Seizures and cancer: drug interactions of anticonvulsants with chemotherapeutic agents, tyrosine kinase inhibitors and glucocorticoids.
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Benit CP, Vecht CJ
Seizures and cancer: drug interactions of anticonvulsants with chemotherapeutic agents, tyrosine kinase inhibitors and glucocorticoids.
Neurooncol Pract. 2016 Dec;3(4):245-260. doi: 10.1093/nop/npv038. Epub 2015 Oct 11.
- PubMed ID
- 31385988 [ View in PubMed]
- Abstract
Patients with cancer commonly experience seizures. Combined therapy with anticonvulsant drugs (AEDs) and chemotherapeutic drugs or tyrosine kinase inhibitors carries inherent risks on drug-drug interactions (DDIs). In this review, pharmacokinetic studies of AEDs with chemotherapeutic drugs, tyrosine kinase inhibitors, and glucocorticoids are discussed, including data on maximum tolerated dose, drug clearance, elimination half-life, and organ exposure. Enzyme-inducing AEDs (EIAEDs) cause about a 2-fold to 3-fold faster clearance of concurrent chemotherapeutic drugs metabolized along the same pathway, including cyclophosphamide, irinotecan, paclitaxel, and teniposide, and up to 4-fold faster clearance with the tyrosine kinase inhibitors crizotinib, dasatinib, imatinib, and lapatinib. The use of tyrosine kinase inhibitors, particularly imatinib and crizotinib, may lead to enzyme inhibition of concurrent therapy. Many of the newer generation AEDs do not induce or inhibit drug metabolism, but they can alter enzyme activity by other drugs including AEDs, chemotherapeutics and tyrosine kinase inhibitors. Glucocorticoids can both induce and undergo metabolic change. Quantitative data on changes in drug metabolism help to apply the appropriate dose regimens. Because the large individual variability in metabolic activity increases the risks for undertreatment and/or toxicity, we advocate routine plasma drug monitoring. There are insufficient data available on the effects of tyrosine kinase inhibitors on AED metabolism.
DrugBank Data that Cites this Article
- Drug Enzymes
Drug Enzyme Kind Organism Pharmacological Action Actions Primidone Cytochrome P450 3A4 Protein Humans UnknownInducerDetails - Drug Interactions
Drugs Interaction Integrate drug-drug
interactions in your softwareAlclometasonePhenytoin The serum concentration of Alclometasone can be decreased when it is combined with Phenytoin. AlclometasoneFosphenytoin The serum concentration of Alclometasone can be decreased when it is combined with Fosphenytoin. AmcinonidePhenytoin The serum concentration of Amcinonide can be decreased when it is combined with Phenytoin. AmcinonideFosphenytoin The serum concentration of Amcinonide can be decreased when it is combined with Fosphenytoin. Beclomethasone dipropionatePhenytoin The serum concentration of Beclomethasone dipropionate can be decreased when it is combined with Phenytoin.