title: [Therapeutic drug monitoring of ethosuximide].
abstract: Ethosuximide is a minor antiepileptic drug, available in France since 1965, indicated in           the epilepsy absence, whose interest was reassessed from recent clinical trials, showing           that it was the first choice, in term of risk benefit relationship, in this indication. It           is a chiral molecule that presents a high bioavailability, a lack of protein binding,           hepatic metabolism and urinary excretion. Its elimination half-life is long, between 40           and 60 h in adults, 30 and 40 h in children. The therapeutic range is established at           40-100 mg/L (283-708 µmol/L), but the upper limit is probably underestimated.          The clinical           studies of relation exposure effects, although ancient (from the 1970s) and realized with           methodologies that do not meet current criteria, show concentration-efficacy and -toxicity           relationship and the risk of drug interactions is proven. It is a drug preponderantly           prescribed in children, a vulnerable population with physiological change with age. To           benefit at best of its effectiveness, it is necessary to have relatively high plasma           concentrations. Despite these arguments and due to the lack of studies providing a           sufficient level of evidence, the recommendation can only be "potentially useful",           assessment probably underestimated.
authors.affiliation: CHU Pontchaillou, Laboratoire de Pharmacologie Biologique, Rennes, France.
authors.forename: Danièle
authors.initials: D
authors.lastname: Bentué-Ferrer
authors.forename: Olivier
authors.initials: O
authors.lastname: Tribut
authors.forename: Marie-Clémence
authors.initials: MC
authors.lastname: Verdier
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D004347:Drug Interactions; D016903:Drug Monitoring; D004827:Epilepsy / Q000188:drug therapy; D005013:Ethosuximide; D006207:Half-Life; D006801:Humans
chemical_list: D000927:Anticonvulsants; D005013:Ethosuximide