DDInter542 DDInter1189
Dicoumarol is an oral anticoagulant agent that works by interfering with the metabolism of vitamin K. In addition to its clinical use, it is also used in biochemical experiments as an inhibitor of reductases.
Methylphenidate is a central nervous system stimulant used most commonly in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) and for narcolepsy. Also known as the marketed products Ritalin, Concerta, or Biphentin, methylphenidate is used with other treatment modalities (psychological, educational, cognitive behaviour therapy, etc) to improve the following group of developmentally inappropriate symptoms associated with ADHD: moderate-to-severe distractibility, short attention span, hyperactivity, emotional lability, and impulsivity. Long-acting formulations of psychostimulants such as methylphenidate, , and are considered the most effective and widely used treatment for ADHD, and are considered first-line options for children, adolescents, and adults as recommended by CADDRA (Canadian ADHD Resource Alliance). CADDRA recommends the use of methylphenidate due to long term studies, of over twenty years in duration, which show methylphenidate is safe and effective. While its exact mechanism is unclear, methylphenidate (MPH) has been shown to act as a norepinephrine and dopamine reuptake inhibitor (NDRI), thereby increasing the presence of these neurotransmitters in the extraneuronal space and prolonging their action. There is a dose-related effect of psychostimulants on receptor stimulation, where higher doses are shown to increase norepinephrine (NE) and dopamine (DA) efflux throughout the brain which can result in impaired cognition and locomotor-activating effects. In contrast, low doses are found to selectively activate NE and DA neurotransmission within the prefrontal cortex which is an area of the brain thought to play a prominent role in ADHD pathophysiology, thereby improving clinical efficacy and preventing side effects. The lower doses used to treat ADHD are not associated with the locomotor-activating effects associated with higher doses and instead reduce movement, impulsivity, and increase cognitive function including sustained attention and working memory.[A177541, A177544] Methylphenidate's beneficial effects in sustaining attention have also been shown to be mediated by alpha-1 adrenergic receptor activity. Clinical findings have shown that children with ADHD have an abnormality in the dopamine transporter gene (DAT1), the D4 receptor gene (DRD-4), and/or the D2 receptor gene that may be at least partly overcome by the dopaminergic effects of methylphenidate, suggesting a possible mode of action. When provided as Biphentin®, methylphenidate is released through a multi-layer release delivery system (MLRTM) where 40% of the dose is provided as an immediate release and 60% is provided through a gradual release. Biphentin was designed to be an alternative to separate doses of immediate-release (IR) methylphenidate by providing a biphasic concentration-time profile when given as a single dose. The MLRTM release system allows for a sustained effect for 10-12 hours, allowing for once-daily dosing that covers the major times that ADHD impairment might occur (such as school, homework periods, during the work day, etc). When provided as Concerta®, methylphenidate is released through the patented Osmotic Controlled-Release Oral Delivery (OROS) system where 22% of the dose is provided as an immediate release and 78% is provided through a gradual release. OROS is comprised of an osmotically active trilayer core surrounded by a semipermeable membrane with an immediate-release drug overcoat. Within an aqueous environment, such as the stomach, the drug overcoat, which consists of 22% of the dose, dissolves within one hour, providing an initial immediate-release formulation of methylphenidate. Water then permeates through the membrane into the tablet core where the osmotically active polymer excipients expand, allowing methylphenidate to release slowly through the orifice over a period of 6-7 hours. Concerta also provides a sustained 10-12 hour effect, allowing for once-daily dosing. Methylphenidate contains a blackbox warning stating that CNS stimulants, including methylphenidate-containing products and amphetamines, have a high potential for abuse and dependence. This abuse potential is likely related to the effects associated with higher doses of methylphenidate, which induce surface expression of the dopamine transporter (DAT). In particular, increased dopamine in key brain areas is associated with the reinforcing and addictive properties of psychostimulants such as methylphenidate, and even amplifies the potency and reinforcing effects of other drugs of abuse such as amphetamines, making ADHD sufferers more susceptible to their addictive effects. Concerns about abuse potential have spurred research into medications with fewer effects on DAT and the use of non-stimulant ADHD medications including and .
