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Biphentin®

What is the active ingredient?

Methylphenidate

How does it work?

It uses a technology called multilayer release (MLR). Think of each bead in the capsule as an onion skin format so that each layer releases the medication over time. The methylphenidate leads to a decrease in reuptake of the dopamine from the presynaptic sites of the neuron and makes more dopamine available.

How is it metabolized and excreted?

It is metabolized by the cytochrome enzymes of the liver and excreted in the kidney.

How fast does it work and how long does it last?

The capsule can be opened and sprinkled. This is a 40-60 delivery system so that 40% of the methylphenidate is immediate release so it goes in pretty fast and the rest of the methylphenidate (60%) is released over the next 8-10 hours.

What are the common side effects?

>60% of the patients may suffer from initial insomnia, appetite suppression, headaches, mild nausea, emotional lability as the medications are wearing off, a seriousness in attitude often seen as a perception of dysphoria, dry mouth, dry eyes, diarrhea, and gastric irritation. There are other side effects but they are not common.

Are there any specific major risk factors?

There are cardiovascular risk factors and possibility of sudden death IF there is a preexisting cardiac structural defect, a family history of a conduction problem and/or if the patient themselves had a sudden loss of consciousness that could only be explained by an erratic heart rate.

Can it be safely combined with other medications?

Yes, though it may potentiate the effects of similar agents including those that have a central effect on the brain (e.g. alcohol, cannabis, cocaine etc.)

If it doesn’t work, what should I do next?

Ask your doctor for guidance always but switching to another psychostimulant is usually successful. Some people just respond to another psychostimulant class, like dextro-amphetamine, better.

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