Pharmacokinetic interactions with anti-epileptic drugs

G. Gatti, E. Perucca, S. Lecchini

Research output: Contribution to journalArticle

Abstract

A large number of interactions with anti-epileptic drugs have been reported, although only a proportion of these are of real and documented clinical significance. A particularly important group of interactions is represented by those resulting in inhibition of anti-epileptic drug metabolism, with the attendant risk of precipitating clinical signs of intoxication. Examples include the inhibition of phenytoin metabolism by sulthiame and isoniazid, the inhibition of carbamazepine metabolism by propoxyphene and the inhibition of phenobarbital metabolism by valproic acid. Plasma protein-binding interactions are unlikely to cause a long-lasting alteration in the response to anticonvulsant drugs, but they are important because they change the relationship between total serum drug levels and pharmacological effect. Phenytoin, phenobarbital, primidone, and carbamazepine are potent inducers of the hepatic drug-metabolizing microsomal enzymes. This may result in an enhanced rate of metabolism and reduced effectiveness of a number of other drugs, including steroid oral contraceptives, oral anticoagulants, quinidine, vitamin D, prednisone, dexamethasone and metyrapone.

Original languageEnglish
Pages (from-to)95-100
Number of pages6
JournalInternational Journal of Clinical Pharmacology Research
Volume2
Issue number4 Suppl. 1
Publication statusPublished - 1982

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Pharmacokinetics
Pharmaceutical Preparations
Carbamazepine
Phenytoin
Phenobarbital
Primidone
Dextropropoxyphene
Metyrapone
Quinidine
Isoniazid
Valproic Acid
Oral Contraceptives
Prednisone
Protein Binding
Vitamin D
Anticonvulsants
Anticoagulants
Dexamethasone
Blood Proteins
Steroids

ASJC Scopus subject areas

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

Cite this

Pharmacokinetic interactions with anti-epileptic drugs. / Gatti, G.; Perucca, E.; Lecchini, S.

In: International Journal of Clinical Pharmacology Research, Vol. 2, No. 4 Suppl. 1, 1982, p. 95-100.

Research output: Contribution to journalArticle

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