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Dr. Bob is Robert Hsiung, MD,
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Posted by Angela5 on July 27, 2000, at 9:40:34
My new pdoc would like me to stop taking Adrafinil (due to the lack of adequate info. on it) and begin Cylert instead. Does anyone know what the liver risks are with Cylert? My pdoc didn't mention this, but I noticed on the Clinical Pharmacology website that twice-monthly bloodtests are recommended. Does anyone have experience with this/know the frequency of testing usually necessary?
Thanks,
Angela
Posted by Sunnely on July 28, 2000, at 1:06:52
In reply to Cylert question - bloodtests?, posted by Angela5 on July 27, 2000, at 9:40:34
There were at least 13 cases of liver failure reported to the FDA in patients prescribed pemoline (Cylert) since 1975, 11 of which resulted in death or liver transplantation. The exact cause of pemoline-associated liver disease is uncertain, but a drug-related autoimmune process was suggested.
Because increases in liver enzyme levels have been reported several months after starting pemoline, liver enzymes test should be performed prior to, and at least every 4 to 6 months during, pemoline treatment. It is recommended that pemoline not to be given to patients with impaired liver function, or combined with drugs known to impair liver drug metabolism. Other patients at risk for pemoline-associated liver failure include those receiving concurrent methylphenidate (Ritalin), patients with a pre-existing autoimmune disorder or family history of an autoimmune disease. Pemoline should not be considered as a first-line treatment for patients with attention-deficit hyperactive disorder. Pemoline should only be prescribed after discussing with the patient alternative interventions and potential risks associated with this medication.
Be aware of clinical symptoms that may indicate impending liver problems: loss of appetite, fatigue, and weight loss. These signify immediate determination of liver enzyme levels.
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