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Effect of single doses of sodium valproate on serum phenytoin level and protein binding in epileptic petients
Author(s) -
Monks Anne,
Richens Alan
Publication year - 1980
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1980.14
Subject(s) - phenytoin , drug , pharmacology , anticonvulsant , in vivo , epilepsy , sodium , drug interaction , drug action , medicine , chemistry , biology , microbiology and biotechnology , organic chemistry , psychiatry
Our study underlines the importance of performing protein binding interaction studies in vivo. Predictions from in vitro studies may be misleading because they may not take into account the kinetics of the drug in the whole animal. Probably the most important clinical implication of these findings is that total serum phenytoin levels may fall when sodium valproate is added to therapy and this may lead to an increase in dose under the mistaken belief that the effect of the drug has been reduced. Since it is the bound and not the free drug which is reduced, phenytoin intoxication may result from this misguided action. Clinical Pharmacology and Therapeutics (1980) 27, 89–95; doi: 10.1038/clpt.1980.14