[Therapeutic drug monitoring of felbamate].
Felbamate is a derivative of meprobamate used in second-line partial epilepsy and in the Lennox-Gastaut syndrome. Felbamate is well absorbed and has linear kinetics: C(max) and AUC increasing linearly with dose. The metabolism takes place in the liver. Metabolites represent 40 to 60% of excretion and are eliminated via the urine. The half-life is between 15 and 23 hours. Clearance is dependent on renal function. There is a concentration - efficacy and concentration - toxicity relationship. These arguments are in favour of a TDM but the therapeutic range is not clearly established. Potentially fatal side effects can be caused by felbamate (aplastic anemia, acute liver failure), which limits its use because they are dose-independant.
Tribut
Olivier
O
Laboratoire de Pharmacologie Biologique, CHU Pontchaillou, Rennes, France. olivier.tribut@chu-rennes.fr
Bentué-Ferrer
Danièle
D
Verdier
Marie-Clémence
MC
D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects* / Q000032:analysis / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004347:Drug Interactions; D016903:Drug Monitoring; D004827:Epilepsy / Q000188:drug therapy*; D000078328:Felbamate; D005602:France; D006801:Humans; D048448:Phenylcarbamates / Q000008:administration & dosage / Q000009:adverse effects* / Q000032:analysis / Q000493:pharmacokinetics / Q000627:therapeutic use*; D011409:Propylene Glycols / Q000008:administration & dosage / Q000009:adverse effects* / Q000032:analysis / Q000493:pharmacokinetics / Q000627:therapeutic use*
D000927:Anticonvulsants; D048448:Phenylcarbamates; D011409:Propylene Glycols; D000078328:Felbamate