Pemoline

Pemoline Brand Name– Cylert

What is Pemoline

Pemoline is an oral central nervous system stimulant that is no longer available in the US because of liver toxicity.

This agent possesses pharmacologic actions that are similar to those of the amphetamines and methylphenidate; however, its sympathomimetic effects are minimal. Because of its long half-life, pemoline can be dosed once a day.

Pemoline was indicated for use in attention-deficit hyperactivity disorder (ADHD), however, because of its association with life threatening hepatic failure, it should be not be considered as first line therapy for ADHD.

Pemoline has been used off-label to fight fatigue in multiple sclerosis patients, as an alternative treatment for narcolepsy, and to fight fatigue associated with sustained military operations.

Pemoline was originally approved by the FDA in January 1975.

Indications

  • attention-deficit hyperactivity disorder (ADHD)
  • fatigue
  • narcolepsy

NOTE: This drug is discontinued in the US.

Side Effects

  1. abdominal pain
  2. akathisia
  3. anorexia
  4. aplastic anemia
  5. depression
  6. diarrhea
  7. dizziness
  8. drowsiness
  9. dyskinesia
  10. dystonic reaction
  11. elevated hepatic enzymes
  12. growth inhibition
  13. hallucinations
  14. headache
  15. hepatic failure
  16. hepatitis
  17. hepatotoxicity
  18. insomnia
  19. irritability
  20. jaundice
  21. malaise
  22. nausea
  23. nystagmus
  24. seizures
  25. supranormalization
  26. Tourette’s syndrome
  27. visual impairment
  28. vomiting
  29. weight loss

Monitoring Parameters

  • growth rate
  • LFTs
  • weight

Contraindications

  • alcoholism
  • breast-feeding
  • children
  • depression
  • geriatric
  • growth inhibition
  • hepatic disease
  • hepatitis
  • hepatotoxicity
  • jaundice
  • pregnancy
  • renal failure
  • renal impairment
  • seizure disorder
  • substance abuse
  • suicidal ideation
  • tics
  • Tourette’s syndrome

Interactions

  • Acarbose
  • Acebutolol
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Albiglutide
  • Albuterol
  • Albuterol; Ipratropium
  • Alogliptin; Pioglitazone
  • Alpha-glucosidase Inhibitors
  • Amantadine
  • Anticonvulsants
  • Armodafinil
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Atenolol
  • Atenolol; Chlorthalidone
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Bendroflumethiazide; Nadolol
  • Beta-blockers
  • Betaxolol
  • Bethanechol
  • Bisoprolol
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bosentan
  • Bretylium
  • Brimonidine; Timolol
  • Bupropion
  • Bupropion; Naltrexone
  • Caffeine
  • Caffeine; Ergotamine
  • Canagliflozin
  • Canagliflozin; Metformin
  • Carbamazepine
  • Cardiac glycosides
  • Carteolol
  • Carvedilol
  • Clonazepam
  • Cocaine
  • Colchicine
  • Colchicine; Probenecid
  • Dapagliflozin
  • Dapagliflozin; Metformin
  • Dapagliflozin; Saxagliptin
  • Diazepam
  • Digitoxin
  • Digoxin
  • Dipeptidyl Peptidase-4 Inhibitors
  • Dorzolamide; Timolol
  • Dronabinol
  • Dulaglutide
  • Dyphylline
  • Dyphylline; Guaifenesin
  • Empagliflozin
  • Empagliflozin; Linagliptin
  • Empagliflozin; Linagliptin; Metformin
  • Empagliflozin; Metformin
  • Epoprostenol
  • Ertugliflozin
  • Ertugliflozin; Metformin
  • Ertugliflozin; Sitagliptin
  • Esmolol
  • Ethotoin
  • Exenatide
  • Felbamate
  • Fluticasone; Umeclidinium; Vilanterol
  • Fluticasone; Vilanterol
  • Fosphenytoin
  • Gabapentin
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Green Tea
  • Guanabenz
  • Haloperidol
  • Hydantoins
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Iloprost
  • Incretin Mimetics
  • Indacaterol
  • Indacaterol; Glycopyrrolate
  • Insulin Degludec; Liraglutide
  • Insulin Glargine; Lixisenatide
  • Insulins
  • Iobenguane I 131
  • Iohexol
  • Iopamidol
  • Iopromide
  • Ioversol
  • Isocarboxazid
  • Isosulfan Blue
  • Labetalol
  • Lacosamide
  • Lamotrigine
  • Levalbuterol
  • Levetiracetam
  • Levobetaxolol
  • Levobunolol
  • Levothyroxine
  • Levothyroxine; Liothyronine (Porcine)
  • Levothyroxine; Liothyronine (Synthetic)
  • Liothyronine
  • Liraglutide
  • Lithium
  • Lixisenatide
  • Lorazepam
  • Loxapine
  • Macitentan
  • Maprotiline
  • Mecamylamine
  • Meglitinides
  • Mephobarbital
  • Metformin; Pioglitazone
  • Metformin; Rosiglitazone
  • Metoprolol
  • Miglitol
  • Modafinil
  • Molindone
  • Monoamine oxidase inhibitors
  • Nabilone
  • Nadolol
  • Nebivolol
  • Nebivolol; Valsartan
  • Nitrates
  • Non-Ionic Contrast Media
  • Oxcarbazepine
  • Penbutolol
  • Phenelzine
  • Phenobarbital
  • Phenothiazines
  • Phentermine; Topiramate
  • Phenytoin
  • Pimozide
  • Pindolol
  • Pioglitazone
  • Pramlintide
  • Primidone
  • Procarbazine
  • Propranolol
  • Rasagiline
  • Riociguat
  • Rosiglitazone
  • Selegiline
  • Selexipag
  • Semaglutide
  • SGLT2 Inhibitors
  • Sodium Oxybate
  • Sotalol
  • St. John’s Wort, Hypericum perforatum
  • Sulfonylureas
  • Theophylline, Aminophylline
  • Thiazolidinediones
  • Thiothixene
  • Thyroid hormones
  • Tiagabine
  • Timolol
  • Topiramate
  • Tranylcypromine
  • Treprostinil
  • Umeclidinium; Vilanterol
  • Valproic Acid, Divalproex Sodium
  • Vasodilators
  • Vigabatrin
  • Zonisamide
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