Dicoumarol {u} (Compound) resembles {v} (Compound) Warfarin
Warfarin {u} may cause a minor interaction that can limit clinical effects when taken with {v} Methylphenidate
Dicoumarol {u} (Compound) resembles {v} (Compound) Phenprocoumon
Phenprocoumon {u} (Compound) resembles {v} (Compound) Warfarin
Warfarin {u} may cause a minor interaction that can limit clinical effects when taken with {v} Methylphenidate
Dicoumarol {u} (Compound) resembles {v} (Compound) Warfarin
Warfarin {u} may cause a minor interaction that can limit clinical effects when taken with {v} Dexmethylphenidate
Dexmethylphenidate {u} (Compound) resembles {v} (Compound) Methylphenidate
Dicoumarol {u} (Compound) resembles {v} (Compound) Warfarin
Warfarin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Doxepin
Doxepin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Methylphenidate
Dicoumarol {u} (Compound) binds {v} (Gene) CYP2C9
CYP2C9 {u} (Gene) is bound by {v} (Compound) Formoterol
Formoterol {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Methylphenidate
Dicoumarol {u} (Compound) resembles {v} (Compound) Acenocoumarol
Acenocoumarol {u} (Compound) causes {v} (Side Effect) Vomiting
Vomiting {u} (Side Effect) is caused by {v} (Compound) Methylphenidate
Dicoumarol {u} (Compound) resembles {v} (Compound) Warfarin
Warfarin {u} may cause a minor interaction that can limit clinical effects when taken with {v} Procarbazine
Procarbazine {u} may lead to a major life threatening interaction when taken with {v} Methylphenidate
Dicoumarol {u} (Compound) binds {v} (Gene) CRYZ
CRYZ {u} (Gene) is downregulated by {v} (Compound) Bupropion
Bupropion {u} may lead to a major life threatening interaction when taken with {v} Methylphenidate
Dicoumarol {u} (Compound) binds {v} (Gene) CYP2C9
CYP2C9 {u} (Gene) is bound by {v} (Compound) Warfarin
Warfarin {u} may cause a minor interaction that can limit clinical effects when taken with {v} Methylphenidate
Dicoumarol {u} (Compound) resembles {v} (Compound) Warfarin
Warfarin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Bupropion
Bupropion {u} may lead to a major life threatening interaction when taken with {v} Methylphenidate
Dicoumarol (Compound) resembles Warfarin (Compound) and Warfarin may cause a minor interaction that can limit clinical effects when taken with Methylphenidate
Dicoumarol (Compound) resembles Phenprocoumon (Compound) and Phenprocoumon (Compound) resembles Warfarin (Compound) and Warfarin may cause a minor interaction that can limit clinical effects when taken with Methylphenidate
Dicoumarol (Compound) resembles Warfarin (Compound) and Warfarin may cause a minor interaction that can limit clinical effects when taken with Dexmethylphenidate and Dexmethylphenidate (Compound) resembles Methylphenidate (Compound)
Dicoumarol (Compound) resembles Warfarin (Compound) and Warfarin may cause a moderate interaction that could exacerbate diseases when taken with Doxepin and Doxepin may cause a moderate interaction that could exacerbate diseases when taken with Methylphenidate
Dicoumarol (Compound) binds CYP2C9 (Gene) and CYP2C9 (Gene) is bound by Formoterol (Compound) and Formoterol may cause a moderate interaction that could exacerbate diseases when taken with Methylphenidate
Dicoumarol (Compound) resembles Acenocoumarol (Compound) and Acenocoumarol (Compound) causes Vomiting (Side Effect) and Vomiting (Side Effect) is caused by Methylphenidate (Compound)
Dicoumarol (Compound) resembles Warfarin (Compound) and Warfarin may cause a minor interaction that can limit clinical effects when taken with Procarbazine and Procarbazine may lead to a major life threatening interaction when taken with Methylphenidate
Dicoumarol (Compound) binds CRYZ (Gene) and CRYZ (Gene) is downregulated by Bupropion (Compound) and Bupropion may lead to a major life threatening interaction when taken with Methylphenidate
Dicoumarol (Compound) binds CYP2C9 (Gene) and CYP2C9 (Gene) is bound by Warfarin (Compound) and Warfarin may cause a minor interaction that can limit clinical effects when taken with Methylphenidate
Dicoumarol (Compound) resembles Warfarin (Compound) and Warfarin may cause a moderate interaction that could exacerbate diseases when taken with Bupropion and Bupropion may lead to a major life threatening interaction when taken with Methylphenidate