Thrombocytopenia in association with adjunctive felbamate use

Ney, Gershon C.; Schaul, Neil; Loughlin, John; Rai, Kamala; Chandra, V.

doi:10.1212/wnl.44.5.980

Cited by 15 publications

(2 citation statements)

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“…Sporadic cases of thrombocytopenia, probably immune mediated, have been reported with CBZ, PHT, LTG, FBM, PMD, and tiagabine (TGB) (Parker, 1974; Ney et al, 1994; Holtzer and Reisner‐Keller, 1997; Willert et al, 1999; De Berardis et al, 2003; Goraya and Virdi, 2003; Ural et al 2005). Due to their dose dependency and relatively high incidence at serum drug concentrations in the upper range (Beydoun et al, 1997), VPA‐induced thrombocytopenia and abnormal platelet function cannot be regarded as idiosyncratic and will not be discussed here.…”

Section: Most Common Idiosyncratic Reactions To Aedsmentioning

confidence: 99%

Idiosyncratic Adverse Reactions to Antiepileptic Drugs

Zaccara¹,

2007

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Summary: Idiosyncratic drug reactions may be defined as adverse effects that cannot be explained by the known mechanisms of action of the offending agent, do not occur at any dose in most patients, and develop mostly unpredictably in susceptible individuals only. These reactions are generally thought to account for up to 10% of all adverse drug reactions, but their frequency may be higher depending on the definition adopted. Idiosyncratic reactions are a major source of concern because they encompass most life-threatening effects of antiepileptic drugs (AEDs), as well as many other reactions requiring discontinuation of treatment. Based on the underlying mechanisms, idiosyncratic reactions can be differentiated into (1) immunemediated hypersensitivity reactions, which may range from benign skin rashes to serious conditions such as drug-related rash with eosinophilia and systemic symptoms; (2) reactions involving unusual nonimmune-mediated individual susceptibility, often related to abnormal production or defective detoxification of reactive cytotoxic metabolites (as in valproate-induced liver toxicity); and (3) off-target pharmacology, whereby a drug interacts directly with a system other than that for which it is intended, an example being some types of AED-induced dyskinesias. Although no AED is free from the potential of inducing idiosyncratic reactions, the magnitude of risk and the most common manifestations vary from one drug to another, a consideration that impacts on treatment choices. Serious consequences of idiosyncratic reactions can be minimized by knowledge of risk factors, avoidance of specific AEDs in subpopulations at risk, cautious dose titration, and careful monitoring of clinical response.

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Section: Most Common Idiosyncratic Reactions To Aedsmentioning

confidence: 99%

Idiosyncratic Adverse Reactions to Antiepileptic Drugs

Zaccara¹,

2007

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“…Thrombocytopenia has also been reported with FBM (70). The life-threatening nature and higher than expected occurrence of the idiosyncratic events have restricted the use of FBM to patients with severe, refractory epilepsy for whom the potential benefit of FBM outweighs the risks (63) and have resulted in discontinuation of usage in several countries.…”

Section: Tgbmentioning

confidence: 99%

Overview of the Safety of Newer Antiepileptic Drugs

Shorvon

Stefan

1997

Epilepsia

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Summary: Standard antiepileptic drugs (AEDs) are associated with a wide variety of acute and chronic adverse events and with many interactions with each other and with nonAEDs that complicate patient management. The safety and interaction profiles of the newer AEDs have also been intensively studied. Safety data are available for six of the newer AEDs, lamotrigine (LTG), vigabatrin (VGB), gabapentin (GBP), tiagabine (TGB), felbamate (FBM), and topiramate (TPM). The potential for the most recently developed AEDs for producing rare idiosyncratic reactions cannot be ascertained until additional patient exposures have been reported from careful postmarketing surveillance.

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Felbamate

Leppik¹

2004

The Treatment of Epilepsy

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Thrombocytopenia in association with adjunctive felbamate use

Cited by 15 publications

References 0 publications

Idiosyncratic Adverse Reactions to Antiepileptic Drugs

Idiosyncratic Adverse Reactions to Antiepileptic Drugs

Overview of the Safety of Newer Antiepileptic Drugs

Felbamate

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