Serum anticonvulsant concentrations and the risk of drug induced skin eruptions.

Chadwick, D.; Shaw, M.; Foy, P. M.; Rawlins, M. D.; Turnbull, Doug

doi:10.1136/jnnp.47.6.642

Cited by 104 publications

(56 citation statements)

References 5 publications

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“…There was associated fever and lymphadenopathy in 2 of these cases. The incidence of allergic skin reactions with carbamazepine has been reported in upto 16.6% cases, (Chadwick et al ) [7], which agrees with the finding with this study. One case of Steven Johnson syndrome was observed in a patient after only 3 days of therapy.…”

Section: Adverse Drug Reactions Related To Carbamazepinesupporting

confidence: 83%

To Study The Adverse Effect of Carbamazepine in A Tertiary Care Teaching Hospital of North East India.

Bhagawati¹,

Hakim²

2017

IOSR JDMS

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Section: Adverse Drug Reactions Related To Carbamazepinesupporting

confidence: 83%

To Study The Adverse Effect of Carbamazepine in A Tertiary Care Teaching Hospital of North East India.

Bhagawati¹,

Hakim²

2017

IOSR JDMS

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“…The rate has been reported to vary directly with the initial dose of LTG (43). This effect is probably not unique to LTG: dose-related increases in rash incidences have also been reported for CBZ and PHT (6).…”

Section: Discussionmentioning

confidence: 75%

Adding Lamotrigine to Valproate: Incidence of Rash and Other Adverse Effects

et al. 1999

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Summary:Purpose: Valproate (VPA) triples the half-life of lamotrigine (LTG), and combined use may be difficult. The adverse effect (AE) profile of this combination needs clarification.Methods: We prospectively recorded our experience in adding LTG to VPA-containing regimens in 108 patients. Data collected included medications, seizure types and syndromes, and AEs. Patients were followed up to 27 months, until a stable dose was reached, or until LTG was discontinued. Patient management was not altered by this study. There were 60 patients with partial-onset seizures, 30 with generalized onset, and 12 with the Lennox-Gastaut syndrome. In 37, LTG was added to VPA monotherapy, and in 71, to VPA and other drugs. The median starting dose of LTG in our adult patients was 20.8 mglday.Results: LTG was added successfully in 86 (80%) patients. It was discontinued in 22 (20%): seven because of rash, seven for other AEs, and nine for other reasons. Rash occurred in 14 (13%) but caused discontinuation of LTG in only seven. We found a rash rate of 14.2% and a discontinuation rate because of rash of 8.7% among 3 10 patients in whom LTG was added to drug regimens not including VPA. Other AEs included fatigue (12%), gastrointestinal (GI) symptoms (9%), dizziness, headache, and insomnia (3% each). Serious AEs were hallucinations (two patients), hepatic enzyme elevations (two patients), irritability (one patient), and low white blood cell count (one patient). Whether LTG was added to VPA monotherapy or polytherapy made no difference in overall AE rate.Conclusions: LTG can be added to VPA with an acceptable incidence of side effects. LTG-induced rashes are no more common with VPA than with other drugs when LTG is added at very low initial dosages. Rashes are potentially serious and should be evaluated promptly.

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“…These are relatively common on therapy with phenobarbital, phenytoin and carbamazepine, with a frequency ranging from 5% to 15% [33]. Oxcarbazepine, the keto analogue of carbamazepine, is associated with a lower incidence of hypersensitivity reactions than carbamazepine.…”

Section: Cutaneous Reactionsmentioning

confidence: 99%

“…Several lines of evidence indicate that the risk of allergic reactions decreases when treatment is started at a low dose and is increased gradually, possibly because slow titration may allow desensitization to occur [43]. A relation between starting dose (and titration rate) and the incidence of cutaneous reactions has been particularly demonstrated in therapy with lamotrigine [34], carbamazepine and phenytoin [33]. For example, in lamotrigine monotherapy trials in adults, rash occurred in 6.1% of patients when the dose in the fi rst treatment week was <31 mg/day, and in 20.5% of patients when the dose was between 62.5 and 125 mg/day [34].…”

Section: Starting Dose and Titration Ratementioning

confidence: 99%

Management of Side‐Effects of Antiepileptic Drugs

Zaccara¹,

Balestrieri²,

Ragazzoni³

2009

The Treatment of Epilepsy

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Serum anticonvulsant concentrations and the risk of drug induced skin eruptions.

Abstract: SUMMARY In two prospective studies of anticonvulsant therapy there was a high incidence of drug-induced skin reactions to phenytoin (7%) and carbamazepine (16.6%). High initial serum concentrations of these drugs appeared to be a factor influencing the occurrence of such skin reactions.

Cited by 104 publications

References 5 publications

To Study The Adverse Effect of Carbamazepine in A Tertiary Care Teaching Hospital of North East India.

To Study The Adverse Effect of Carbamazepine in A Tertiary Care Teaching Hospital of North East India.

Adding Lamotrigine to Valproate: Incidence of Rash and Other Adverse Effects

Management of Side‐Effects of Antiepileptic Drugs

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