Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey.
Department of Clinical Pharmacy, Erasmus MC, Rotterdam, the Netherlands.
Eur J Clin Pharmacol. 2022 Oct;78(10):1697-1701. doi: 10.1007/s00228-022-03370-7. Epub 2022 Aug 5.
Management and dose adjustment are a major concern for clinicians in the absence of specific clinical outcome data for patients on antiepileptic drugs (AEDs), in the event of short-term (5 days) nirmatrelvir/ritonavir co-exposure. Therefore, in this report, we identified drugs that require dose adjustment because of drug-drug interactions (DDIs) between nirmatrelvir/ritonavir and AEDs. We hereby used four databases (Micromedex Drug Interaction, Liverpool Drug Interaction Group for COVID-19 Therapies, Medscape Drug Interaction Checker, and Lexicomp Drug Interactions) and DDI-Predictor.In the light of applying the DDI-Predictor, for carbamazepine, clobazam, oxcarbazepine, eslicarbazepine, phenytoin, phenobarbital, pentobarbital, rufinamide, and valproate as CYP3A4 inducers, we recommend that a dose adjustment of short-term nirmatrelvir/ritonavir as a substrate (victim) drug would be more appropriate instead of these AEDs to avoid impending DDI-related threats in patients with epilepsy.
在缺乏抗癫痫药物 (AED) 患者短期（5 天）同时使用奈玛特韦/利托那韦的具体临床结果数据的情况下，管理和剂量调整是临床医生的主要关注点。因此，在本报告中，我们确定了由于奈玛特韦/利托那韦与 AED 之间的药物相互作用 (DDI) 需要调整剂量的药物。为此，我们使用了四个数据库（Micromedex 药物相互作用、利物浦 COVID-19 治疗药物相互作用组、Medscape 药物相互作用检查器和 Lexicomp 药物相互作用）和 DDI-Predictor。根据 DDI-Predictor 的应用，对于卡马西平、氯巴占、奥卡西平、依斯巴肼、苯妥英、苯巴比妥、戊巴比妥、鲁非酰胺和丙戊酸钠作为 CYP3A4 诱导剂，我们建议调整奈玛特韦/利托那韦的短期剂量作为底物（受害者）药物，而不是这些 AED，以避免癫痫患者潜在的 DDI 相关威胁。
