Dept. of Neurology, Jagiellonian University Medical College, Krakow, Poland.
Dept. of Neurology, Jagiellonian University Medical College, Krakow, Poland.
Seizure. 2019 Mar;66:47-52. doi: 10.1016/j.seizure.2019.01.014. Epub 2019 Jan 16.
This study aimed to analyze the extent of co-medication and to assess potential interactions between antiepileptic drugs (AEDs) and other drugs among patients with epilepsy.
We studied 663 consecutive patients with epilepsy seen in tertiary outpatient clinic. Data on epilepsy and current treatment with AED(s) were collected from structured interview and medical records. Other medications used regularly were classified according to the Anatomical Therapeutic Chemical classification system. Possible drug interactions between AEDs and other drugs were analyzed with the use of IBM Micromedex® database.
Studied sample included 395 women; 54.5% of subjects were on monotherapy. Enzyme-inducing AED(s) were used by 127 patients (19.2%). Among 265 patients who used medications other than AEDs (40.0% of all subjects), potential major and moderate interactions between AEDs and other drugs were found in 80 patients (30.1%). Most prevalent major interactions included: ethinylestradiol/estradiol - valproate/oxcarbazepine/carbamazepine, sertraline-carbamazepine, and simvastatin-carbamazepine. A total number of currently used medications (OR = 1.26 [1.07-1.48] per one additional medication; p = 0.005) and the use of enzyme-inducing AEDs (OR = 2.78 [1.51-5.12]; p < 0.001) were independent predictors of interactions between AEDs and other drugs.
Co-medication is common (40%) among patients with epilepsy. Potential major or moderate interactions between AED(s) and other drugs are noted in 30.1% of patients exposed to at least one medication other than AED (12.1% of the entire cohort). The risk of potential interactions increases with the number of medications used chronically and with the use of hepatic enzyme-inducing AEDs.
本研究旨在分析抗癫痫药物（AED）与其他药物之间的合并用药程度，并评估其潜在相互作用。
我们研究了在三级门诊就诊的 663 例连续癫痫患者。通过结构化访谈和病历收集癫痫和当前 AED 治疗的数据。根据解剖治疗化学分类系统对经常使用的其他药物进行分类。使用 IBM Micromedex®数据库分析 AED 与其他药物之间可能存在的药物相互作用。
研究样本包括 395 名女性；54.5%的患者接受单药治疗。127 名患者（19.2%）使用酶诱导型 AED。在 265 名使用 AED 以外药物的患者中（占所有患者的 40.0%），发现 80 名患者（30.1%）存在 AED 与其他药物之间的潜在严重和中度相互作用。最常见的主要相互作用包括：乙炔雌二醇/雌二醇-丙戊酸/奥卡西平/卡马西平、舍曲林-卡马西平，以及辛伐他汀-卡马西平。目前使用的药物数量（每增加一种药物的比值比[OR] = 1.26 [1.07-1.48]；p = 0.005）和使用酶诱导型 AED（OR = 2.78 [1.51-5.12]；p < 0.001）是 AED 与其他药物相互作用的独立预测因素。
癫痫患者合并用药很常见（40%）。暴露于至少一种 AED 以外药物的患者中（占整个队列的 12.1%），有 30.1%的患者存在 AED 之间潜在的严重或中度相互作用。潜在相互作用的风险随着长期使用的药物数量和使用肝酶诱导型 AED 而增加。
