Taking Concerta With Diphenhydramine Or Doxylamine

In our latest question and answer, the pharmacist discusses the use of diphenhydramine or doxylamine with Concerta (methylphenidate).

Taking Concerta With Diphenhydramine Or Doxylamine
May 22, 2018

Emmie asked

I took Concerta this morning and cannot sleep I want to know if it’s safe to take a otc sleeping pill?

Answer

Awake Woman In bedThere is no drug-drug interaction between Concerta (methylphenidate) and over the counter sleep aids such as diphenhydramine and doxylamine. However, they do have opposing effects as Concerta is a stimulant while diphenhydramine and doxylamine are CNS depressants. As such, they should not be used at the same time as they may attenuate the effects of each other. Nevertheless, it isn't a problem to take Concerta in the morning and a sleep aid at night.

Over The Counter Sleep Aids

While there are numerous over the counter sleep aid products (e.g. Unisom, ZzzQuil, Tylenol PM, NyQuil), most of them contain one of two ingredients:

  • Diphenhydramine
  • Doxylamine

Both diphenhydramine and doxylamine are "first-generation" antihistamines and have significant sedative effects, which is why they are used to treat insomnia. They are both relatively short acting and have a duration of action around 4 to 6 hours. 

Diphenhydramine is an active ingredient in Unisom SleepGels, Tylenol PM an ZzzQuil. Doxylamine is an active ingredient in NyQuil and Unisom SleepTabs.

Concerta

Concerta is an extended-release methylphenidate product used for the treatment of ADHD. Concerta uses a "biphasic" release mechanism. After taking by mouth, part of the dose is released immediately, with the rest of the dose gradually released over the next 5 to 9 hours.

If you are having trouble sleeping when you take Concerta, consider taking it early in the morning. If that doesn't help, you should speak with your doctor regarding a dose or medication change as you shouldn't rely on an over the counter sleep aid on a nightly basis. As mentioned above however, intermittent use of a sleep aid that contains diphenhydramine or doxylamine at night is safe if you take Concerta in the morning.

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