RETROSPECTIVE STUDY ON THERAPEUTIC DRUG MONITORING OF LAMOTRIGINE IN INDIAN EPILEPTIC PATIENTS

Authors

  • Prajakta Kadam Research Laboratories, P.D. Hinduja Hospital and Medical Research Centre, V. S. Marg, Mahim, Mumbai 400016
  • Alpa Dherai Department of Lab Medicine, P.D. Hinduja Hospital and Medical Research Centre, V. S. Marg, Mahim, Mumbai 400016
  • Prasad Naik Department of Lab Medicine, P.D. Hinduja Hospital and Medical Research Centre, V. S. Marg, Mahim, Mumbai 400016
  • Rohan Lokhande Department of Lab Medicine, P.D. Hinduja Hospital and Medical Research Centre, V. S. Marg, Mahim, Mumbai 400016
  • Vrajesh Udani Department of Pediatric Neurology, P.D. Hinduja Hospital and Medical Research Centre, V. S. Marg, Mahim, Mumbai 400016
  • Roop Gursahani Department of Neurology, P.D. Hinduja Hospital and Medical Research Centre, V. S. Marg, Mahim, Mumbai 400016
  • Tester F. Ashavaid Research Laboratories, P.D. Hinduja Hospital and Medical Research Centre, V. S. Marg, Mahim, Mumbai 400016, Department of Lab Medicine, P.D. Hinduja Hospital and Medical Research Centre, V. S. Marg, Mahim, Mumbai 400016

Keywords:

Lamotrigine, Adjunctive therapy, Inter-individual variation, Drug monitoring

Abstract

Objective: Antiepileptic drugs (AED) are administered either singly or in combination with other drugs. Their pharmacokinetics is influenced by drug-drug interaction & inter-individual variations. Lamotrigine (LTG) is a second order AED with similar constraints.

Hence studying the relationship between lamotrigine dosage and plasma concentration was undertaken to offer assistance in therapeutic regimen.

Methods: Pre-dose blood samples for lamotrigine estimation were obtained from 267 patients (138adults & 127children) including 2 pregnant women. Lamotrigine estimation was done by high performance liquid chromatography.

Results: In our study more children (73%) than adults (34%) were on adjunctive therapy with inhibitors (valproic acid) or inducers (phenytoin, carbamazepine, oxcarbamazepine). Irrespective of co-therapy lamotrigine level within therapeutic range with an optimal seizure control was obtained only in 76% of children and 65% adults. In case of polytherapy with valproic acid, when lamotrigine dose was maintained similar or lower than monotherapy, lamotrigine levels were 105% and 65% higher in adults and children respectively. Increased volume as observed in pregnancy had a remarkable influence on lamotrigine level. An increase in drug dose with an increase in gestation was required in both pregnant women to maintain the plasma level.

Conclusion: Inter-individual variations, co-medications and clinical conditions like pregnancy influence plasma lamotrigine level. Thus, drug monitoring is essential to obtain therapeutic efficacy for individual dose optimization.

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Published

31-08-2014

How to Cite

Kadam, P., A. Dherai, P. Naik, R. Lokhande, V. Udani, R. Gursahani, and T. F. Ashavaid. “RETROSPECTIVE STUDY ON THERAPEUTIC DRUG MONITORING OF LAMOTRIGINE IN INDIAN EPILEPTIC PATIENTS”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 6, no. 8, Aug. 2014, pp. 430-3, https://journals.innovareacademics.in/index.php/ijpps/article/view/1825.

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