From the Research
Concerta (Methylphenidate) Absorption in Patients with Gastric Bypass
- The absorption of Concerta (Methylphenidate) may be affected in patients with gastric bypass, particularly those who have undergone Roux-en-Y gastric bypass (RYGB) 1.
- A case study reported that a patient experienced a lack of methylphenidate efficacy after RYGB, which was resolved by using a transdermal patch instead of an oral product 1.
- The study suggests that bariatric surgeries may alter the absorption of orally administered methylphenidate in an unpredictable manner, and close monitoring of therapeutic/toxic effects is recommended 1.
Factors Affecting Methylphenidate Absorption
- The absorption of methylphenidate is affected by the site of release in the gastrointestinal tract, with delayed-release and extended-release formulations exhibiting different pharmacokinetic profiles 2.
- The stability of methylphenidate is compromised under certain pH conditions, with up to 60% of the drug being spontaneously hydrolyzed in the absence of bacteria 3.
- Gut microbiota may also play a role in reducing the bioavailability of methylphenidate, although the exact mechanisms are not fully understood 3.
Clinical Implications
- Patients with gastric bypass, particularly those with RYGB, may require close monitoring of methylphenidate levels and adjustment of dosing regimens to ensure optimal therapeutic effects 1, 4.
- Non-oral formulations of methylphenidate, such as transdermal patches, may be preferred in some patients with gastric bypass to minimize the impact of altered absorption on therapeutic effects 1, 4.