Possible Interaction: Ethanol and Dexmethylphenidate

“Background/Purpose Ethanol coadministered with immediate-release dl-methylphenidate (dl-MPH) or dexmethylphenidate (d-MPH) significantly increases the geomean maximum plasma concentration (Cmax) of d-MPH 22% and 15%, respectively, and elevates overall drug exposure and psychostimulant effects.”

“Administration of the pure isomer d-MPH precludes this absorption phase pharmacokinetic interaction with ethanol.”

“Combining pure d-MPH with ethanol significantly (P < 0.005) increased the area under the effect curves (AUC0–5.25h) of all 5 subscales.”

“These findings provide evidence of a pharmacodynamic component to d-MPH– ethanol synergistic interactions and carry implications for the rational drug individualization in the treatment of attention-deficit/hyperactivity disorder.”

“During the absorption phase of dl-MPH, concomitant ethanol significantly elevated d-MPH plasma concentrations (44–99%; P < 0.005).”

“ Ethanol increased the d-MPH area under the curve (AUC)0-inf by 21% following dl-MPH (P < 0.001) and 14% for d-MPH (P = 0.001).”

“Similarly, ethanol led to the enantioselective formation of l-EPH and to an elevation in d-MPH concentrations with both MTS and oral MPH.”

“Specifically, we asked: (1) will ethanol increase d-MPH biological concentrations, (2) will MTS facilitate the systemic bioavailability of l-MPH, and (3) will l-MPH enantioselectively interact with ethanol to yield l-ethylphenidate (l-EPH)?”