title: A quick review of carbamazepine pharmacokinetics in epilepsy from 1953 to 2012.
abstract: BACKGROUND
  Carbamazepine has been used as AEDs since 1965, and is most effective against partial seizures. Two basic mechanisms of action have been proposed: 1) enhancement of sodium channel inactivation by reducing high-frequency repetitive firing of action potentials, 2) and action on synaptic transmission. The aim of this study was to provide a review of carbamazepine pharmacokinetics and its management guidelines in Iranian epileptic population.
  
  
  METHODS
  Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO), Web of Science were searched; 1600, 722 and 167 research and review articles relevant to the topics; carbamazepine pharmacokinetics, carbamazepine pharmacokinetics in epilepsy and review on carbamazepine pharmacokinetics in epilepsy were found, respectively.
  
  
  RESULTS
  Carbamazepine is highly bound to plasma proteins. In patients the protein-bound fraction ranged from 75-80% of the total plasma concentration. Bioavailability ranges from 75-85%. The rate or extent of absorption was not be affected by food. It is completely metabolized and the main metabolite is carbamazepine-epoxide (CBZ-E). Carbamazepine induces its own metabolism, leading to increased clearance, shortened serum half-life, and progressive decrease in serum levels. Increases in daily dosage are necessary to maintain plasma concentration. Severe liver dysfunction may cause disordered pharmacokinetics. In cardiac failure, congestion of major vital organs, including kidneys, may result in abnormally slow absorption and metabolism.
  
  
  CONCLUSIONS
  Carbamazepine shows variability due to its narrow therapeutic window. Therefore clinical management in a3n Iranian epileptic population should focus on results derived from therapeutic drug monitoring in order to reduce inter and intra- individual variability in plasma drug concentrations.
authors: Isfahan Neurosciences Research Centre, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors: Zahra
authors: Z
authors: Tolou-Ghamari
authors: Mohammad
authors: M
authors: Zare
authors: Jafar Mehvari
authors: JM
authors: Habibabadi
authors: Mohammad Reza
authors: MR
authors: Najafi
keywords: Carbamazepine; epilepsy; epoxide; pharmacokinetics; review
references: BMJ. 2010 Dec 02;341:c6581
references: 21127116
references: J Child Neurol. 2004 Jun;19(6):453-5
references: 15446396
references: Dermatology. 2012;225(2):154-62
references: 23037884
references: Riv Neurol. 1984 Nov-Dec;54(6):390-8
references: 6528208
references: Clin Chem Lab Med. 2000 Nov;38(11):1209-11
references: 11156362
references: Am Fam Physician. 2007 Aug 1;76(3):391-6
references: 17708140
references: J Pharm Pharmacol. 2011 Jul;63(7):976-81
references: 21635265
references: Clin Neuropharmacol. 1995 Feb;18(1):1-12
references: 8665529
references: Indian J Dermatol Venereol Leprol. 2005 Jan-Feb;71(1):35-7
references: 16394359
references: Pharmacopsychiatry. 2006 Sep;39(5):192-3
references: 16944411
references: Eur J Neurol. 1995 Apr;2(2):101-5
references: 24283608
references: J Med Econ. 2012;15(5):862-8
references: 22494266
references: Epilepsia. 2008 Dec;49 Suppl 9:63-73
references: 19087119
references: Saudi Med J. 2004 Oct;25(10):1499-500
references: 15494834
references: Can Med Assoc J. 1979 Apr 7;120(7):817-24
references: 371777
references: J Pharm Sci. 2003 Nov;92(11):2260-71
references: 14603511
references: J Nephropathol. 2012 Apr;1(1):23-30
references: 24475383
references: Wien Klin Wochenschr. 2004 Feb 28;116(4):112-8
references: 15038401
references: Rinsho Shinkeigaku. 1995 May;35(5):553-5
references: 7664529
references: Psychiatry Clin Neurosci. 1998 Feb;52(1):3-12
references: 9682927
references: Drug Metab Lett. 2012 Sep 1;6(3):207-12
references: 23140557
references: Epilepsia. 1996;37 Suppl 6:S4-11
references: 8941036
references: Curr Neuropharmacol. 2010 Sep;8(3):254-67
references: 21358975
references: J Pharmacol Sci. 2006 Apr;100(4):310-4
references: 16575152
references: Pain Pract. 2004 Sep;4(3):194-203
references: 17173601
references: J Sep Sci. 2010 Aug;33(15):2294-301
references: 20574961
references: Przegl Lek. 2008;65(11):759-63
references: 19205356
references: Pediatr Dermatol. 1996 Jul-Aug;13(4):316-20
references: 8844754
references: Ther Drug Monit. 2012 Apr;34(2):176-81
references: 22406657
references: Epilepsia. 1995;36 Suppl 2:S2-12
references: 8784210
references: Mol Pharmacol. 2010 Oct;78(4):631-8
references: 20643904
references: Arch Dis Child. 2011 Jul;96(7):643-7
references: 21415043
references: Drugs R D. 2004;5(1):17-22
references: 14725486
references: Clin Pharmacol Ther. 1998 Sep;64(3):286-8
references: 9757152
references: Epilepsia. 2013 Jan;54(1):11-27
references: 23016553
references: Acta Neurol Scand. 2009 Sep;120(3):170-5
references: 19719808
references: Seizure. 2011 Nov;20(9):667-72
references: 21763158
references: Acta Biomed. 2006 Apr;77(1):17-9
references: 16856703
references: Ann Neurol. 2011 Feb;69(2):352-9
references: 21246600
references: J Pediatr Pharmacol Ther. 2012 Jan;17(1):31-44
references: 23118657
references: Drug Intell Clin Pharm. 1983 Sep;17(9):642-4
references: 6225634
references: J Clin Pharm Ther. 2012 Jun;37(3):352-5
references: 21883329
references: Neurology. 2004 Nov 23;63(10 Suppl 4):S3-8
references: 15557548
references: Fundam Clin Pharmacol. 2000 Jul-Aug;14(4):301-19
references: 11030437
references: Eur J Pharm Sci. 2009 Dec 8;38(5):512-8
references: 19804822
references: Neuroscientist. 2012 Aug;18(4):360-72
references: 22235060
references: Genet Couns. 2012;23(1):19-24
references: 22611638
references: Epilepsia. 1999 Nov;40(11):1471-83
references: 10565572
references: Brain Dev. 1997 Jun;19(4):300-2
references: 9187483
references: Br J Clin Pharmacol. 1989 Mar;27(3):323-8
references: 2497766