Therapeutic Drug Monitoring of Carbamazepine

Panday, Dipesh Raj; Panday, Karishma Rajbhandari; Basnet, Madhur; Kafle, Shyam; Shah, Bhupendra; Rauniar, Gajendra Prasad

doi:10.4172/2376-0281.1000245

Cited by 13 publications

(15 citation statements)

References 16 publications

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“…Consequently, patients stabilized on CBZ A are used to receive a relatively high drug load just a few minutes after tablet ingestion, and they should be advised never to switch their medication to another brand unless a close plasma drug monitoring and therapeutic response monitoring are conducted. 9,10 CBZ B and CBZ C showed a comparable in-vitro release profile. Therefore, in case of unavailability of each one of them offers an acceptable alternative to the other when its unavailable to use by the patient.…”

Section: Figure 6: the Cumulative Release Profile Of Cbz D Product Conclusionmentioning

confidence: 86%

Comparative Study of Different Products of Carbamazepine Tablets Available in Iraqi Market

Al-Shaheen

Majeed

Al-Zidan

2021

J. Drug Delivery Ther.

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Carbamazepine (CBZ) is a widely used antiepileptic drug to control grand mal epilepsy, as well as for the treatment of peripheral neuralgia. According to the biopharmaceutical classification system (BCS), CBZ is considered a class II drug. CBZ is characterized by a slow and irregular gastrointestinal absorption, with irregular oral bioavailability; due to its low water solubility. Therefore, the release of the drug from the dosage form (tablets in this study) and the subsequent step of dissolution represent the most important parameters that decide whether a sufficient plasma concentration will be achieved or not. In the current study, the FTIR study for the pure API, CBZ, and the different commercially available brands of CBZ conventional tablets, available in the Iraqi drug market (Mosul city as an example), were examined. Subsequently, various quality control parameters such as the weight variation, content uniformity, friability, and hardness of the conventional CBZ tablets were conducted. Moreover, the disintegration and the dissolution tests of the different brands of CBZ available in the Iraqi drug market were performed. Keywords: Antiepileptic Drug, Bioequivalence; Epilepsy; Generic; Brand vs generic; IVIVC; QC

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Section: Figure 6: the Cumulative Release Profile Of Cbz D Product Conclusionmentioning

confidence: 86%

Comparative Study of Different Products of Carbamazepine Tablets Available in Iraqi Market

Al-Shaheen

Majeed

Al-Zidan

2021

J. Drug Delivery Ther.

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“…Conversely, CBZ, PHT, PHB and TPM increase the clearance of ESL and decrease its plasma concentration by about 20-33%. ESL reduces concentration of simvastatin and rosuvastatin by 54% and up to 39%, respectively [29,99,100]. CBD significantly increase levels of ESL in serum [23,25].…”

Section: Eslicarbazepinementioning

confidence: 92%

“…The TPM biological half-life becomes up to 50% shorter after administration with enzyme-inducing AEDs. Over 200 drugs are known to interact with TPM [100,175]. TPM clearance is also decreased by lithium, propranolol, amitryptiline and sumatriptan, diltiazem, hydrochlorthiazide, metformin, propranolol and, finally, posaconazole, increasing the level of TPM in serum [98].…”

Section: Topiramatementioning

confidence: 99%

Pharmacokinetic Drug–Drug Interactions among Antiepileptic Drugs, Including CBD, Drugs Used to Treat COVID-19 and Nutrients

Karaźniewicz−Łada

Główka

Mikulska

et al. 2021

IJMS

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Anti-epileptic drugs (AEDs) are an important group of drugs of several generations, ranging from the oldest phenobarbital (1912) to the most recent cenobamate (2019). Cannabidiol (CBD) is increasingly used to treat epilepsy. The outbreak of the SARS-CoV-2 pandemic in 2019 created new challenges in the effective treatment of epilepsy in COVID-19 patients. The purpose of this review is to present data from the last few years on drug–drug interactions among of AEDs, as well as AEDs with other drugs, nutrients and food. Literature data was collected mainly in PubMed, as well as google base. The most important pharmacokinetic parameters of the chosen 29 AEDs, mechanism of action and clinical application, as well as their biotransformation, are presented. We pay a special attention to the new potential interactions of the applied first-generation AEDs (carbamazepine, oxcarbazepine, phenytoin, phenobarbital and primidone), on decreased concentration of some medications (atazanavir and remdesivir), or their compositions (darunavir/cobicistat and lopinavir/ritonavir) used in the treatment of COVID-19 patients. CBD interactions with AEDs are clearly defined. In addition, nutrients, as well as diet, cause changes in pharmacokinetics of some AEDs. The understanding of the pharmacokinetic interactions of the AEDs seems to be important in effective management of epilepsy.

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“…PRP is the progenitor of a new class of antiepileptics and its plasmatic free amount can be significantly affected by co-administration with other ASMs that compete for plasma protein binding [ 75 ]. CBZ metabolism is influenced by multiple factors and its plasma amount shows a non-linear correlation with the administered dose [ 76 ]. In view of the above, we report in detail some recent studies that have focused their attention on the importance of evaluating the free drug plasma concentration of these drugs.…”

Section: Examples Of Protein Binding Influence In Asms Polytherapeutic Regimens: Valproic Acid Phenytoin Perampanel and Carbamazepinementioning

confidence: 99%

The Effect of Plasma Protein Binding on the Therapeutic Monitoring of Antiseizure Medications

et al. 2021

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Epilepsy is a widely diffused neurological disorder including a heterogeneous range of syndromes with different aetiology, severity and prognosis. Pharmacological treatments are based on the use, either in mono- or in polytherapy, of antiseizure medications (ASMs), which act at different synaptic levels, generally modifying the excitatory and/or inhibitory response through different action mechanisms. To reduce the risk of adverse effects and drug interactions, ASMs levels should be closely evaluated in biological fluids performing an appropriate Therapeutic Drug Monitoring (TDM). However, many decisions in TDM are based on the determination of the total drug concentration although measurement of the free fraction, which is not bound to plasma proteins, is becoming of ever-increasing importance since it correlates better with pharmacological and toxicological effects. Aim of this work has been to review methodological aspects concerning the evaluation of the free plasmatic fraction of some ASMs, focusing on the effect and the clinical significance that drug-protein binding has in the case of widely used drugs such as valproic acid, phenytoin, perampanel and carbamazepine. Although several validated methodologies are currently available which are effective in separating and quantifying the different forms of a drug, prospective validation studies are undoubtedly needed to better correlate, in real-world clinical contexts, pharmacokinetic monitoring to clinical outcomes.

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Therapeutic Drug Monitoring of Carbamazepine

Cited by 13 publications

References 16 publications

Comparative Study of Different Products of Carbamazepine Tablets Available in Iraqi Market

Comparative Study of Different Products of Carbamazepine Tablets Available in Iraqi Market

Pharmacokinetic Drug–Drug Interactions among Antiepileptic Drugs, Including CBD, Drugs Used to Treat COVID-19 and Nutrients

The Effect of Plasma Protein Binding on the Therapeutic Monitoring of Antiseizure Medications

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