[Pharmacokinetic aspects of carbamazepine and valproic acid using in reproductive-age women with epilepsy].
Dynamics of carbamazepine and valproic acid concentrations in the middle of follicular and lutein menstrual cycle phases has been studied in women with epilepsy, aged 21-30 years. Nineteen patients were treated with valproic acid (Depakine 900-2000 mg/day), 35--with carbamazepine (500-1200 mg/day). All the patients have been treated during at least 6 months, the remission being observed during the last 3 months. Control group consists of 17 healthy age-matched women with no positive familial history of nervous and endocrine diseases. Carbamazepine and valproic acid concentrations were measured in blood serum using high-performance liquid chromatography. Blood for analysis was donated on an empty stomach in the morning before the next dose (i.e. at the lowest concentration) and two hours after the drug taking. Mean carbamazepine concentrations (4-12 mcg/ml) in the women with epilepsy were adequate when the day dose was more than 10 mg/kg. Carbamazepine concentrations during lutein phase were significantly lower (p < 0.03), comparing to those in the follicular phase. However, in the lutein phase, progesterone, which concentration was ten times higher is follicular one, has an additional effect, acting as anticonvulsive agent. Valproic acid concentrations do not significantly differ in the lutein and follicular phases that allows Depakine using in catamenial epilepsy. Practitioners are not recommended to overestimate the anti-epileptic drug (AED) concentration monitoring because the usage of the lower AED individual therapeutic dose, not achieving even the mean therapeutic drug concentrations, is acceptable. This seems to be of extremely importance for women with potential maternal role function.
Karlov
V A
VA
Vlasov
P N
PN
Sokolov
A V
AV
Tishchenkova
I F
IF
D000328:Adult; D000927:Anticonvulsants / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use*; D002220:Carbamazepine / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use*; D002851:Chromatography, High Pressure Liquid; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D005298:Fertility / Q000187:drug effects*; D005498:Follicular Phase / Q000187:drug effects*; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects*; D012074:Remission Induction; D014635:Valproic Acid / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use*
D000927:Anticonvulsants; D002220:Carbamazepine; D014635:Valproic Acid