Effects of Application to Two Different Skin Sites on the Pharmacokinetics of Transdermal Methylphenidate in Pediatric Patients with Attention-Deficit/Hyperactivity Disorder

González, Mario A.; Campbell, Dawn; Rubin, Jonathan

doi:10.1089/cap.2008.0081

Cited by 14 publications

(14 citation statements)

References 15 publications

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“…A comparison of two sites found that application of MTS to the hip resulted in a significantly greater C max than application to the scapula (33.8 ± 10.2 vs. 26.2 ± 11.2 ng/mL, p = 0.01 hip vs. scapula) in boys and girls (aged 6–12 years) during a 16-h wear time [26]. The area under the curve from 0 to 16 h (AUC 0–16 ) was also greater with hip placement, although the t max was only slightly longer with hip placement.…”

Section: Transdermal Methylphenidate In Attention-deficit Hyperactivimentioning

confidence: 99%

Transdermal Therapy for Attention-Deficit Hyperactivity Disorder with the Methylphenidate Patch (MTS)

Findling

Dinh²

2014

CNS Drugs

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Transdermal technology is currently approved in the US for the administration of more than 20 medications. This current review describes the clinical research pertaining to the use of a methylphenidate patch in the treatment of attention-deficit hyperactivity disorder (ADHD) in children and adolescents. PubMed searches were conducted using the search term ‘methylphenidate transdermal system’, and were limited to clinical trials. No limits were set for dates of publication. A total of 21 citations were identified. Studies evaluating the safety and efficacy of the methylphenidate transdermal system (MTS) in children and adolescents were included in this review. Additional studies were identified from bibliographies and the ‘Related Citations’ section of PubMed searches. The MTS delivers a range of methylphenidate doses using a drug-in-adhesive matrix patch. According to current labeling, the patch should be applied to the hip once daily for a maximum of 9 h. Serum methylphenidate levels increase over wear time, with mean time to maximum concentration (tmax) reached between 8 and 10 h for a 9-h wear time, and the elimination half-life for methylphenidate is 3–4 h after patch removal. In clinical trials, ADHD symptoms were measured using the ADHD Rating Scale, Version IV, and several parent-, teacher-, and patient-rated scales. Treatment effects show statistically significant differences from baseline symptom scores starting at the first evaluation, 2 h after the patch is applied, with significant benefit lasting up to 12 h with a 9-h wear time. Adverse events with the MTS are similar to those seen with other formulations of methylphenidate, with the exception of skin-related reactions at the site of application, which were generally mild to moderate in severity. The incidence of contact allergic dermatitis with MTS is <1 %. Statistically significant improvements in health-related quality of life and medication satisfaction were also observed with the MTS compared with placebo, and after switching from oral extended-release (ER) methylphenidate. Transdermal drug delivery is an effective and safe means of administering methylphenidate for patients with ADHD.

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Section: Transdermal Methylphenidate In Attention-deficit Hyperactivimentioning

confidence: 99%

Transdermal Therapy for Attention-Deficit Hyperactivity Disorder with the Methylphenidate Patch (MTS)

Findling

Dinh²

2014

CNS Drugs

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“…Transdermal methylphenidate bypasses the oral route entirely, and in short-term studies is associated with efficacy throughout the day, with improved family quality of life, and when carefully titrated, little effect on sleep [44-46]. Greater absorption of medication occurs when the patch is applied to the buttocks rather than to the subscapular area [47]. …”

Section: Adhd Treatmentsmentioning

confidence: 99%

Advances in understanding and treating ADHD

Antshel

Hargrave

Simonescu

et al. 2011

BMC Med

108

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Attention deficit hyperactivity disorder (ADHD) is a neurocognitive behavioral developmental disorder most commonly seen in childhood and adolescence, which often extends to the adult years. Relative to a decade ago, there has been extensive research into understanding the factors underlying ADHD, leading to far more treatment options available for both adolescents and adults with this disorder. Novel stimulant formulations have made it possible to tailor treatment to the duration of efficacy required by patients, and to help mitigate the potential for abuse, misuse and diversion. Several new non-stimulant options have also emerged in the past few years. Among these, cognitive behavioral interventions have proven popular in the treatment of adult ADHD, especially within the adult population who cannot or will not use medications, along with the many medication-treated patients who continue to show residual disability.

