Browne T R, Szabo G K, Evans J E, Evans B A, Greenblatt D J, Mikati M A
Department of Neurology, Boston University School of Medicine, MA.
Neurology. 1988 Jul;38(7):1146-50. doi: 10.1212/wnl.38.7.1146.
Addition of carbamazepine to phenytoin monotherapy resulted in the following significant (p less than 0.05) changes: (1) increased mean phenytoin serum concentration; (2) decreased phenytoin clearance, due to decreased production of phenytoin dihydrodiol and p-hydroxyphenyl-phenylhydantoin; (3) increased phenytoin elimination half-life; and (4) increased drug-related toxicity. Close monitoring is required after addition of carbamazepine to phenytoin.
在苯妥英单药治疗基础上加用卡马西平导致了以下显著(p<0.05)变化:(1)苯妥英血清平均浓度升高;(2)苯妥英清除率降低,原因是苯妥英二氢二醇和对羟基苯基苯妥英的生成减少;(3)苯妥英消除半衰期延长;以及(4)药物相关毒性增加。在苯妥英治疗中加用卡马西平后需要密切监测。