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Drug monitoring of lamotrigine and oxcarbazepine combination during pregnancy
Author(s) -
Wegner Ilse,
Edelbroek Peter,
De Haan GerritJan,
Lindhout Dick,
Sander Josemir W.
Publication year - 2010
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2010.02771.x
Subject(s) - oxcarbazepine , lamotrigine , medicine , pregnancy , pharmacokinetics , drugs in pregnancy , therapeutic drug monitoring , active metabolite , drug , epilepsy , pharmacology , antiepileptic drug , anesthesia , fetus , carbamazepine , psychiatry , biology , genetics
Summary Little is known about pregnancy‐induced alterations in the pharmacokinetics of the newer antiepileptic drugs, especially when used in combinations. Two women receiving combination therapy of lamotrigine (LTG) and oxcarbazepine (OXC) were followed prospectively during pregnancy and puerperium. Steady‐state concentrations of LTG and the active metabolite of OXC, 10‐hydroxycarbazepine (MHD), were measured at regular intervals using a dried blood spot method, and clearances were calculated. A strong effect of pregnancy on the clearance of both LTG and MHD was seen. An increase in seizure frequency occurred in both women. This stresses the importance of therapeutic drug monitoring of LTG and MHD during pregnancy. In case of breakthrough seizures or increased seizure frequency, dosage adjustment of both drugs may be required.