Oxcarbazepine‐induced liver injury after sensitization by valproic acid: a case report

Mermelstein, Alanna Chait; Mermelstein, Joseph; Adam, Tarek; Brody, Benjamin D.; Dubin, Marc G.

doi:10.1111/bdi.12381

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…There are isolated reports of anticonvulsant hypersensitivity syndrome and hepatitis. [112][113][114] Topiramate Topiramate can produce hyperammonemia when combined with valproic acid, but hepatotoxicity when used as monotherapy is very rare. There are a few reports of severe hepatotoxicity, including one individual who was also receiving carbamazepine who required a liver transplant.…”

Section: Oxcarbazepinementioning

confidence: 99%

Antiepileptic Drugs and Liver Disease

Vidaurre

Gedela

Yarosz

2017

Pediatric Neurology

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Acute, symptomatic seizures or epilepsy may complicate the course of hepatic disease. Choosing the most appropriate antiepileptic drug in this setting represents a difficult challenge, as most medications are metabolized by the liver. This article focuses on the acute and chronic treatment of seizures in patients with advanced liver disease and reviews the hepatotoxic potential of specific antiepileptic drugs. Newer antiepileptic drugs without, or with minimal, hepatic metabolism, such as levetiracetam, lacosamide, topiramate, gabapentin, and pregabalin should be used as first-line therapy. Medications undergoing extensive hepatic metabolism, such as valproic acid, phenytoin, and felbamate should be used as drugs of last resort. In special circumstances, as in patients affected by acute intermittent porphyria, exposure to most antiepileptic drugs could precipitate attacks. In this clinical scenario, bromides, levetiracetam, gabapentin, and vigabatrin constitute safe choices. For the treatment of status epilepticus, levetiracetam and lacosamide, available in intravenous preparations, are good second-line therapies after benzodiazepines fail to control seizures. Hepatotoxicity is also a rare and unexpected side effect of some antiepileptic drugs. Drugs such as valproic acid, phenytoin, and felbamate, have a well-recognized association with liver toxicity. Other antiepileptic drugs, including phenobarbital, benzodiazepines, ethosuximide, and the newer generations of antiepileptic drugs, have only rarely been linked to hepatotoxicity. Thus physicians should be mindful of the pharmacokinetic profile and the hepatotoxic potential of the different antiepileptic drugs available to treat patients affected by liver disease.

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Section: Oxcarbazepinementioning

confidence: 99%

Antiepileptic Drugs and Liver Disease

Vidaurre

Gedela

Yarosz

2017

Pediatric Neurology

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“…The need for careful monitoring of drug levels and patient response when these drugs are co-administered is highlighted. 28 , 29 In clinical practice, this interaction requires a delicate approach to administration and monitoring designed to balance efficacy and safety. 27 Doses may need to be adjusted while closely watching for any signs of toxicity or adverse effects to optimize treatment outcomes for patients with these antiepileptic drugs.…”

Section: Discussionmentioning

confidence: 99%

Valproate encephalopathy: Case series and literature review

Pan,

Zhao,

Liu

et al. 2024

SAGE Open Medical Case Reports

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Valproate encephalopathy is one of the unusual and severe but treatable side effect. This research focuses on four female patients who had valproate medication for epilepsy and developed an increased frequency of seizures, exacerbated disruption of consciousness, gastrointestinal problems, cognitive dysfunction, ataxia, and psychobehavioral abnormalities. The patient’s symptoms improved over time once sodium valproate was stopped. As a result, when using sodium valproate, one should be aware of the risk of sodium valproate encephalopathy and cease using the medication right once if any of the above symptoms of unknown etiology manifest clinically. We also go over the potential pathogenesis that lead to valproate encephalopathy and the heightened risk of encephalopathy from taking antiepileptic medications together. It was stressed how crucial it is to identify, diagnose, and treat sodium valproate encephalopathy as soon as possible.

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Oxcarbazepine/valproic acid interaction

2016

Reactions Weekly

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Oxcarbazepine‐induced liver injury after sensitization by valproic acid: a case report

Abstract: Our findings suggest that a longer washout period or another agent should be considered when transitioning from valproic acid to oxcarbazepine.

Cited by 3 publications

References 11 publications

Antiepileptic Drugs and Liver Disease

Antiepileptic Drugs and Liver Disease

Valproate encephalopathy: Case series and literature review

Oxcarbazepine/valproic acid interaction

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