Pharmacokinetic Drug–Drug Interactions among Antiepileptic Drugs, Including CBD, Drugs Used to Treat COVID-19 and Nutrients

Karaźniewicz−Łada, Marta; Główka, Anna K.; Mikulska, Aniceta Ada; Główka, Franciszek

doi:10.3390/ijms22179582

Cited by 27 publications

(20 citation statements)

References 182 publications

(285 reference statements)

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“…It has several mechanisms of action including increase in gamma amino butyric acid (GABA) activity and blockage of voltage-gated Na+, Ca2+ and K+ channels. Valproate extensively metabolized in the liver via glucuronidation, β-oxidation and oxidation by cytochrome P450[ 37 ]. Valproate inhibits CYP2C9, uridine glucoronate-glucuronsyl transferase (UGT), and epoxide hydrolase[ 22 ].…”

Section: Asms With the High Potential Of Liver Injurymentioning

confidence: 99%

“…Valproate inhibits CYP2C9, uridine glucoronate-glucuronsyl transferase (UGT), and epoxide hydrolase[ 22 ]. Protease inhibitors, such as lopinavir/ritonavir could increase metabolism of valproate by induction of valproate glucuronidation[ 37 ]. In contrast, valproate decreases the plasma concentrations of darunavir/cobicistat and increases the concentrations of lopinavir/ritonavir[ 36 ].…”

Section: Asms With the High Potential Of Liver Injurymentioning

confidence: 99%

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Potential risk of liver injury in epileptic patients during COVID-19 pandemic

Tabrizi¹,

Sharifi-Razavi²

2022

World J Virol

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Most of the antiseizure medications (ASMs) are metabolized in liver and many of them particularly first-generation ASMs have the potential to increase liver enzymes or induce liver injury. Hence, treatment of new onset seizures or epilepsy by ASMs during the course of coronavirus disease 2019 (COVID-19), which could potentially be complicated by hepatic dysfunction, is a challenging clinical issue. Intravenous form of levetiracetam which has no significant hepatic metabolism or drug-drug interaction is often a favorable option to control seizures in acute phase of COVID-19. Administration of enzyme inducer ASMs and valproate with the well-known hepatotoxicity and common drug interactions is not generally recommended. In patients with epilepsy who are under control with potentially hepatotoxic ASMs, close observation and cautious dose reduction or drug switch should be considered if any evidence of hepatic impairment exists. However, risks of possible breakthrough seizures should be weighed against benefits of lowering the hazard of liver injury. In patients with epilepsy who receive polytherapy with ASMs, transient dose modification with the tendency to increase the dose of ASMs with more favorable safety profile and less drug interaction and decrease the dose of drugs with main hepatic metabolism, high protein binding, potential to cause liver injury and known drug-drug reaction should be considered. Finally, decision making should be individualized based on patients’ conditions and course of illness.

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Section: Asms With the High Potential Of Liver Injurymentioning

confidence: 99%

Section: Asms With the High Potential Of Liver Injurymentioning

confidence: 99%

Potential risk of liver injury in epileptic patients during COVID-19 pandemic

Tabrizi¹,

Sharifi-Razavi²

2022

World J Virol

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“…The time to peak level is 1–2 h after oral administration, the distribution volume is 0.5–1 L/kg, and the plasma protein binding capacity is about 25% ( 20 ). It is metabolized by CYP2C9 and CYP2C19 isoenzymes in the liver and has a half-life of about 5–18 h ( 20 , 77 ). M/P ratio is 0.72 and RID is 8.4–8.6% ( 20 ).…”

Section: Metabolic Pathway Of Asms and The Influence Of Asms In Human...mentioning

confidence: 99%

Management of anti-seizure medications in lactating women with epilepsy

et al. 2022

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Epilepsy is a common neurological disease. At present, there are about 70 million epilepsy patients in the world, half of them are women, and 30–40% of women with epilepsy are of childbearing potential. Patients with epilepsy who are of childbearing potential face more challenges, such as seizures caused by hormonal fluctuations and the risk of adverse effects on the mother and baby from taking anti-seizure medications (ASMs). Breast milk is one of the best gifts that a mother can give her baby, and breastfeeding can bring more benefits to the baby. Compared with healthy people, people with epilepsy have more concerns about breastfeeding because they are worried that ASMs in their milk will affect the growth and development of the baby, and they are always faced with the dilemma of whether to breastfeed after childbirth. Regarding, whether women with epilepsy can breastfeed while taking ASMs, and whether breastfeeding will adversely affect the baby is still an important topic of concern for patients and doctors. This article reviews the existing research on breastfeeding-related issues in women with epilepsy to guide clinical practice, and improve the breastfeeding compliance of women with epilepsy.

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“…Especially for chronic diseases for which patients seem to follow a stable treatment that allows them to manage their condition (i.e., COPD, asthma, or other respiratory diseases), the complications of COVID-19 may raise new challenges and needs for therapy adjustments. Similar tasks may be raised for other cases of patients that receive chronic treatments, such as people with epilepsy or people with coagulation problems, to name some of a few [ 54 , 55 , 128 , 129 , 130 , 131 ]. Therefore, it is crucial that healthcare professionals, especially those in COVID-19 clinics, be as aware as possible regarding responsiveness and management of adverse drug events (ADEs), ADRS, and/or DDIs in order to ensure drug safety and avoid any misdiagnosis [ 94 , 95 , 123 , 124 , 125 , 132 , 133 ].…”

Section: Healthcare Personnel In Covid-19 Clinics: Identifying and Manage Ddis And Adrsmentioning

confidence: 99%

Drug Interactions for Patients with Respiratory Diseases Receiving COVID-19 Emerged Treatments

Spanakis

Patelarou

et al. 2021

IJERPH

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Pandemic of coronavirus disease (COVID-19) is still pressing the healthcare systems worldwide. Thus far, the lack of available COVID-19-targeted treatments has led scientists to look through drug repositioning practices and exploitation of available scientific evidence for potential efficient drugs that may block biological pathways of SARS-CoV-2. Till today, several molecules have emerged as promising pharmacological agents, and more than a few medication protocols are applied during hospitalization. On the other hand, given the criticality of the disease, it is important for healthcare providers, especially those in COVID-19 clinics (i.e., nursing personnel and treating physicians), to recognize potential drug interactions that may lead to adverse drug reactions that may negatively impact the therapeutic outcome. In this review, focusing on patients with respiratory diseases (i.e., asthma or chronic obstructive pulmonary disease) that are treated also for COVID-19, we discuss possible drug interactions, their underlying pharmacological mechanisms, and possible clinical signs that healthcare providers in COVID-19 clinics may need to acknowledge as adverse drug reactions due to drug-drug interactions.

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Pharmacokinetic Drug–Drug Interactions among Antiepileptic Drugs, Including CBD, Drugs Used to Treat COVID-19 and Nutrients

Cited by 27 publications

References 182 publications

Potential risk of liver injury in epileptic patients during COVID-19 pandemic

Potential risk of liver injury in epileptic patients during COVID-19 pandemic

Management of anti-seizure medications in lactating women with epilepsy

Drug Interactions for Patients with Respiratory Diseases Receiving COVID-19 Emerged Treatments

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