Friel P N, Leal K W, Wilensky A J
Ther Drug Monit. 1979;1(2):243-8. doi: 10.1097/00007691-197901020-00005.
The interaction between valproic acid (VPA) and phenytoin (DPH) was examined during therapeutic monitoring in an epileptic outpatient population. Gas-liquid chromatographic methods were used to measure DPH and VPA concentrations. (1) In 12 patients on stable DPH regimens, the mean DPH level declined from 19.7 to 15.3 microgram/ml when VPA was added (p less than 0.001). (2) In 20 patients receiving DPH and VPA, the median free fraction was 15.8%, compared to 9.1% free DPH in 40 patients receiving DPH only or DPH and phenobarbital (p less than 0.001). (3) Addition of VPA to a stable DPH regimen may result in a transient increased risk of DPH toxicity, followed by restabilization at the original free DPH level.
在癫痫门诊患者的治疗监测过程中，对丙戊酸（VPA）与苯妥英（DPH）之间的相互作用进行了研究。采用气液色谱法测量DPH和VPA的浓度。（1）在12例采用稳定DPH治疗方案的患者中，添加VPA后，DPH的平均水平从19.7微克/毫升降至15.3微克/毫升（p<0.001）。（2）在20例接受DPH和VPA治疗的患者中，游离分数中位数为15.8%，而在40例仅接受DPH或接受DPH和苯巴比妥治疗的患者中，游离DPH为9.1%（p<0.001）。（3）在稳定的DPH治疗方案中添加VPA可能会导致DPH毒性风险短暂增加，随后在原来的游离DPH水平重新稳定。
