Influence of aging on serum phenytoin concentrations: a pharmacokinetic analysis based on therapeutic drug monitoring data

Epilepsy Research
Dina BattinoE Perucca

Abstract

The influence of aging on the pharmacokinetics of phenytoin at steady-state was evaluated retrospectically by comparing apparent oral clearance values (CL/F) in 75 patients aged 65-90 years (mean, 71.7 +/- 5.3 years) receiving phenytoin alone (n = 58) or in combination with phenobarbital (n = 17) and in an equal number of control patients aged 20-50 years (mean, 36.7 +/- 8.5 years) matched for gender, body weight, and comedication. All data were derived from the database of the therapeutic drug monitoring service (TDMS) of an academic neurological hospital. On average, elderly patients were found to exhibit slightly higher CL/F values compared with controls (14.6 +/- 4.7 ml h(-1) kg(-1) versus 13.1 +/- 4.2 ml h(-1) kg(-1), P < 0.05), the difference being probably related to the dose-dependent nature of phenytoin metabolism and the fact that elderly patients received lower dosages (4.4 +/- 1.1 mg kg(-1)day(-1) versus 5.3 +/- 1.1 mg kg(-1) day(-1), P < 0.001) and had lower serum phenytoin concentrations (14.1 +/- 5.7 microg ml(-1) versus 18.6 +/- 6.8 microg ml(-1), P < 0.0001). Gender and phenobarbital comedication were not found to exert any statistically significant influence on phenytoin CL/F. By contrast, in the elderly group...Continue Reading

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Citations

Jul 3, 2013·International Journal of Clinical Pharmacy·Andrea Tobler, Stefan Mühlebach
Sep 27, 2006·Pharmacogenetics and Genomics·Sarah K TateHorng-Huei Liou
Apr 11, 2008·Clinical Pharmacokinetics·Jennifer M Butler, Evan J Begg
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Dec 17, 2008·Therapeutic Drug Monitoring·Noriyasu FukuokaShushi Morita
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Sep 26, 2020·Biofabrication·Kyung Hee NohCho-Rok Jung
Jan 9, 2021·European Geriatric Medicine·Arduino A Mangoni, Elzbieta A Jarmuzewska
Aug 8, 2020·Expert Opinion on Drug Metabolism & Toxicology·Roberta RobertiRita Citraro

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