What happens if i start of with 54 mg of concerta ?

It depends.: The starting dose of Concerta depends on what other meds you are taking, and how you have been treated until that point. Without knowing this, it is hard to say. Start at the dose your doctor (who knows you better than we do) prescribed, if you are having problems with that dose, let your doc know and adjustments can then be made if necessary.

Concerta: Hi, why do you want to take Concerta? Is it for ADHD? if that so you need to take it under close supervision of an experienced Psychiatrists due to numerous and dangerous side effect of medication including: high blood pressure and therefore heart attack and Stroke, Arrhythmia and etc.

May be too strong: If you have not started with a lower dose and built up to 54 mg, you may find the dose too strong. In that case you may experience a racing heart rate, high blood pressure, headache or restlessness. Speak to your prescriber about how to determine the appropriate dose.