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Lamotrigine in children and adolescents : The impact of age on its serum concentrations and on the extent of drug interactions

Reimers, Arne LU ; Skogvoll, Eirik ; Sund, Janne Kutschera and Spigset, Olav (2007) In European Journal of Clinical Pharmacology 63(7). p.687-692
Abstract

Objective: To investigate the impact of age and co-treatment with other drugs on the serum concentrations of lamotrigine in children and adolescents. Methods: A review of routine serum concentration measurements of lamotrigine performed in our laboratory yielded a total of 744 serum samples from 296 subjects (110 males, 186 females, age: 2-19 years) suitable for statistical analysis. The primary outcome variable was the dose-corrected lamotrigine serum concentration, expressed as the lamotrigine concentration/dose (C/D) ratio. A linear mixed model that allowed multiple observations from the same patient was used to identify and quantify the effect of factors influencing the lamotrigine C/D ratio. Results: According to the model, the... (More)

Objective: To investigate the impact of age and co-treatment with other drugs on the serum concentrations of lamotrigine in children and adolescents. Methods: A review of routine serum concentration measurements of lamotrigine performed in our laboratory yielded a total of 744 serum samples from 296 subjects (110 males, 186 females, age: 2-19 years) suitable for statistical analysis. The primary outcome variable was the dose-corrected lamotrigine serum concentration, expressed as the lamotrigine concentration/dose (C/D) ratio. A linear mixed model that allowed multiple observations from the same patient was used to identify and quantify the effect of factors influencing the lamotrigine C/D ratio. Results: According to the model, the lamotrigine C/D ratio decreases by 6% per year of age. Valproate and levetiracetam were found to raise the lamotrigine C/D ratio, whereas the following co-medications reduced it: carbamazepine, clobazam, fluoxetine, clonazepam and ethinyl estradiol. The effect of carbamazepine decreased with increasing age. No gender difference was detected. Conclusions: Age is an important factor with respect to the pharmacokinetics and the extent of drug interactions of lamotrigine in children and adolescents. In this population, older individuals will need higher doses than younger ones in order to achieve the same serum concentrations.

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author
; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Age, Children, Drug interactions, Lamotrigine, Serum concentration
in
European Journal of Clinical Pharmacology
volume
63
issue
7
pages
687 - 692
publisher
Springer
external identifiers
  • pmid:17497143
  • scopus:34250361918
ISSN
0031-6970
DOI
10.1007/s00228-007-0308-2
language
English
LU publication?
no
id
74dc99a9-f357-4818-abf8-bdb24b625901
date added to LUP
2024-08-31 14:55:16
date last changed
2024-09-02 13:02:08
@article{74dc99a9-f357-4818-abf8-bdb24b625901,
  abstract     = {{<p>Objective: To investigate the impact of age and co-treatment with other drugs on the serum concentrations of lamotrigine in children and adolescents. Methods: A review of routine serum concentration measurements of lamotrigine performed in our laboratory yielded a total of 744 serum samples from 296 subjects (110 males, 186 females, age: 2-19 years) suitable for statistical analysis. The primary outcome variable was the dose-corrected lamotrigine serum concentration, expressed as the lamotrigine concentration/dose (C/D) ratio. A linear mixed model that allowed multiple observations from the same patient was used to identify and quantify the effect of factors influencing the lamotrigine C/D ratio. Results: According to the model, the lamotrigine C/D ratio decreases by 6% per year of age. Valproate and levetiracetam were found to raise the lamotrigine C/D ratio, whereas the following co-medications reduced it: carbamazepine, clobazam, fluoxetine, clonazepam and ethinyl estradiol. The effect of carbamazepine decreased with increasing age. No gender difference was detected. Conclusions: Age is an important factor with respect to the pharmacokinetics and the extent of drug interactions of lamotrigine in children and adolescents. In this population, older individuals will need higher doses than younger ones in order to achieve the same serum concentrations.</p>}},
  author       = {{Reimers, Arne and Skogvoll, Eirik and Sund, Janne Kutschera and Spigset, Olav}},
  issn         = {{0031-6970}},
  keywords     = {{Age; Children; Drug interactions; Lamotrigine; Serum concentration}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{687--692}},
  publisher    = {{Springer}},
  series       = {{European Journal of Clinical Pharmacology}},
  title        = {{Lamotrigine in children and adolescents : The impact of age on its serum concentrations and on the extent of drug interactions}},
  url          = {{http://dx.doi.org/10.1007/s00228-007-0308-2}},
  doi          = {{10.1007/s00228-007-0308-2}},
  volume       = {{63}},
  year         = {{2007}},
}