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https://hdl.handle.net/2440/37123
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Type: | Journal article |
Title: | Influence of cirrhosis on lamotrigine pharmacokinetics |
Author: | Marcellin, P. De Bony, F. Garret, C. Altman, C. Boige, V. Castelnau, C. Laurent-Puig, P. Trinchet, J. Rolan, P. Chen, C. Mamet, J. Bidault, R. |
Citation: | British Journal of Clinical Pharmacology, 2001; 51(5):410-414 |
Publisher: | Blackwell Publishing Ltd |
Issue Date: | 2001 |
ISSN: | 0306-5251 1365-2125 |
Statement of Responsibility: | P. Marcellin, F. De Bony, C. Garret, C. Altman, V. Boige, C. Castelnau, P. Laurent-Puig, J. C. Trinchet, P. Rolan, C. Chen, J. P. Mamet, R. Bidault |
Abstract: | AIMS: Lamotrigine, an antiepileptic drug, is cleared from the systemic circulation mainly by glucuronidation. The possibility of changes in the pharmacokinetics of lamotrigine in plasma owing to hepatic dysfunction has been evaluated. METHODS: Thirty-six subjects, including 24 patients with various degrees of liver cirrhosis and 12 healthy volunteers received a single 100 mg dose of lamotrgine. Blood samples were taken for 7 days in all subjects, except nine with severe cirrhosis, who had a 29 day blood sampling period. RESULTS: The pharmacokinetics of lamotrigine were comparable between the patients with moderate cirrhosis (corresponding to Child-Pugh grade A) and the healthy subjects. Plasma oral clearance mean ratios (90% confidence interval) in patients with severe cirrhosis without or with ascites (corresponding, respectively, to Child-Pugh grade B and C) to healthy subjects were, respectively, 60% (44%, 83%) and 36% (25%, 52%). Plasma half-life mean ratios (90% confidence interval) in these two patient groups to healthy subjects were, respectively, 204% (149%, 278%) and 287% (202%, 408%). CONCLUSIONS: Lamotrigine administered as a single oral dose of 100 mg was well tolerated in all groups. Initial, escalation and maintenance doses should generally be reduced by approximately 50 or 75% in patients with Child-Pugh Grade B or C cirrhosis. Escalation and maintenance doses should be adjusted according to clinical response. |
Keywords: | Cirrhosis lamotrigine pharmacokinetics |
DOI: | 10.1046/j.1365-2125.2001.01389.x |
Published version: | http://dx.doi.org/10.1046/j.1365-2125.2001.01389.x |
Appears in Collections: | Aurora harvest 6 Pharmacology publications |
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