Methylphenidate: Difference between revisions

>David Hedlund
unlink methylphenidate
>David Hedlund
Combination with alcohol: {{headerpanel|{{Template:Warning/Alcohol_induced_dose_dumping_(AIDD)}}}}
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===Combination with alcohol===
===Combination with alcohol===
Methylphenidate (when taken orally) has a low bioavailability around 30%. If taken with alcohol (ethanol), blood plasma levels of dexmethylphenidate are increased by up to 40%.<ref>{{cite journal | vauthors=((Patrick, K.)), ((Straughn, A.)), ((Minhinnett, R.)), ((Yeatts, S.)), ((Herrin, A.)), ((DeVane, C.)), ((Malcolm, R.)), ((Janis, G.)), ((Markowitz, J.)) | journal=Clinical pharmacology and therapeutics | title=Influence of Ethanol and Gender on Methylphenidate Pharmacokinetics and Pharmacodynamics | volume=81 | issue=3 | pages=346–353 | date= March 2007 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3188424/ | issn=0009-9236 | doi=10.1038/sj.clpt.6100082}}</ref> A metabolite called [[ethylphenidate]] is also formed.<ref>{{cite journal | vauthors=((Markowitz, J. S.)), ((DeVane, C. L.)), ((Boulton, D. W.)), ((Nahas, Z.)), ((Risch, S. C.)), ((Diamond, F.)), ((Patrick, K. S.)) | journal=Drug Metabolism and Disposition: The Biological Fate of Chemicals | title=Ethylphenidate formation in human subjects after the administration of a single dose of methylphenidate and ethanol | volume=28 | issue=6 | pages=620–624 | date= June 2000 | issn=0090-9556}}</ref>
Methylphenidate (when taken orally) has a low bioavailability around 30%. If taken with alcohol (ethanol), blood plasma levels of dexmethylphenidate are increased by up to 40%.<ref>{{cite journal | vauthors=((Patrick, K.)), ((Straughn, A.)), ((Minhinnett, R.)), ((Yeatts, S.)), ((Herrin, A.)), ((DeVane, C.)), ((Malcolm, R.)), ((Janis, G.)), ((Markowitz, J.)) | journal=Clinical pharmacology and therapeutics | title=Influence of Ethanol and Gender on Methylphenidate Pharmacokinetics and Pharmacodynamics | volume=81 | issue=3 | pages=346–353 | date= March 2007 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3188424/ | issn=0009-9236 | doi=10.1038/sj.clpt.6100082}}</ref> A metabolite called [[ethylphenidate]] is also formed.<ref>{{cite journal | vauthors=((Markowitz, J. S.)), ((DeVane, C. L.)), ((Boulton, D. W.)), ((Nahas, Z.)), ((Risch, S. C.)), ((Diamond, F.)), ((Patrick, K. S.)) | journal=Drug Metabolism and Disposition: The Biological Fate of Chemicals | title=Ethylphenidate formation in human subjects after the administration of a single dose of methylphenidate and ethanol | volume=28 | issue=6 | pages=620–624 | date= June 2000 | issn=0090-9556}}</ref>


====Alcohol induced dose dumping (AIDD)====
====Alcohol induced dose dumping (AIDD)====
This dose dumping effect is an unintended rapid release of large amounts of a given drug, when administered through a modified-release dosage while co-ingesting ethanol.<ref>{{Cite journal | vauthors = D'Souza S, Mayock S, Salt A |date=December 2017 |title=A review of in vivo and in vitro aspects of alcohol-induced dose dumping |journal=AAPS Open |language=en |volume=3 |issue=1 |doi=10.1186/s41120-017-0014-9 |issn=2364-9534|doi-access=free }}</ref> This is considered a pharmaceutical disadvantage due to the high risk of causing drug-induced toxicity by increasing the absorption and serum concentration above the therapeutic window of the drug. The best way to prevent this interaction is by avoiding the co-ingestion of both substances or using specific controlled-release formulations that are resistant to AIDD.
{{headerpanel|{{Template:Warning/Alcohol_induced_dose_dumping_(AIDD)}}}}


In vitro data suggest that some extended-release stimulants may experience dose dumping in the presence of alcohol. This is a concern because the ADHD patient population is at risk for alcohol abuse. The potential for dose dumping when taking extended-release stimulants with alcohol could lead to unintended and dangerous side effects for those with ADHD.<ref>{{cite journal |last1=Jain |first1=R |last2=Stark |first2=JG |title=Safety and efficacy considerations due to misuse of extended-release formulations of stimulant medications. |journal=Postgraduate medicine |date=September 2016 |volume=128 |issue=7 |pages=672-81 |doi=10.1080/00325481.2016.1218259 |pmid=27467139}}</ref>
In vitro data suggest that some extended-release stimulants may experience dose dumping in the presence of alcohol. This is a concern because the ADHD patient population is at risk for alcohol abuse. The potential for dose dumping when taking extended-release stimulants with alcohol could lead to unintended and dangerous side effects for those with ADHD.<ref>{{cite journal |last1=Jain |first1=R |last2=Stark |first2=JG |title=Safety and efficacy considerations due to misuse of extended-release formulations of stimulant medications. |journal=Postgraduate medicine |date=September 2016 |volume=128 |issue=7 |pages=672-81 |doi=10.1080/00325481.2016.1218259 |pmid=27467139}}</ref>