Influence of concurrent antiepileptic medication on the pharmacokinetics of lamotrigine as add‐on therapy in epileptic children

• Published in: British journal of clinical pharmacology Vol. 41; no. 4; pp. 325 - 330
• Main Authors: VAUZELLE‐KERVROËDAN, F., REY, E., CIEUTA, C., PARIENTE‐KHAYAT, A., PONS, G., D′ATHIS, P., BIDAULT, R., DULAC, O., OLIVE, G.
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Science Ltd 01.04.1996; Blackwell Science
• Subjects: Anticonvulsants - blood; Anticonvulsants - pharmacokinetics; Anticonvulsants. Antiepileptics. Antiparkinson agents; antiepileptic drugs; Biological and medical sciences; Child, Preschool; children; Drug Therapy, Combination; epilepsy; Epilepsy - metabolism; Humans; Infant; Lamotrigine; Medical sciences; Neuropharmacology; Original; pharmacokinetics; Pharmacology. Drug treatments; Triazines - blood; Triazines - pharmacokinetics; Human; Nervous system diseases; Epilepsy; Central nervous system disease; Oral administration; Anticonvulsant; Drug interaction; Metabolism; Pharmacokinetics; Child; Cerebral disorder
• ISSN: 0306-5251; 1365-2125
• DOI: 10.1046/j.1365-2125.1996.31610.x

1 Lamotrigine is a new antiepileptic drug, chemically unrelated to currently used antiepileptic medication. Its pharmacokinetics can be influenced by concomitant antiepileptic medication. 2 This study was performed to assess the pharmacokinetic profile of lamotrigine in three groups of children treated with different types of comedication: drugs known to induce, to inhibit or to have no clinically significant influence on drug metabolism, respectively. 3 Thirty‐one children aged 6 months to 5 years were included and received a 2 mg kg−1 single oral dose. Lamotrigine plasma profiles were different between the three comedication groups. The half‐lives (mean±s.d.) were: 7.7±1.8 h, 21.9±6.8 h, 44.7±10.2 h in the ‘inducer’, ‘other’ and ‘inhibitor’ groups respectively. 4 Patients were then dosed to steady state, with the dosage adjusted on the basis of the single dose pharmacokinetics to achieve a minimum plasma concentration between 1.5 and 3 mg l−1. The mean minimum plasma concentration for the three groups was 2.54±1.28 mg l−1 at steady state. 5 Dosage of lamotrigine can be optimised with knowledge of the metabolic effects of antiepileptic comedication.