Contin Manuela, Albani Fiorenzo, Ambrosetto Giovanni, Avoni Patrizia, Bisulli Francesca, Riva Roberto, Tinuper Paolo, Baruzzi Agostino
Neurology Clinic, Department of Neurological Sciences, University of Bologna, Bologna, Italy.
Epilepsia. 2006 Sep;47(9):1573-5. doi: 10.1111/j.1528-1167.2006.00558.x.
This is the first report comparing intrasubject lamotrigine (LTG) plasma concentrations between hormonal contraceptive (HC) intake and week-off phases in epilepsy patients receiving combined LTG and HC treatment. We describe the variation in LTG plasma concentrations with hormonal contraceptive (HC) monthly intake cycles in a series of eight patients with epilepsy.
Venous blood samples were prospectively drawn from patients before their first morning dose of LTG, once between days 18 and 21 of HC intake and once between days 5 and 7 of the HC-free week.
Median LTG plasma concentrations were significantly higher during the HC washout week than during the phase of HC intake (p = 0.02). The median value of intrasubject percentage increase was 27%, with a wide interpatient variability.
These findings are in line with a preliminary report on healthy volunteers. Standardization of blood sampling in relation to HC intake cycles is advisable when planning LTG therapeutic monitoring in patients receiving HC.
这是首篇比较接受拉莫三嗪（LTG）与激素避孕药（HC）联合治疗的癫痫患者在服用激素避孕药期间和停药期体内拉莫三嗪血浆浓度的报告。我们描述了一系列8例癫痫患者中拉莫三嗪血浆浓度随激素避孕药每月服用周期的变化情况。
前瞻性地采集患者首次晨起服用拉莫三嗪前的静脉血样，在服用激素避孕药的第18至21天之间采集一次，在无激素避孕药的第5至7天之间采集一次。
拉莫三嗪血浆浓度中位数在激素避孕药停药期显著高于服用期（p = 0.02）。受试者体内百分比增加值中位数为27%，患者间差异较大。
这些发现与关于健康志愿者的初步报告一致。在为接受激素避孕药治疗的患者规划拉莫三嗪治疗监测时，建议根据激素避孕药服用周期对采血进行标准化。
Zotero 插件