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Drug Interactions between Cotempla XR-ODT and isoflurane

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

isoflurane methylphenidate

Applies to: isoflurane and Cotempla XR-ODT (methylphenidate)

GENERALLY AVOID: The administration of volatile general anesthetics during therapy with indirect-acting sympathomimetics (e.g. methylphenidate, ephedrine) or their derivatives may increase the risk of hypertension and/or cardiac arrhythmias. The proposed mechanism is anesthetic-induced myocardial sensitization to the stimulation caused by sympathomimetics.

MANAGEMENT: Until more information is available, caution is advisable if volatile general anesthetics are administered concomitantly with indirect-acting sympathomimetics or any of their derivatives. If the combination is required, dosage adjustments are recommended, and the patient's hemodynamic status should be closely monitored. When surgery is planned, it is recommended that indirect-acting sympathomimetics or their derivatives be discontinued prior to the day of surgery. Prescribing information for individual products should be consulted.

References (8)
  1. (2001) "Product Information. Ritalin (methylphenidate)." Novartis Pharmaceuticals
  2. (2022) "Product Information. Metadate CD (methylphenidate)." Celltech Pharmaceuticals Inc
  3. (2001) "Product Information. Focalin (dexmethylphenidate)." Mikart Inc
  4. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  5. Cerner Multum, Inc. "Australian Product Information."
  6. (2013) "Product Information. Ritalin LA (methylphenidate)." Quality Care Products/Lake Erie Medical
  7. (2021) "Product Information. Azstarys (dexmethylphenidate-serdexmethylphenidate)." Corium, Inc.
  8. (2019) "Product Information. Isoflurane (isoflurane)." Piramal Critical Care Ltd

Drug and food interactions

Moderate

methylphenidate food

Applies to: Cotempla XR-ODT (methylphenidate)

GENERALLY AVOID: Alcohol may exacerbate the adverse central nervous system effects of psychoactive drugs, including methylphenidate.

GENERALLY AVOID: Consumption of alcohol while taking certain sustained-release formulations of methylphenidate may cause rapid release of the drug, resulting in increased systemic levels of methylphenidate. In vitro studies have been conducted using Metadate CD 60 mg and Ritalin LA 40 mg capsules, as well as Concerta 18 mg tablet. At an alcohol concentration of 40%, an increase in the release rate of methylphenidate was observed in the first hour for Metadate CD and Ritalin LA, resulting in 84% and 98% of the methylphenidate being released, respectively. In contrast, there was no increased release of methylphenidate in the first hour for Concerta. These results are considered to be representative of the other available strengths of the corresponding product.

MANAGEMENT: Patients treated with methylphenidate should be advised to avoid alcohol or medications that contain alcohol.

References (3)
  1. (2022) "Product Information. Metadate CD (methylphenidate)." Celltech Pharmaceuticals Inc
  2. (2002) "Product Information. Concerta (methylphenidate)." Alza
  3. (2013) "Product Information. Ritalin LA (methylphenidate)." Quality Care Products/Lake Erie Medical

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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