A viewpoint on rational and irrational fixed-drug combinations

Expert Review of Clinical Pharmacology
Barbara BłaszczykStanislaw J Czuczwar

Abstract

Considering that there are around 30% of patients with epilepsy resistant to monotherapy, the use of synergistic combinations of antiepileptic drugs is of particular importance. This review shows most beneficial as well as irrational combined treatments both from an experimental and clinical point of view. Areas covered: Preferably, experimental data derived from studies evaluating synergy, additivity, or antagonism by relevant methods, in terms of anticonvulsant or neurotoxic effects and pharmacokinetic data have been considered. Although there have been no randomized clinical trials on this issue, the clinical data have been analyzed from studies on considerable numbers of patients. Case-report studies have been not considered. Expert commentary: The experimental data provide a strong support that co-administration of lamotrigine with carbamazepine is negative, considering the anticonvulsant and neurotoxic effects. Clinical reports do not entirely support this conclusion. Other experimentally documented negative combinations comprise lamotrigine+ oxcarbazepine and oxcarbazepine+ phenytoin. From the experimental and clinical point of view, a combination of lamotrigine+ valproate may deserve recommendation. Other most positive ...Continue Reading

References

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Citations

Apr 18, 2019·Expert Opinion on Drug Metabolism & Toxicology·Barbara MiziakStanisław J Czuczwar
Dec 20, 2019·Expert Review of Neurotherapeutics·Alberto VerrottiVincenzo Belcastro
Apr 2, 2020·International Journal of Molecular Sciences·Barbara MiziakStanisław J Czuczwar
Nov 30, 2018·Expert Opinion on Pharmacotherapy·Monika BanachStanisław J Czuczwar
Mar 3, 2020·Frontiers in Pharmacology·Felicia PattiRaffaele Pezzani
Feb 13, 2019·CNS Drugs·Anna SerafiniPhilippe Gelisse
Oct 30, 2020·Frontiers in Endocrinology·Barbara MiziakStanisław J Czuczwar
Dec 20, 2020·Expert Review of Neurotherapeutics·Krzysztof Łukawski, Stanisław J Czuczwar
Feb 18, 2020·European Journal of Pharmaceutical Sciences : Official Journal of the European Federation for Pharmaceutical Sciences·Faheem Hyder PottooGhulam Md Ashraf
May 18, 2021·Expert Review of Neurotherapeutics·Michele AscoliEdoardo Ferlazzo
Jul 27, 2021·Expert Opinion on Drug Metabolism & Toxicology·Krzysztof Łukawski, Stanisław J Czuczwar

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