View Full Version : methylphenidate and antacids


@tension
07-04-06, 01:39 AM
Hello,
I am on Concerta 54mg plus regular Ritalin. The package insert of the brand name (Novartis) Ritalin that I am taking says it should not be administered together with antacids since these would "substantially reduce the effectiveness of Ritalin".
Now here's my question: It has been often stated that the effect of amphetamine-derived drugs, methyphendiate being one of them, would be increased/prolonged by the classic antacid sodium bicarbonate (aka baking soda).
As these two statements apparently seem to contradict each other, I asked my doc about this and got no basically no conclusive answer.

Given one can safely assume the sodium - amphetamine statement to be true, then sodium bicarbonate would be an exception to the antacids recommendation stated by Novartis?
Or, approaching the Novartis "logic" from the opposite angle: in contrary to the frequently read note that having an overly acidic stomach (be it from certain foods or pathologically) is generally known to accelarate the excretion rate (thus lessening the effectiveness) of MPH, would somebody who suffers from chronic heartburn therefore be able to maintain Ritalin's effectiveness by ditching his/her antacid (non sodium) medication?
This seems even more counterintuitive to me.

No matter how I look at it, it all doesnt seem to make much sense.

Apart from expensive medical abstracts, I have basically looked in every possible corner of the web trying to find a detailed explanation of the Novartis advice, only to return empty handed. All pages that do deal with it merely reiterate this one-liner without offering any underlying details that would give this argument some weight.

I hope somebody can explain to me what point I am missing in this, since I am really at loss here struggling with chronic reflux which I fear could potentially render my ADD medication useless.

thanks in advance

SnappyCloud
07-04-06, 10:13 AM
I did not know acid stomach (and even acid urine) affected the absorbtion od MPH-interesting.

I can tell you I have GERD (and acid urine) and take Prilosec for the former. When I took amphetamine, I noticed variable elimination patterns - I even took baking soda (urine alkalizer) once, achieving a higher concentration of amphetamine; BTW,this is not recommended. My psych new about the stomach acidity eliminating amphetamine faster, but was surprised to learn that acidic urine is also a contributor (my pharmacist did not know about either!).

I don't seem to have the fast elimination problem on MPH, however.

attention
07-05-06, 08:26 AM
Sodium Bicarb ONLY works to prolong METH/AMPHETAMINES life, not Methylphenidate, which when swallowed is poorly absorbed~11%-30% of the drug is absorbed and gets to work-hence the popular abuse, by other methods of admin of Methylphenidate:S.

@tension
07-08-06, 08:08 PM
Sodium Bicarb ONLY works to prolong METH/AMPHETAMINES life, not Methylphenidate...Can you cite a source to back up this statement?

here (http://health.howstuffworks.com/define-methylphenidate.htm) is one of several sources I found claiming that the described sodium bicarb - methylphenidate interaction does exist:
Acetazolamide and sodium bicarbonate can decrease the elimination of methylphenidate from the body, thereby prolonging its action and increasing the risk of side effects.

attention
07-09-06, 07:04 AM
I STAND BY MY STATEMENT.

However looking throught my Rit info fact sheet, systemac biovailability is ONLY 30% (11-51%)-hence it popular admin with other modes of absorbtion-nasal-IV-plugging.

Ritalin is basically the Morphine of oral bioavailability meds~30%-poor.

Thanks

@tension
07-09-06, 08:17 PM
I STAND BY MY STATEMENT.
Ok, if you have come to this conclusion by your own experience, I would be interested in learning some details as to why you think so.

By "not working", do you mean:
a) coadministration of sodium bicarbonate simply has no effect on methylphenidate
b) coadministration of sodium bicarbonate has an attenuating effect on methylphenidate

Which meds (Ritalin, Concerta, etc.) did you make this experience with?
If not taken simultaneously, how far apart was the ingestion of MPH and sodium bicarb?
Doses?