Camfield P, Hwang P, Camfield C, Fraser A, Soldin S, al-Quadah A K
IWK Children's Hospital, Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Can J Neurol Sci. 1992 May;19(2):204-7.
We report the first comparison of Chewable and Regular Carbamazepine (CBZ) tablets in children with epilepsy. Forty-four children receiving chronic monotherapy CBZ participated. In month 1 children received regular CBZ; in month 2, the same dose of Chewable CBZ. Once per week fasting predose CBZ and CBZ epoxide serum levels were determined. In a subset of 15 children, at the end of each month serum levels were obtained every 2 hours for 12 hours beginning pre-dose. Standards for CBZ and CBZ epoxide were tested in each centre. Overall, weekly levels showed no consistent differences between the month on chewable CBZ and regular CBZ. Seizure control and rates of reported side effects were similar. In five patients chewable CBZ produced higher peak CBZ levels while five had higher peaks with regular CBZ. In conclusion, regular and chewable CBZ often have unpredictable differences in peak but not trough levels of CBZ suggesting that peak level side effects with one form of CBZ might be alleviated by changing to the other.
我们报告了癫痫患儿中咀嚼型与普通卡马西平（CBZ）片剂的首次比较。44名接受卡马西平长期单一疗法的儿童参与了研究。第1个月，儿童服用普通卡马西平；第2个月，服用相同剂量的咀嚼型卡马西平。每周一次在空腹给药前测定卡马西平和卡马西平环氧化物的血清水平。在15名儿童的亚组中，每个月末，从给药前开始，每2小时获取一次血清水平，持续12小时。每个中心都对卡马西平和卡马西平环氧化物的标准进行了检测。总体而言，每周的水平显示，在服用咀嚼型卡马西平和普通卡马西平的月份之间没有一致的差异。癫痫发作控制情况和报告的副作用发生率相似。5名患者服用咀嚼型卡马西平后卡马西平峰值水平较高，而5名患者服用普通卡马西平后峰值较高。总之，普通型和咀嚼型卡马西平在卡马西平峰值水平而非谷值水平上往往存在不可预测的差异，这表明通过更换剂型，一种卡马西平的峰值水平副作用可能会得到缓解。
