Carbamazepine- and oxcarbazepine-induced hyponatremia in people with epilepsy

Bianca Berghuis, Job van der Palen, Gerrit-Jan de Haan, Dick Lindhout, Bobby P C Koeleman, Josemir W Sander, EpiPGX Consortium, Federico Zara

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To ascertain possible determinants of carbamazepine (CBZ)- and oxcarbazepine (OXC)-induced hyponatremia in a large cohort of people with epilepsy.

METHODS: We collected data on serum sodium levels in people with epilepsy who were attending a tertiary epilepsy center while on treatment with CBZ or OXC. We defined hyponatremia as Na+ ≤134 mEq/L and severe hyponatremia as Na+ ≤128 mEq/L.

RESULTS: We identified 1,782 people who had used CBZ (n = 1,424) or OXC (n = 358), of whom 50 were treated with both drugs. Data on sodium level measurements were available in 1,132 on CBZ and in 289 on OXC. Hyponatremia occurred in 26% of those taking CBZ and 46% of those taking OXC. This was severe in 7% in the CBZ group and 22% in the OXC group. Hyponatremia was symptomatic in 48% and led to admissions in 3%. Age over 40 years, high serum levels of CBZ and OXC, and concomitant use of other antiepileptic drugs were the main risk factors for hyponatremia in both treatment groups. Female patients on OXC were at a higher risk than male patients of hyponatremia. The risk of hyponatremia on CBZ was significantly associated with the risk of hyponatremia on OXC within a subgroup that used both drugs consecutively.

SIGNIFICANCE: Hyponatremia is a common problem in people taking CBZ or OXC. Regular ascertainment of sodium levels in those taking either drug is recommended and results should be acted on.

Original languageEnglish
Pages (from-to)1227-1233
Number of pages7
JournalEpilepsia
Volume58
Issue number7
DOIs
Publication statusPublished - Jul 2017

Fingerprint

Hyponatremia
Carbamazepine
Epilepsy
Sodium
oxcarbazepine
Pharmaceutical Preparations
Serum
Anticonvulsants

Keywords

  • Adult
  • Anticonvulsants
  • Carbamazepine
  • Cohort Studies
  • Drug Therapy, Combination
  • Epilepsy
  • Female
  • Humans
  • Hyponatremia
  • Male
  • Middle Aged
  • Risk Factors
  • Sex Factors
  • Sodium
  • Journal Article
  • Research Support, Non-U.S. Gov't

Cite this

Berghuis, B., van der Palen, J., de Haan, G-J., Lindhout, D., Koeleman, B. P. C., Sander, J. W., ... Zara, F. (2017). Carbamazepine- and oxcarbazepine-induced hyponatremia in people with epilepsy. Epilepsia, 58(7), 1227-1233. https://doi.org/10.1111/epi.13777

Carbamazepine- and oxcarbazepine-induced hyponatremia in people with epilepsy. / Berghuis, Bianca; van der Palen, Job; de Haan, Gerrit-Jan; Lindhout, Dick; Koeleman, Bobby P C; Sander, Josemir W; EpiPGX Consortium ; Zara, Federico.

In: Epilepsia, Vol. 58, No. 7, 07.2017, p. 1227-1233.

Research output: Contribution to journalArticle

Berghuis, B, van der Palen, J, de Haan, G-J, Lindhout, D, Koeleman, BPC, Sander, JW, EpiPGX Consortium & Zara, F 2017, 'Carbamazepine- and oxcarbazepine-induced hyponatremia in people with epilepsy', Epilepsia, vol. 58, no. 7, pp. 1227-1233. https://doi.org/10.1111/epi.13777
Berghuis B, van der Palen J, de Haan G-J, Lindhout D, Koeleman BPC, Sander JW et al. Carbamazepine- and oxcarbazepine-induced hyponatremia in people with epilepsy. Epilepsia. 2017 Jul;58(7):1227-1233. https://doi.org/10.1111/epi.13777
Berghuis, Bianca ; van der Palen, Job ; de Haan, Gerrit-Jan ; Lindhout, Dick ; Koeleman, Bobby P C ; Sander, Josemir W ; EpiPGX Consortium ; Zara, Federico. / Carbamazepine- and oxcarbazepine-induced hyponatremia in people with epilepsy. In: Epilepsia. 2017 ; Vol. 58, No. 7. pp. 1227-1233.
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abstract = "OBJECTIVE: To ascertain possible determinants of carbamazepine (CBZ)- and oxcarbazepine (OXC)-induced hyponatremia in a large cohort of people with epilepsy.METHODS: We collected data on serum sodium levels in people with epilepsy who were attending a tertiary epilepsy center while on treatment with CBZ or OXC. We defined hyponatremia as Na+ ≤134 mEq/L and severe hyponatremia as Na+ ≤128 mEq/L.RESULTS: We identified 1,782 people who had used CBZ (n = 1,424) or OXC (n = 358), of whom 50 were treated with both drugs. Data on sodium level measurements were available in 1,132 on CBZ and in 289 on OXC. Hyponatremia occurred in 26{\%} of those taking CBZ and 46{\%} of those taking OXC. This was severe in 7{\%} in the CBZ group and 22{\%} in the OXC group. Hyponatremia was symptomatic in 48{\%} and led to admissions in 3{\%}. Age over 40 years, high serum levels of CBZ and OXC, and concomitant use of other antiepileptic drugs were the main risk factors for hyponatremia in both treatment groups. Female patients on OXC were at a higher risk than male patients of hyponatremia. The risk of hyponatremia on CBZ was significantly associated with the risk of hyponatremia on OXC within a subgroup that used both drugs consecutively.SIGNIFICANCE: Hyponatremia is a common problem in people taking CBZ or OXC. Regular ascertainment of sodium levels in those taking either drug is recommended and results should be acted on.",
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AU - Berghuis, Bianca

