2006
DOI: 10.1111/j.1528-1167.2006.00629.x
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Increased Apparent Oral Clearance of Valproic Acid during Intake of Combined Contraceptive Steroids in Women with Epilepsy

Abstract: Summary:Purpose: To determine potential changes in total and unbound serum valproic acid (VPA) concentrations at steadystate during a cycle of intake of combined hormonal contraceptive (HC) steroids.Methods: Blood samples were collected from nine women stabilized on VPA monotherapy on two separate randomized occasions: (i) at the end of the 4-to 7-day HC-free interval, and (ii) on the last day of the HC intake period. Trough concentrations of VPA in serum and serum ultrafiltrates were determined by fluorescenc… Show more

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Cited by 56 publications
(20 citation statements)
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“…Similar observations about increased clearance with possible worsening seizure control, have been made about OXC during pregnancy, but reports about effects of concomitant OCP use are lacking [1,65]. Findings of a study of VPA with OCP use in women were that total and unbound VPA concentrations were higher during the OCP-free interval than during the OCP interval [21]. VPA clearance increased by 21.5% for total VPA and 45% for free VPA.…”
Section: Antiepileptic Drugs and Hormonal Contraceptive Interactionsmentioning
confidence: 70%
“…Similar observations about increased clearance with possible worsening seizure control, have been made about OXC during pregnancy, but reports about effects of concomitant OCP use are lacking [1,65]. Findings of a study of VPA with OCP use in women were that total and unbound VPA concentrations were higher during the OCP-free interval than during the OCP interval [21]. VPA clearance increased by 21.5% for total VPA and 45% for free VPA.…”
Section: Antiepileptic Drugs and Hormonal Contraceptive Interactionsmentioning
confidence: 70%
“…Lamotrigine -see below Sodium valproate -not clinically significant 4,5 AEDs that cause liver enzyme inhibition: Sodium valproate -may raise the blood levels of hepatically metabolised drugs, with important effects on some other AEDs, particularly lamotrigine; but this would tend to make hormonal contraceptives more effective, without evidence of any clinically important added risk of adverse effects Table 6 Contraceptive preparations that inhibit ovulation Combined hormonal contraceptives Desogestrel (Cerazette ® ) Etonogestrel (Implanon ® ) -the active metabolite of desogestrel Medroxyprogesterone acetate (Depo-Provera ® )…”
Section: Aeds Affected By Hormonal Contraceptionmentioning
confidence: 99%
“…These fluctuations are most likely due to an induction of UGT1A4, the enzyme responsible for the glucoronidation of lamotrigine, by EE. VPA levels also seem to be reduced by the concomitant use of hormonal contraceptives Galimberti, 2006). Just as with lamotrigine the magnitude of observed fluctuations of the VPA levels appear to vary interindividually.…”
Section: Contraception and Epilepsymentioning
confidence: 95%