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Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications
Journal article   Open access   Peer reviewed

Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications

Matthew D Krasowski
Pharmaceuticals (Basel, Switzerland), Vol.3(6), pp.1909-1935
2010
DOI: 10.3390/ph3061908
PMCID: PMC2904466
PMID: 20640233
url
https://doi.org/10.3390/ph3061908View
Published (Version of record) Open Access

Abstract

In the past twenty years, 14 new antiepileptic drugs have been approved for use in the United States and/or Europe. These drugs are eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, rufinamide, stiripentol, tiagabine, topiramate, vigabatrin and zonisamide. In general, the clinical utility of therapeutic drug monitoring has not been established in clinical trials for these new anticonvulsants, and clear guidelines for drug monitoring have yet to be defined. The antiepileptic drugs with the strongest justifications for drug monitoring are lamotrigine, oxcarbazepine, stiripentol, and zonisamide. Stiripentol and tiagabine are strongly protein bound and are candidates for free drug monitoring. Therapeutic drug monitoring has lower utility for gabapentin, pregabalin, and vigabatrin. Measurement of salivary drug concentrations has potential utility for therapeutic drug monitoring of lamotrigine, levetiracetam, and topiramate. Therapeutic drug monitoring of the new antiepileptic drugs will be discussed in managing patients with epilepsy.
epilepsy seizures Review anticonvulsants drug toxicity drug monitoring

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