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Carbamazepine Clearance in Paediatric Epilepsy Patients

Influence of Body Mass, Dose, Sex and Co-Medication

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Summary

Carbamazepine clearance was studied in Black paediatric epilepsy patients, 90 receiving monotherapy and 17 on combination therapy. For patients on monotherapy the following relationships are shown: clearance decreases with increasing body mass (r = 0.87); clearance increases with increasing dose (r = 0.70); and mean clearances for males are higher than those for females throughout the mass ranges, though the difference is not statistically significant.

In the case of patients on carbamazepine plus another anticonvulsant, clearance also decreases with increasing body mass, and increases with increasing dose. Furthermore, in the mass groups which corresponded with those on monotherapy, mean carbamazepine clearance is higher by a factor varying from 1.3 to 1.7; in the corresponding dosage groups, it is higher by a factor of between 1.4 and 1.7.

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References

  • Battino D, Bossi L, Croci D, Franschetti S, Gomeni C, et al. Carbamazepine plasma levels in children and adults: influence of age, dose and associated therapy. Therapeutic Drug Monitoring 2(4): 315–322, 1980

    PubMed  CAS  Google Scholar 

  • Bertilsson L. Clinical pharmacokinetics of carbamazepine. Clinical Pharmacokinetics 3: 128–143, 1978

    Article  PubMed  CAS  Google Scholar 

  • Bertilsson L, Höjer B, Tybring G, Osterloh J, Rane A. Autoinduction of carbamazepine metabolism in children examined by a stable isotope technique. Clinical Pharmacology and Therapeutics 27(1): 83–88, 1980

    Article  PubMed  CAS  Google Scholar 

  • Dodson WE. Carbamazepine efficacy and utilisation in children. Epilepsia 28 (Suppl. 3): S17–S24, 1987

    Article  PubMed  Google Scholar 

  • Eadie MJ, Tyrer JH. Anticonvulsant therapy: pharmacological basis and practice, 2nd ed, Churchill Livingstone, Edinburgh, 1980

    Google Scholar 

  • Eichelbaum M, Ekbom K, Bertilsson L, Ringberger VA, Rane A. Plasma kinetics of carbamazepine and its epoxide metabolite in man after single and multiple doses. European Journal of Clinical Pharmacology 8: 337–341, 1975

    Article  PubMed  CAS  Google Scholar 

  • Eichelbaum M, Köthe KW, Hoffman F, van Unruh GE. Kinetics and metabolism of carbamazepine during combined antiepileptic drug therapy. Clinical Pharmacology and Therapeutics 26(3): 366–371, 1979

    PubMed  CAS  Google Scholar 

  • Eichelbaum M, Tomson T, Tybring G, Bertilsson L. Carbamazepine metabolism in man: induction and pharmacogenetic aspects. Clinical Pharmacokinetics 10: 80–90, 1985

    Article  PubMed  CAS  Google Scholar 

  • Elyas AA, Patsalos NP, Agabato OA, Brett EM, Lascelles PT. Factors influencing simultaneous concentrations of total and free carbamazepine and carbamazepine-10,11-epoxide in serum of children with epilepsy. Therapeutic Drug Monitoring 8: 288–292, 1986

    Article  PubMed  CAS  Google Scholar 

  • Faigle JW, Feldman KF. Pharmacokinetic data of carbamazepine and its major metabolites in man. In Schneider et al. (Eds) Clinical pharmacology of antiepileptic drugs, Springer-Verlag, Berlin, 1975

    Google Scholar 

  • Familusi JB. Preliminary Nigerian experience in the use of carbamazepine in chiidren with intractable seizures. Epilepsia 26(1): 10–14, 1985

    Article  PubMed  CAS  Google Scholar 

  • Furlanut M, Montanari G, Bonin P, Casara GL. Carbamazepine and carbamazepine-10,11-epoxide serum concentrations in epileptic children. Journal of Pediatrics 106: 491–495, 1985

    Article  PubMed  CAS  Google Scholar 

  • Gilman AG, Goodman LS, Rall TW, Murad F (Eds). Goodman & Gilman (Eds) The pharmacological basis of therapeutics, 7th ed., Macmillan, New York, 1985

    Google Scholar 

  • Grasela TH, Sheiner LB, Rambeck B, Boegnigk HE, et al. Steady-state pharmacokinetics of phenytoin from routinely collected patient data. Clinical Pharmacokinetics 8: 355–364, 1983

    Article  PubMed  CAS  Google Scholar 

  • Huf R, Schain RJ. Long-term experience with carbamazepine (Tegretol) in children with seizures. Journal of Paediatrics 97: 310–312, 1980

    Article  CAS  Google Scholar 

  • Kumps A. Dose-dependency of the ratio between carbamazepine serum level and dosage in patients with epilepsy. Therapeutic Drug Monitoring 3: 271–274, 1981

    Article  PubMed  CAS  Google Scholar 

  • Kumps A, Mardens Y. A retrospective study on epileptic patients treated with carbamazepine: interaction between age and co-medication on drug disposition. Pharmaceutica Acta Helvetiae 57: 160–164, 1983

    Google Scholar 

  • Levy RH, Pitlick WH, Troupin AS, Green JR, Neale JM. Pharmacokinetics of carbamazepine in normal man. Clinical Pharmacology and Therapeutics 17: 657–668, 1975

