Clinical pharmacokinetics of new-generation antiepileptic drugs at the extremes of age

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Abstract

In recent years, several new-generation antiepileptic drugs (AEDs) have been introduced in clinical practice. These agents, which include felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, tiagabine, topiramate, vigabatrin and zonisamide, are being increasingly used in the treatment of epilepsy at the extremes of age. For a rational prescribing of these drugs in specific age groups, major pharmacokinetic changes that occur during development and aging need to be taken into consideration. A review of available evidence indicates that the apparent oral clearance (CL/F) of new-generation AEDs in children is increased by 20-170% (depending on the type of drug and characteristics of the patients studied) compared with adults, with the highest CL/F values usually being observed in the youngest age groups. These findings do not necessarily apply to the first weeks of life, when drug eliminating capacity is still undergoing maturation, as in the case of lamotrigine for which preliminary data suggest that CL/F in neonates aged

Original languageEnglish
Pages (from-to)351-363
Number of pages13
JournalClinical Pharmacokinetics
Volume45
Issue number4
DOIs
Publication statusPublished - 2006

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ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

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