Pediatric Neurology Unit, Soroka University Medical Center, Beer Sheva, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Epilepsia. 2022 May;63(5):1276-1278. doi: 10.1111/epi.17212. Epub 2022 Mar 9.
Presented herein are recommendations for use of nirmatrelvir/ritonavir in patients with epilepsy, as issued by the Steering Committee of the Israeli chapter of the International League Against Epilepsy. The recommendations suggest that patients on moderate-to-strong enzyme-inducing antiseizure medications (ASMs) and everolimus should not be treated with nirmatrelvir/ritonavir; rectal diazepam may be used as an alternative to buccal midazolam; doses of ASMs that are cytochrome P450 (CYP3A4) substrates might be adjusted; and patients treated with combinations of nirmatrelvir/ritonavir and ASMs that are CYP3A4 substrates or lamotrigine should be monitored for drug efficacy and adverse drug reactions.
本文介绍了国际抗癫痫联盟以色列分会指导委员会发布的尼马曲韦/利托那韦在癫痫患者中的使用建议。建议指出，正在使用中-强酶诱导性抗癫痫药物（ASMs）和依维莫司的患者不应使用尼马曲韦/利托那韦；直肠地西泮可用作口腔咪达唑仑的替代药物；细胞色素 P450（CYP3A4）底物的 ASMs 剂量可能需要调整；接受尼马曲韦/利托那韦联合使用的患者 CYP3A4 底物或拉莫三嗪应监测药物疗效和不良反应。
