Drug Interactions between Ritalin LA and tafenoquine

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.

ADJUST DOSING INTERVAL: Food enhances the oral bioavailability of tafenoquine. According to the manufacturer, tafenoquine peak plasma concentration (Cmax) and systemic exposure (AUC) increased by 31% and 41%, respectively, when administered as an investigational capsule formulation with a high-calorie, high-fat meal (approximately 1000 calories; 15% protein, 25% carbohydrate, 60% fat) relative to the fasted state.

MANAGEMENT: Tafenoquine should be administered with food.