Webster L K, Mihaly G W, Jones D B, Smallwood R A, Phillips J A, Vajda F J
Eur J Clin Pharmacol. 1984;27(3):341-3. doi: 10.1007/BF00542172.
The pharmacokinetics of a single oral dose (400 mg) of carbamazepine and sodium valproate were compared in peptic ulcer patients before and after four weeks of a therapeutic course of either cimetidine (1 g/day, n = 6 subjects) or ranitidine (300 mg/day, n = 6 subjects). There was a small (up to 20%) but statistically significant decrease in oral clearance of carbamazepine after cimetidine treatment. A similar fall in sodium valproate clearance in five cimetidine-treated patients was accompanied by a significantly prolonged elimination half-life. No such trends were demonstrated during ranitidine treatment. Since both anticonvulsants are partly metabolized by hepatic mixed function oxidases, an inhibition by cimetidine at this level may be responsible for the observed impairment of clearance. Thus a potentially important clinical interaction may occur in patients taking anticonvulsants and cimetidine concurrently.
在消化性溃疡患者中，比较了西咪替丁（1克/天，n = 6名受试者）或雷尼替丁（300毫克/天，n = 6名受试者）治疗四周前后，单次口服剂量400毫克卡马西平和丙戊酸钠的药代动力学。西咪替丁治疗后，卡马西平的口服清除率有小幅（高达20%）但具有统计学意义的下降。五名接受西咪替丁治疗的患者中丙戊酸清除率的类似下降伴随着消除半衰期的显著延长。雷尼替丁治疗期间未显示出此类趋势。由于两种抗惊厥药均部分通过肝脏混合功能氧化酶代谢，西咪替丁在该水平的抑制作用可能是观察到的清除率受损的原因。因此，同时服用抗惊厥药和西咪替丁的患者可能会发生潜在重要的临床相互作用。
