Drug Interaction Report

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: Administration of tenapanor immediately before a meal may enhance its effectiveness. In clinical trials, administration of tenapanor 5 to 10 minutes before a meal increased the 24-hour stool sodium excretion compared to taking tenapanor in the fed or fasting state. The resulting higher levels of sodium in the intestine and colon cause an increase in water secretion into the intestinal lumen, which accelerates intestinal transit time and results in a softer stool consistency.

MANAGEMENT: The manufacturer recommends administering tenapanor immediately prior to breakfast or the first meal of the day and immediately prior to dinner.