Influence of Additional Therapy with Zonisamide (Excegran) on Protein Binding and Metabolism of Carbamazepine |
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| Authors: | Taketsuga Minami,Ichiro Ieiri,Kenji Ohtsubo&dagger ,Yoshihiro Hirakawa&dagger ,Kohji Ueda,Shun Higuchi,Toshinobu Aoyama&dagger |
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| Affiliation: | Department of Pediatrics, Faculty of Medicine, Kyushu University;Department of Clinical Pharmacokinetics, Division of Pharmaceutical Science, Post-Graduate School, Kyushu University;Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan |
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| Abstract: | Summary: The influence of comedication with zonisamide (ZNS) on protein binding and carbamazepine (CBZ) metabolism was studied in 16 pediatric epileptic patients. Correlations were evaluated between ZNS daily dose and individual change of level per dose ratio (L/D ratio), free fraction, and carbamazepine-10,11-epoxide/CBZ level ratio (CBZEKBZ). Statistical significant negative correlation was observed between LID ratio and ZNS daily dose. Despite alteration in the L/D ratio, the free fraction of CBZ was unaltered in combination with ZNS. To assess the effect of addition of ZNS on CBZ metabolism, the CBZE/CBZ level ratio was compared; this ratio showed a tendency to increase with increase in ZNS dose. Consequently, ZNS is considered to have a significant effect on CBZ metabolism but not on protein binding. |
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| Keywords: | Epilepsy Zonisamide Carbamazepine Metabolism Protein binding Leve/dose ratio |
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