Relation of blood platelet count during carbamazepine and oxcarbazepine treatment with daily dose, and serum concentrations of carbamazepine, carbamazepine-10, 11-epoxide, and 10-hydroxycarbazepine

Abstract

Background: Carbamazepine (CBZ) occasionally causes haematological disorders such as thrombocytopenia, and recently a case of oxcarbazepine (OXCBZ)-induced thrombocytopenia has been described. The aim of our study was blood platelet count determination in epileptic patients treated with CBZ and OXCBZ, and its relationship with the dose and serum levels of these drugs and its metabolites.Methods: The serum levels of CBZ and its epoxide, and the pharmacologically active monohydroxy derivative of OXCBZ were determined in 137 patients treated with CBZ, and 60 patients treated with OXCBZ. The platelet count, mean platelet volume, and platelet size distribution width were also determined.Results: The diff erence between the platelet counts of the patient groups treated with CBZ and OXCBZ was not signifi cant. No signifi cant correlations between the platelet count and serum levels of the administered antiepileptic drugs and their metabolites were found. However, signifi cant negative correlations between the platelet count and the daily doses of CBZ and OXCBZ were obtained (p < 0.01). In 5 cases (4 treated with CBZ and 1 with OXCBZ) the platelet count was <150 x 10 9 /l. Conclusions: In accordance with the mean platelet volume and platelet distribution width, the thrombocytopenia observed in some of the patients studied was due to a hyper-destruction of peripheral blood platelets. However, the results obtained suggest that the mechanism of CBZ or OXCBZ-induced thrombocytopenia is not due to a direct toxicity of these drugs or their major metabolites on the circulating platelets. Although, the patients treated with OXCBZ shown a lower prevalence for thrombocytopenia (1.7 %) than those treated with CBZ (2.9 %), the routine platelet count monitoring in patients treated with both drugs may be recommended.

Carbamazepine-Induced Hematological and Immunological Alterations in Egyptian Children with Idiopathic Generalized Seizures

“…Correspondingly, the assessment of 137 patients who were on CBZ therapy and 60 patients on oxcarbazepine (OXCBZ) after 3 months of treatment revealed a negative correlation between platelet count and daily doses of both drugs, and five patients (four received CBZ and one received OXCBZ) had a significant reduction in platelets (thrombocytopenia) with increased platelets destruction and reduced platelet survival. 19 In the current study, CBZ therapy and its duration were associated with reduced white blood cells (WBCs), within the neutral range, in epileptic children. Also, leukopenia was reported in 31.7% (13 out of 41) of epileptic Iranian children and adolescents on CBZ therapy after 1 year follow-up, with one patient having to discontinue treatment due to severe leukopenia after 6 months.…”

Eski ve Yeni Kuşak Antiepileptik İlaçların Hemogram Parametrelerine Etkileri Farklı Mı?

“…[8,9] Thrombocytopenia observed in some patients using CBZ or OXC has been attributed to excessive destruction of peripheral blood platelets. [10] It has been shown that the mechanism of thrombocytopenia is not directly related to the toxicity of CBZ, OXC or their metabolites. [10] Routine monitoring of platelet counts is recommended in patients treated with CBZ and OXC.…”

“…[10] It has been shown that the mechanism of thrombocytopenia is not directly related to the toxicity of CBZ, OXC or their metabolites. [10] Routine monitoring of platelet counts is recommended in patients treated with CBZ and OXC. [10] VPA may cause cytopenia by directly affecting the bone marrow or acting on one or more cell lines (pancytopenia, neutropenia, leukopenia).…”

Effects of oxcarbazepine use on hemogram, liver, thyroid functions, lipid profile in childhood epilepsy

“…In the literature, it was suggested that oxcarbazepine causes thrombocytopenia and thrombocytopenia that regress with the cessation of treatment, and these patients should be monitored concerning hemogram parameters [19,20] . Hyperhomocysteinemia is known to induce atherosclerosis through endothelial damage.…”