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Pemoline (Cylert)
( PEM-oh-leen)
Pregnancy Category: B Cylert Cylert Chewable (C-IV) (Rx)

Classification: CNS stimulant

Action/Kinetics: Believed to act by dopaminergic mechanisms. Causes a decrease in hyperactivity and a prolonged attention span in children. Peak serum levels: 2-4 hr. Duration: Up to 8 hr. t 1/2: 12 hr. Steady state: 2-3 days; beneficial effects may not be noted for 3-4 weeks. Approximately 50% is bound to plasma protein. Metabolized by the liver, and approximately 50% is excreted unchanged by the kidneys.

Uses: Attention-deficit disorders. Due to possible life-threatening hepatic failure, not usually first-line therapy. Investigational: Narcolepsy.

Contraindications: Hypersensitivity to drug. Tourette's syndrome. Children under 6 years of age.

Special Concerns: Safe use during lactation has not been established. Use with caution in impaired renal or kidney function. Chronic use in children may cause growth suppression.

Side Effects: CNS: Insomnia (most common). Dyskinesia of the face, tongue, lips, and extremities; precipitation of Tourette's syndrome. Mild depression, headache, nystagmus, dizziness, hallucinations, irritability, seizures. Exacerbation of behavior disturbances and thought disorders in psychotic children. GI: Transient weight loss, gastric upset, nausea. Miscellaneous: Skin rash, hepatic toxicity, hepatic failure.

Laboratory Test Alterations: AST, ALT, serum LDH.

Overdose Management: Symptoms: Symptoms of CNS stimulation and sympathomimetic effects including agitation, confusion, delirium, euphoria, headache, muscle twitching, mydriasis, vomiting, hallucinations, flushing, sweating, tachycardia, hyperreflexia, tremors, hyperpyrexia hypertension, seizures (may be followed by coma). Treatment: Reduce external stimuli. If symptoms are not severe, induce vomiting or undertake gastric lavage. Chlorpromazine can be used to decrease the CNS stimulation and sympathomimetic effects.

How Supplied: Chew Tablet: 37.5 mg; Tablet: 18.75 mg, 37.5 mg, 75 mg

?Tablets, Chewable Tablets Attention-deficit disorders.
Children, 6 years and older, initial: 37.5 mg/day as a single dose in the morning; increase at 1-week intervals by 18.75 mg until desired response is attained up to maximum of 112.5 mg/day. Usual maintenance: 56.25-75 mg/day.
Adults: 50-200 mg/day in two divided doses.

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