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ФАРМАКОЛОГИЧЕСКАЯ СОВМЕСТИМОСТЬ

Response to methylphenidate

Methylphenidate (MPH) is a central nervous system psychostimulant drug used to treat attention deficit hyperactivity disorder (ADHD) in both adults and children. Furthermore, it is also used to treat narcolepsy.

ACTION MECHANISM

Methylphenidate blocks the reuptake of norepinephrine and dopamine in the presynaptic neuron and increases the release of these monoamines to the extraneuronal space. It is believed that methylphenidate increases synaptic levels of dopamine by inhibiting the dopamine transporter (DAT).

CONTRAINDICATIONS

Methylphenidate is contraindicated in patients who present: Hypersensitivity to this drug, glaucoma, pheochromocytoma or hyperthyroidism.

It is contraindicated in patients who are being treated with MAOIs and during 14 days after stopping this treatment.

Methylphenidate is also contraindicated in patients with a diagnosis or history of severe depression, anorexia nervosa, psychotic symptoms, suicidal tendencies, severe mood disorders, mania, schizophrenia, psychopathic personality disorder, severe and episodic bipolar disorder.
Contraindicated also in patients suffering from pre-existing cardiovascular disorders including severe hypertension, heart failure, occlusive arterial disease, angina, congenital heart disease, cardiomyopathies, myocardial infarction, arrhythmias, channelopathies; pre-existing cerebrovascular disorders; brain aneurysm; vascular abnormalities including vasculitis or stroke.

It should also not be prescribed in individuals with a history of pronounced stomach inactivity with pH values> 5.5 under treatment with H2 receptor blockers or antacid treatment.

PHARMACOLOGICAL INTERACTIONS

There may be an increase in blood pressure if methylphenidate is taken concomitantly with vasopressors and halogenated anesthetics.
Methylphenidate inhibits the metabolism of coumarin anticoagulants, phenobarbital, phenytoin, primidone, tricyclic antidepressants, and serotonin reuptake inhibitors.

Methylphenidate reduces the effectiveness of: antihypertensive drugs.
Caution should be exercised when prescribing methylphenidate together with dopaminergic drugs including antipsychotics and drugs that increase blood pressure.

SIDE EFFECTS

Some of these side effects can occur when you are taking methylphenidate.
Nasopharyngitis, sinusitis, infection of the upper part of the respiratory tract; anorexia, decreased appetite, moderate reduction in weight and height gain (long-term use in children); insomnia, nervousness, tics, aggressiveness, anxiety, emotional lability, agitation, depression, abnormal behavior, irritability, mood swings; headache, dizziness, dyskinesia, psychomotor hyperactivity, somnolence, paraesthesia, tension headache; arrhythmia, tachycardia, palpitations; arterial hypertension; cough, pharyngolaryngeal pain; abdominal pain, vomiting, nausea, diarrhea, gastric upset, dry mouth, dyspepsia; alopecia, pruritus, rash, hives; arthralgia, muscle tension, muscle spasms; irritability, pyrexia, growth retardation (prolonged use in children); weight loss; changes in blood pressure and heart rate; accommodation disorders; vertigo; increased alanine aminotransferase levels; priapism.

BRAND NAMES

Adhansia XR®
Aptensio XR®
Concerta®
Cotempla® XR-ODT
Jornay PM®
Metadato® CD
Metadato® ER¶
Metilina®
Metilina® ER¶
Quillichew® ER

GENE OR REGION STUDIED


  • ABCB1
  • TH
  • ADGRL3
  • CES1
  • COMT
  • DRD1

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