Boxed warning (abuse, misuse, and addiction): Ritalin has a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CNS stimulants, including Ritalin, can result in overdose and death, and this risk is increased with higher doses or unapproved methods of administration, such as snorting or injection. • Risks to Patients with Serious Cardiac Disease: Avoid use in patients with known structural cardiac abnormalities, cardiomyopathy, serious cardiac arrhythmias, coronary artery disease, or other serious cardiac disease. • Increased Blood Pressure and Heart Rate: Monitor blood pressure and pulse. • Psychiatric Adverse Reactions: Prior to initiating Ritalin, screen patients for risk factors for developing a manic episode. If new psychotic or manic symptoms occur, consider discontinuing Ritalin.