hrvatski

Klinički značajne interakcije antiepileptika

Epilepsy is a cronic disease, 30 % of epileptic patients take more than one AED and therapy is usually lifetime long. Antiepileptic drugs (AEDs) have a high potential for drug interactions due to their specific pharmakokinetic parameters: strong ability to induce or inhibit the cytochrome P450 system, which is the main route of drug metabolism, some of them have a narrow therapeutic range. A total of 18 AEDs were analised (8 from the first and 10 from the second AED generation) from which 11 are registered in Croatia. Majority of clinically significant drug interactions among AEDs 14 were two-way interactions. There were no clinically significant interactions among the second generation AEDs. Results show there are considerably more clinically significant drug interactions with first than with the second of generation AEDs (88%:12%). First generation AEDs had the most of clinically significant drug interactions with groups J, N and C of Anatomical Therapeutic Chemical Classification of drugs. Most significant drugs with a high potential for interactions with antiepileptics from that groups are: calcium channel blockers - verapamil and diltiazem, amiodarone, doxyciclyne, macrolide antibiotics - erythromycin and telithromycin, metronidazole, protease inhibitors, fluvoxamine and selective serotonine reuptake inhibitors. Other noted groups of drugs of Anatomical Therapeutic Chemical classification that have clinically significant drug interactions with the first generation of AEDs are oral contraceptives, anticancer drugs, cyclosporine and theophylline. Second generation of AEDs had the most of clinically significant drug interactions with groups G and N of Anatomical Therapeutic Chemical Classification of drugs, mainly with oral contraceptives.

interakcije lijekova, antiepileptici

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