Impact of age, weight and concomitant treatment on lamotrigine pharmacokinetics

Journal of Clinical Pharmacy and Therapeutics
B B BrzakovićM Š Prostran

Abstract

Lamotrigine metabolism may be substantially altered with concomitant administration of valproic acid and/or carbamazepine. Such alterations may require the adjustment of lamotrigine dose to ensure optimal treatment efficacy and safety. The extent of lamotrigine interactions was investigated dependent on age, gender, weight and dose of concomitant carbamazepine and/or valproic acid in 65 patients with epilepsy. Lamotrigine plasma steady-state oral clearance (CLss/F) and area under the curve (AUCss) were calculated from the dose of drug, average steady-state concentration (Css) and interval of administration. Multiple regression analysis was used for the identification and quantification of factors that influenced lamotrigine pharmacokinetics. Age and dose of carbamazepine and valproic acid had significant influence on lamotrigine CLss/F and AUCss. Carbamazepine was associated with a dose-dependent increase and valproic acid with a dose-dependent decrease of lamotrigine metabolism rate. The effect of carbamazepine was more pronounced. Younger patients were expected to metabolize lamotrigine more rapidly whereas overweight patients may be less susceptible to interactions. Gender had no influence on lamotrigine pharmacokinetics. Th...Continue Reading

References

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Citations

Nov 19, 2013·European Journal of Clinical Pharmacology·Branka BrzakovićMilena Pokrajac
Nov 21, 2015·British Journal of Clinical Pharmacology·Sandra GastrupPer Damkier
Apr 30, 2015·Drug Metabolism and Pharmacokinetics·Qiuning WangYingjie Guo
Apr 28, 2016·Clinical and Experimental Pharmacology & Physiology·André Oliveira BaldoniLeonardo Regis Leira Pereira
Jan 4, 2019·Neuropsychopharmacology Reports·Shogo ItabashiKiyoyuki Kitaichi
Jun 23, 2016·The Cochrane Database of Systematic Reviews·Sridharan RamaratnamAnthony G Marson
Mar 21, 2020·The Cochrane Database of Systematic Reviews·Mariangela PanebiancoAnthony G Marson
Jul 2, 2020·The Cochrane Database of Systematic Reviews·Rebecca BresnahanAnthony G Marson
Jan 28, 2020·Therapeutic Drug Monitoring·Takeshi SuzukiTsuyoshi Kondo
Dec 6, 2014·Therapeutic Drug Monitoring·Girish S NaikDenise H Fleming
Feb 21, 2018·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·T Yu NoskovaR D Sejfulla

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