TY - JOUR
T1 - Impaired oral absorption of methylphenidate after Roux-en-Y gastric bypass
AU - Azran, Carmil
AU - Langguth, Peter
AU - Dahan, Arik
N1 - Publisher Copyright:
© 2017 American Society for Bariatric Surgery
PY - 2017/7/1
Y1 - 2017/7/1
N2 - The anatomic and physiologic changes in the gastrointestinal (GI) tract after bariatric surgery may significantly affect the pharmacokinetics of medications taken by the patients for various reasons. Unfortunately, there is little information regarding changes in drug absorption after bariatric surgeries, limiting the ability of medical professionals to produce clear recommendations on what changes should be made to the formulations and dosing regimens of drugs after bariatric surgery. In this article, we report and analyze a case of 52-year-old male patient with morbid obesity and attention-deficit/hyperactivity disorder (ADHD) who experienced lack of methylphenidate efficacy after Roux en-Y gastric bypass (RYGB), which was eventually resolved by using the transdermal patch instead of an oral product. Interestingly, in the same patient, a prior gastric band had no effect on the drug's efficacy. Especially in light of a recent case report of methylphenidate toxicity after RYGB, these 2 cases suggest that bariatric surgeries may alter the absorption of orally administered methylphenidate in an unpredictable manner; hence, it is prudent to closely monitor the therapeutic/toxic effects of methylphenidate after bariatric surgery, and to be aware of nonoral treatment options of this medication.
AB - The anatomic and physiologic changes in the gastrointestinal (GI) tract after bariatric surgery may significantly affect the pharmacokinetics of medications taken by the patients for various reasons. Unfortunately, there is little information regarding changes in drug absorption after bariatric surgeries, limiting the ability of medical professionals to produce clear recommendations on what changes should be made to the formulations and dosing regimens of drugs after bariatric surgery. In this article, we report and analyze a case of 52-year-old male patient with morbid obesity and attention-deficit/hyperactivity disorder (ADHD) who experienced lack of methylphenidate efficacy after Roux en-Y gastric bypass (RYGB), which was eventually resolved by using the transdermal patch instead of an oral product. Interestingly, in the same patient, a prior gastric band had no effect on the drug's efficacy. Especially in light of a recent case report of methylphenidate toxicity after RYGB, these 2 cases suggest that bariatric surgeries may alter the absorption of orally administered methylphenidate in an unpredictable manner; hence, it is prudent to closely monitor the therapeutic/toxic effects of methylphenidate after bariatric surgery, and to be aware of nonoral treatment options of this medication.
KW - ADHD
KW - Bariatric Surgery
KW - Drug absorption
KW - Methylphenidate
KW - Obesity
KW - Oral drug administration
KW - Roux-en-Y gastric bypass
UR - http://www.scopus.com/inward/record.url?scp=85017566022&partnerID=8YFLogxK
U2 - 10.1016/j.soard.2017.03.003
DO - 10.1016/j.soard.2017.03.003
M3 - Review article
AN - SCOPUS:85017566022
SN - 1550-7289
VL - 13
SP - 1245
EP - 1247
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
IS - 7
ER -