Drug interactions in epilepsy care: perspective on the newer generation antiepileptic drugs.
Pharmacokinetic interactions involving the antiepileptic drugs have long been considered to be an unavoidable component of epilepsy treatment. Many of the 'older' generation of antiepileptic drugs, including carbamazepine, phenytoin and phenobarbital, are recognized to cause hepatic induction of drug-metabolizing enzyme systems, such as the cytochrome P450 and UDP-gluculronyltransferase. Such interactions are not uncommonly implicated in resulting in clinically significant treatment complications. During the latter half of 1990s, a number of new antiepileptic drugs have become available to clinicians. Generally speaking, a common feature of these 'newer' generation medications are improved pharmacokinetic characteristics, including an improved drug interaction profile. The aim of this review is to summarize the data, both experimental and clinical, regarding pharmacokinetic interactions with the newer antiepileptic drugs.
Gidal
Barry E
BE
University of Wisconsin, School of Pharmacy & Dept. of Neurology, 777 Highland Ave, Madison, WI 53705, USA. begidal@pharmacy.wisc.edu
Nemergut
Christopher P
CP
French
Jacqueline A
JA