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“…[11] Reported results were obtained after daily application of methylphenidate transdermal system to the hip (each application lasting 9 hours). [11] Results of this trial are supplemented by data from trials in children aged 6-12 years with ADHD who received methylphenidate transdermal system, [12,13] and by data from the manufacturer's prescribing information. [11] Results of this trial are supplemented by data from trials in children aged 6-12 years with ADHD who received methylphenidate transdermal system, [12,13] and by data from the manufacturer's prescribing information.…”

Section: Pharmacokinetic Profilementioning

confidence: 99%

“…[11] Accumulation was seen with repeated application; the steady-state accumulation ratio for adolescents receiving methylphenidate transdermal system 10 mg for 28 days was 83% relative to a single application of methylphenidate transdermal system 10 mg. [11] An approximately dose-proportional increase in d-methylphenidate plasma trough concentrations was seen in adolescents receiving methylphenidate transdermal system 10-30 mg. [11] In adolescents receiving methylphenidate transdermal system, the plasma concentration-time profile of l-methylphenidate approximated that of d-methylphenidate, although l-methylphenidate concentrations were about half those of d-methylphenidate. [12] In children with ADHD, the bioavailability of d,l-methylphenidate was »31% greater following a single 16-hour application of methylphenidate transdermal system (patch size of 25 cm 2 ) to the hip versus the scapula. [12] In children with ADHD, the bioavailability of d,l-methylphenidate was »31% greater following a single 16-hour application of methylphenidate transdermal system (patch size of 25 cm 2 ) to the hip versus the scapula.…”

Section: Pharmacokinetic Profilementioning

confidence: 99%

“…[11] The pharmacokinetics of methylphenidate transdermal system differ, depending on the site of application. [12] The rate and extent of methylphenidate absorption were increased when methylphenidate transdermal system was applied to inflamed versus intact skin and when heat was applied to the patch following application. [12] The rate and extent of methylphenidate absorption were increased when methylphenidate transdermal system was applied to inflamed versus intact skin and when heat was applied to the patch following application.…”

Section: Pharmacokinetic Profilementioning

confidence: 99%

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Methylphenidate Transdermal System

Keating

2011

CNS Drugs

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Methylphenidate transdermal system uses DOT Matrix™ technology and, once applied to the skin, releases methylphenidate continuously. In the US, methylphenidate transdermal system is indicated for use in the treatment of attention-deficit hyperactivity disorder (ADHD). According to the results of a randomized, double-blind, multicentre, 7-week trial (core trial), methylphenidate transdermal system 10-30 mg was effective in adolescents aged 13-17 years with ADHD. The mean ADHD-Rating Scale-IV (ADHD-RS-IV) total score (primary endpoint) decreased to a significantly greater extent in adolescents receiving methylphenidate transdermal system than in those receiving placebo transdermal system. Following the core trial, adolescents could subsequently receive methylphenidate transdermal system in an extension study of ≈6 months duration. From the start of the core trial to the end of the extension study, methylphenidate transdermal system recipients demonstrated a significant reduction in the mean ADHD-RS-IV total score. Methylphenidate transdermal system was generally well tolerated in adolescents with ADHD. The vast majority of treatment-emergent adverse events were of mild to moderate severity in both the short-term core trial and the longer-term extension study.

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Effects of Application to Two Different Skin Sites on the Pharmacokinetics of Transdermal Methylphenidate in Pediatric Patients with Attention-Deficit/Hyperactivity Disorder

Cited by 14 publications

References 15 publications

Transdermal Therapy for Attention-Deficit Hyperactivity Disorder with the Methylphenidate Patch (MTS)

Transdermal Therapy for Attention-Deficit Hyperactivity Disorder with the Methylphenidate Patch (MTS)

Advances in understanding and treating ADHD

Methylphenidate Transdermal System

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