Posted by SLS on July 14, 2000, at 8:07:48
In reply to Re: World Wide ADRAFINIL, posted by JohnL on July 14, 2000, at 3:59:25
Hi JohnL.
Given the possibility that I may be taking adrafinil (Olmifon) in the near future, I would like to know more specific details regarding its potential to cause liver problems. One statement often cited is that when taking adrafinil, it is necessary to test for liver abnormalities in a way similar to Cylert (pemoline). By itself, this is a meaningless statement. One could just as easily replace the word "Cylert" with the word "Depakote". Perhaps the writer was simply trying to convey the idea that tests need to be performed, and decided to choose Cylert as an example because it is also considered a type of stimulant.
What type of liver abnormalities? How serious can these abnormalities be? Can any hepatotoxity produced lead to irreversible damage or liver failure? What is the rate of occurrence?
These are the questions that I would like to have the answers to.
> But when one the last time we ever heard of someone actually experiencing a liver condition while taking Cylert?
For me, 1998. I guess they occur every year, although infrequently.
It seems that Cylert is most likely to produce hepatic injury in children under the age of twelve who are also taking Ritalin. Several liver transplants have been necessary. I don't know why the authors of the abstract I included below were only able to find one report.
> "Metabolism
> 75% level of hepatic metabilism in the liver to an acid derivative, then glucoronic acid conjugation."I believe this metabolic derivative is modafinil. It is my understanding that adrafinil is converted into modafinil by the liver.
- Scott-----------------------------------------------------------
2: J Pediatr 1998 May;132(5):894-7Pemoline hepatotoxicity in children.
Marotta PJ, Roberts EA
Division of Gastroenterology and Nutrition, Hospital for Sick Children, Toronto,
Ontario, Canada.Pemoline hepatotoxicity ranges from asymptomatic elevations in levels of serum
aminotransferases to fulminant liver failure. We report five cases of pemoline
hepatotoxicity in children (four boys, one girl), including the only reported
case resulting in orthotopic liver transplantation. We conclude that pemoline
causes toxic liver damage in children. The severity of the damage is highly
variable, and its onset may be late in the course of treatment. Pemoline and
methylphenidate may act synergistically to cause liver damage. The levels of
serum aminotransferases should be monitored throughout treatment with these
agents.Publication Types:
Review
Review of reported casesPMID: 9602211, UI: 98264921
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