    PubMed  CAS  Google Scholar 

  • Meinardi H. Carbamazepine: general discussion. In Schneider et al. (Eds) Clinical pharmacology of antiepileptic drugs, Springer-Verlag, Berlin, 1975

    Google Scholar 

  • Miller R, Rheeders M, Klein C, Suchet I. Population pharmacokinetics of phenytoin in South African blacks. South African Medical Journal 72: 188–190, 1987

    PubMed  CAS  Google Scholar 

  • Morselli PL. Carbamazepine: absorption, distribution and excretion. In Penry & Daly (Eds) Complex and partial seizures. Advances in Neurology 11: 279–293, 1975

    Google Scholar 

  • Morselli PL, Bossi L. Carbamazepine: absorption, distribution and excretion. In Woodbury et al. (Eds) Antiepileptic drugs, 2nd ed., Raven Press, New York, 1982

    Google Scholar 

  • Morselli PL, Gerna M, De Maio D, Zanda G, et al. Pharmacokinetic studies on carbamazepine in volunteers and in epileptic patients. In Schneider et al. (Eds) Clinical pharmacology of antiepileptic drugs, Springer-Verlag, Berlin, 1975

    Google Scholar 

  • O’Donohoe NV. Epilepsies of childhood. Butterworths, London, 1979

    Google Scholar 

  • Peck CC. Bedside clinical pharmacokinetics: simple techniques for individualising drug therapy. Pharmacometrics Press, Rockville, Maryland, 1984

    Google Scholar 

  • Perucca E, Bittencourt P, Richens A. Effect of dose increments on serum carbamazepine concentration in epileptic patients. Clinical Pharmacokinetics 5: 576–582, 1980

    Article  PubMed  CAS  Google Scholar 

  • Pynnönen S, Sillanpää M, Frey H, Iisalo E. Carbamazepine and its 10,11-epoxide in children and adults with epilepsy. European Journal of Clinical Pharmacology 11: 129–133, 1977

    Article  PubMed  Google Scholar 

  • Rambeck B, May T, Juergens U. Serum concentrations of carbamazepine and its epoxide and diol metabolites in epileptic patients: the influence of dose and co-medication. Therapeutic Drug Monitoring 9: 298–303, 1987

    Article  PubMed  CAS  Google Scholar 

  • Rane A, Hojer B, Wilson JT. Kinetics of carbamazepine and its 10,11-epoxide metabolite in children. Clinical Pharmacology and Therapeutics 19(3): 276–283. 1976

    PubMed  CAS  Google Scholar 

  • Rey E, D’Athis P, De Lauture D, Dulac O, Aicardi J, et al. Pharmacokinetics of carbamazepine in the neonate and in the child. International Journal of Clinical Pharmacology and Biopharmacy 17(2): 90–96, 1979

    PubMed  CAS  Google Scholar 

  • Reynolds EH, Shorvon SD. Single drug or combination therapy for epilepsy? Drugs 21: 374–382, 1981

    Article  PubMed  CAS  Google Scholar 

  • Riva A, Contin M, Albani F, Perucca E, Gaetano P, et al. Free concentration of carbamazepine and carbamazepine-10,11-epoxide in children and adults: influence of age and phenobarbitone co-medication. Clinical Pharmacokinetics 10: 524–531, 1985

    Article  PubMed  CAS  Google Scholar 

  • Sanchez A, Duran JA, Serrano JS. Steady-state carbamazepine plasma concentration-dose ratios in epileptic patients. Clinical Pharmacokinetics 11: 411–414, 1986

    Article  PubMed  CAS  Google Scholar 

  • Schain RJ, War JW, Guthrie D. Carbamazepine as an anticonvulsant in children. Neurology 27: 476–480, 1977

    Article  PubMed  CAS  Google Scholar 

  • Schmidt D. Reduction of two-drug therapy in intractable epilepsy. Epilepsia 24: 368–376, 1983

    Article  PubMed  CAS  Google Scholar 

  • Schneider H. Carbamazepine: general discussion. In Schneider et al. (Eds) Clinical pharmacology of antiepileptic drugs, Springer-Verlag, Berlin, 1975

    Chapter  Google Scholar 

  • Shargel L, Yu ABC. Applied biopharmaceutics and pharmacokinetics, Appleton-Century-Crofts, New York, 1980

    Google Scholar 

  • Summers B, Summers RS. Phenobarbitone clearance varies with body mass in paediatric seizure patients. Abstract. United Kingdom Clinical Pharmacy Association Residential Symposium, Oxford, 1987

    Google Scholar 

  • Summers B, Summers RS, Rom S. The effect of a specialist clinic with pharmacist involvement on the management of epilepsy in paediatric patients. Journal of Clinical and Hospital Pharmacy 11: 207–214, 1986

    PubMed  CAS  Google Scholar 

  • Windholz M, Budavari S, Stroumtsos LY, Fertig MN (Eds). The Merck Index, 9th ed., Merck & Co, Rahway, New Jersey, 1976

    Google Scholar 

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  1. School of Pharmacy, Medical University of Southern Africa (MEDUNSA), Pretoria, South Africa

    B. Summers & R. S. Summers

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  1. B. Summers
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Summers, B., Summers, R.S. Carbamazepine Clearance in Paediatric Epilepsy Patients. Clin-Pharmacokinet 17, 208–216 (1989). https://doi.org/10.2165/00003088-198917030-00006

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