AU - van der Palen, Job

AU - de Haan, Gerrit-Jan

AU - Lindhout, Dick

AU - Koeleman, Bobby P C

AU - Sander, Josemir W

AU - EpiPGX Consortium

AU - Zara, Federico

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PY - 2017/7

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N2 - OBJECTIVE: To ascertain possible determinants of carbamazepine (CBZ)- and oxcarbazepine (OXC)-induced hyponatremia in a large cohort of people with epilepsy.METHODS: We collected data on serum sodium levels in people with epilepsy who were attending a tertiary epilepsy center while on treatment with CBZ or OXC. We defined hyponatremia as Na+ ≤134 mEq/L and severe hyponatremia as Na+ ≤128 mEq/L.RESULTS: We identified 1,782 people who had used CBZ (n = 1,424) or OXC (n = 358), of whom 50 were treated with both drugs. Data on sodium level measurements were available in 1,132 on CBZ and in 289 on OXC. Hyponatremia occurred in 26% of those taking CBZ and 46% of those taking OXC. This was severe in 7% in the CBZ group and 22% in the OXC group. Hyponatremia was symptomatic in 48% and led to admissions in 3%. Age over 40 years, high serum levels of CBZ and OXC, and concomitant use of other antiepileptic drugs were the main risk factors for hyponatremia in both treatment groups. Female patients on OXC were at a higher risk than male patients of hyponatremia. The risk of hyponatremia on CBZ was significantly associated with the risk of hyponatremia on OXC within a subgroup that used both drugs consecutively.SIGNIFICANCE: Hyponatremia is a common problem in people taking CBZ or OXC. Regular ascertainment of sodium levels in those taking either drug is recommended and results should be acted on.

AB - OBJECTIVE: To ascertain possible determinants of carbamazepine (CBZ)- and oxcarbazepine (OXC)-induced hyponatremia in a large cohort of people with epilepsy.METHODS: We collected data on serum sodium levels in people with epilepsy who were attending a tertiary epilepsy center while on treatment with CBZ or OXC. We defined hyponatremia as Na+ ≤134 mEq/L and severe hyponatremia as Na+ ≤128 mEq/L.RESULTS: We identified 1,782 people who had used CBZ (n = 1,424) or OXC (n = 358), of whom 50 were treated with both drugs. Data on sodium level measurements were available in 1,132 on CBZ and in 289 on OXC. Hyponatremia occurred in 26% of those taking CBZ and 46% of those taking OXC. This was severe in 7% in the CBZ group and 22% in the OXC group. Hyponatremia was symptomatic in 48% and led to admissions in 3%. Age over 40 years, high serum levels of CBZ and OXC, and concomitant use of other antiepileptic drugs were the main risk factors for hyponatremia in both treatment groups. Female patients on OXC were at a higher risk than male patients of hyponatremia. The risk of hyponatremia on CBZ was significantly associated with the risk of hyponatremia on OXC within a subgroup that used both drugs consecutively.SIGNIFICANCE: Hyponatremia is a common problem in people taking CBZ or OXC. Regular ascertainment of sodium levels in those taking either drug is recommended and results should be acted on.

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KW - Humans

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KW - Male

KW - Middle Aged

KW - Risk Factors

KW - Sex Factors

KW - Sodium

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

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DO - 10.1111/epi.13777

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JO - Epilepsia

JF - Epilepsia

SN - 0013-9580

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