm stemming from misuse, like physical dependence.

Still, we must recognize that kratom’s potential downsides far outweigh those of “traditional” medications like pharmacological opioids or pain killers. 

What is Kratom Used for?

Kratom has become a popular treatment for an expanding list of ailments.

In treating illness, kratom has shown great promise as a herbal pain relief option. Many people who suffer chronic pain have abandoned their pain killers in favor of kratom.

Kratom also has anti-anxiety properties and can promote generalized feelings of calm and relaxation. You can even use it for sleep support.

It might seem strange, but kratom has a whole other side of benefits that can stimulate mental energy. Kratom acts on the CNS and can promote increased focus and creativity and generate euphoric feelings.

Other kratom treatments for weight loss and withdrawal symptoms are being explored.

What’s the Dose of Kratom?

The optimal dose of kratom depends on several factors such as body weight, age, method of consumption, treatment goals, etc.

Consequently, you should be a little skeptical of any formulaic dosage prescriptions you find on the internet. The smart choice is always to go slow, listen to your body, especially if you’re experimenting with a new combination, and always start with small amounts.

With that said, here are the generally recommended dosages for kratom:

  • Low dose — (1-4 grams)
  • Medium dose — (4-8 grams)
  • High dose — (8-12 grams)

It is also important to note that kratom’s effects are highly dependent on the dosage consumed.

Low doses produce the stimulant, nootropic benefits of kratom, while — on the other hand — medium to high doses bring out the analgesic, anxiolytic side.

Related: How Long Should I Wait Between Kratom Doses?

What Are the Side Effects of Kratom?

Kratom has the potential to cause adverse effects.

Thankfully, these effects are usually mild, and they can be easily managed if one scales back their kratom consumption.

The side effects of kratom are:

  • Constipation
  • Dizziness
  • Insomnia
  • Itchiness in the skin
  • Loss of muscle coordination
  • Low blood pressure
  • Low libido
  • Nausea
  • Poor appetite
  • Seizures
  • Tremors

If you need to keep increasing amounts of kratom to produce a reaction, you’re probably developing physical dependence.

If you’re taking kratom every day, you should learn to spot the signs of kratom addiction and know what to do about it: moderation is key.

What Are the Different Types of Kratom?

Kratom comes in three primary strain “types” and one subcategory.

These strains are named after the color of the kratom leaf’s vein. Once they are processed, though, they all look the same.

The strains aren’t the only differentiating factor — where the kratom grows is also significant, as different types of soil composition can affect the plant.

This is why — for example — you’ll typically see a kratom strain having a name like ‘White Papua Kratom.’ ‘White’ refers to the strain and ‘Papua’ to the region in Southeast Asia where the kratom was grown. 

A) White Vein Kratom

White vein kratom is hands-down the best strain option if you’re looking to emphasize the stimulant, nootropic benefits of the kratom plant. It’s perfect for anyone who wants to boost their mental performance.

B) Red Vein Kratom

Red vein kratom can help treat chronic pain or anxiety. This strain produces the effects associated with a mid-to-high kratom dosage: analgesia, anxiety relief, and relaxation.

C) Green Vein Kratom

If you’re unsure what type of experience you want, then green vein kratom is probably your best option. Green-veined strains produce a healthy balance of the effects found in both white and red strains. Think of it as the ‘middle point’ between the two.

D) Yellow Vein Kratom

Yellow vein kratom is the mysterious subcategory of kratom strains. This is because the yellow vein is actually a combination of red and white.

Yellow vein strains are almost identical to green vein kratom, except for the fact that it is much milder, making this strain an excellent choice for beginners.

Key Takeaways: Is it Safe to Mix Kratom & Methylphenidate (Ritalin)?

Kratom and methylphenidate should not be used together. If you want to try them both, never do so without guidance from your doctor.

Kratom’s unique ability to act as both stimulant and sedative makes agonistic and antagonistic interactions possible. Methylphenidate’s metabolism could cause other unknown problems. It’s best to keep these separate.

References

  1. Sun, Z., Murry, D. J., Sanghani, S. P., Davis, W. I., Kedishvili, N. Y., Zou, Q., … & Bosron, W. F. (2004). Methylphenidate is stereoselectively hydrolyzed by human carboxylesterase CES1A1. Journal of Pharmacology and Experimental Therapeutics, 310(2), 469-476.
  2. Casey Laizure, S., Herring, V., Hu, Z., Witbrodt, K., & Parker, R. B. (2013). The role of human carboxylesterases in drug metabolism: have we overlooked their importance?. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 33(2), 210-222.
  3. Greenhill, L. L., Pliszka, S., & Dulcan, M. K. (2002). Practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults. Journal of the American Academy of Child & Adolescent Psychiatry, 41(2), 26S-49S.
  4. Storebø, O. J., Ramstad, E., Krogh, H. B., Nilausen, T. D., Skoog, M., Holmskov, M., … & Gluud, C. (2015). Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). Cochrane Database of Systematic Reviews, (11).
  5. Mitler, M. M. (1994). Evaluation of treatment with stimulants in narcolepsy. Sleep, 17(suppl_8), S103-S106.
  6. Dell’Osso, B., Dobrea, C., Cremaschi, L., Arici, C., & Altamura, A. C. (2014). Wake-promoting pharmacotherapy for psychiatric disorders. Current psychiatry reports, 16(12), 524.
  7. Leonard, B. E., McCartan, D., White, J., & King, D. J. (2004). Methylphenidate: a review of its neuropharmacological, neuropsychological and adverse clinical effects. Human Psychopharmacology: Clinical and Experimental.
  8. Chan, Y. P., Swanson, J. M., Soldin, S. S., Thiessen, J. J., Macleod, S. M., & Logan, W. (1983). Methylphenidate hydrochloride given with or before breakfast: II. Effects on plasma concentration of methylphenidate and ritalinic acid. Pediatrics, 72(1), 56-59.
  9. Spiller, H. A., Hays, H. L., & Aleguas, A. (2013). Overdose of drugs for attention-deficit hyperactivity disorder: clinical presentation, mechanisms of toxicity, and management. CNS drugs, 27(7), 531-543.
  10. Verghese, C., & Abdijadid, S. (2021). Methylphenidate. StatPearls [Internet].