Clinically significant pharmacokinetic drug interactions between antiepileptic drugs.

Article Details

Citation

Tanaka E

Clinically significant pharmacokinetic drug interactions between antiepileptic drugs.

J Clin Pharm Ther. 1999 Apr;24(2):87-92. doi: 10.1046/j.1365-2710.1999.00201.x.

PubMed ID
10380060 [ View in PubMed
]
Abstract

Pharmacokinetic interactions between antiepileptics represent a major potential complication of epilepsy treatment because drug combinations are common. This review discusses pharmacokinetic drug interactions of clinical significance involving antiepileptics and cytochrome P450 (CYP). Most commonly used antiepileptics are eliminated through hepatic metabolism, catalysed by the enzymes CYP2C9, CYP2C19 and CYP3A4 and uridine diphosphate glucuronosyltransferase (UDGPT). Antiepileptics are associated with a wide range of drug interactions, including hepatic enzyme induction and inhibition. Phenytoin, phenobarbiral, primidone and carbamazepine induce CYP and UDPGT enzymes while valproic acid inhibits them. Avoidance of unnecessary polypharmacy, selection of alternative agents with lower interaction potential and careful dosage adjustments based on serum drug concentration monitoring and clinical observation are the main methods for reducing the risks associated with these interactions.

DrugBank Data that Cites this Article

Drugs
Drug Enzymes
DrugEnzymeKindOrganismPharmacological ActionActions
PrimidoneCytochrome P450 2C19ProteinHumans
Unknown
Substrate
Inducer
Details
PrimidoneCytochrome P450 3A4ProteinHumans
Unknown
Inducer
Details