Drug Interactions between dexmethylphenidate / serdexmethylphenidate and ioflupane I 123

MONITOR: Drugs that bind to the dopamine transporter with high affinity may interfere with the image obtained using ioflupane I-123, which also binds to the dopamine transporter. These drugs include amoxapine, amphetamine, benztropine, bupropion, buspirone, cocaine, diethylpropion, ketamine, mazindol, methamphetamine, methylphenidate, modafinil, pemoline, phencyclidine (PCP), phentermine, phenylpropanolamine, pipradrol, selegiline, sertraline, and trihexyphenidyl. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) may increase or decrease ioflupane binding to the dopamine transporter. Whether discontinuation of these drugs prior to ioflupane I-123 administration may help to minimize potential interference is unknown.

MANAGEMENT: Clinicians using ioflupane I-123 should be aware of possible diagnostic interference by drugs that can compete for binding to the dopamine transporter.

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.

MONITOR: Drugs that bind to the dopamine transporter with high affinity may interfere with the image obtained using ioflupane I-123, which also binds to the dopamine transporter. These drugs include amoxapine, amphetamine, benztropine, bupropion, buspirone, cocaine, diethylpropion, ketamine, mazindol, methamphetamine, methylphenidate, modafinil, pemoline, phencyclidine (PCP), phentermine, phenylpropanolamine, pipradrol, selegiline, sertraline, and trihexyphenidyl. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) may increase or decrease ioflupane binding to the dopamine transporter. Whether discontinuation of these drugs prior to ioflupane I-123 administration may help to minimize potential interference is unknown.

MANAGEMENT: Clinicians using ioflupane I-123 should be aware of possible diagnostic interference by drugs that can compete for binding to the dopamine transporter.