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Serum concentration/dose ratio of topiramate during pregnancy

Westin, Andreas Austgulen ; Nakken, Karl Otto ; Johannessen, Svein I. ; Reimers, Arne LU ; Lillestølen, Kari Mette and Brodtkorb, Eylert (2009) In Epilepsia 50(3). p.480-485
Abstract

Purpose: To study the impact of pregnancy on the serum concentration/dose ratio (C/D-ratio) of topiramate (TPM). Methods: Twelve women with epilepsy using TPM during pregnancy, and 15 pregnancies were studied. The main target variable was the C/D-ratio at baseline and during pregnancy. Additional variables were changes in TPM dose, concomitant use of other antiepileptic drugs, seizure frequency, and pregnancy outcome. Clinical and pharmacological data were obtained from the women's medical records. Results: The average C/D-ratios in the second and third trimester were 30% (p = 0.002, n = 11) and 34% (p = 0.001, n = 8) lower than the baseline values, respectively. The interindividual variability was pronounced. Increased seizure... (More)

Purpose: To study the impact of pregnancy on the serum concentration/dose ratio (C/D-ratio) of topiramate (TPM). Methods: Twelve women with epilepsy using TPM during pregnancy, and 15 pregnancies were studied. The main target variable was the C/D-ratio at baseline and during pregnancy. Additional variables were changes in TPM dose, concomitant use of other antiepileptic drugs, seizure frequency, and pregnancy outcome. Clinical and pharmacological data were obtained from the women's medical records. Results: The average C/D-ratios in the second and third trimester were 30% (p = 0.002, n = 11) and 34% (p = 0.001, n = 8) lower than the baseline values, respectively. The interindividual variability was pronounced. Increased seizure frequency was common in pregnant women using TPM, but a correlation to the decline in TPM C/D-ratio could not be established from our data. Discussion: Dose-corrected serum concentrations of TPM appear to decline gradually throughout pregnancy. The underlying mechanisms are not known. Increased glomerular filtration may play a major role. During pregnancy, therapeutic drug monitoring of TPM may be useful.

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author
; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Anticonvulsants, Antiepileptic drugs, Drug monitoring, Epilepsy, Pharmacokinetics, Pregnancy outcome
in
Epilepsia
volume
50
issue
3
pages
480 - 485
publisher
Wiley-Blackwell
external identifiers
  • pmid:19178558
  • scopus:61849124628
ISSN
0013-9580
DOI
10.1111/j.1528-1167.2008.01776.x
language
English
LU publication?
no
id
70c02b65-0a7d-4c77-b802-37577ab7bea4
date added to LUP
2024-08-31 14:58:07
date last changed
2024-10-12 21:01:16
@article{70c02b65-0a7d-4c77-b802-37577ab7bea4,
  abstract     = {{<p>Purpose: To study the impact of pregnancy on the serum concentration/dose ratio (C/D-ratio) of topiramate (TPM). Methods: Twelve women with epilepsy using TPM during pregnancy, and 15 pregnancies were studied. The main target variable was the C/D-ratio at baseline and during pregnancy. Additional variables were changes in TPM dose, concomitant use of other antiepileptic drugs, seizure frequency, and pregnancy outcome. Clinical and pharmacological data were obtained from the women's medical records. Results: The average C/D-ratios in the second and third trimester were 30% (p = 0.002, n = 11) and 34% (p = 0.001, n = 8) lower than the baseline values, respectively. The interindividual variability was pronounced. Increased seizure frequency was common in pregnant women using TPM, but a correlation to the decline in TPM C/D-ratio could not be established from our data. Discussion: Dose-corrected serum concentrations of TPM appear to decline gradually throughout pregnancy. The underlying mechanisms are not known. Increased glomerular filtration may play a major role. During pregnancy, therapeutic drug monitoring of TPM may be useful.</p>}},
  author       = {{Westin, Andreas Austgulen and Nakken, Karl Otto and Johannessen, Svein I. and Reimers, Arne and Lillestølen, Kari Mette and Brodtkorb, Eylert}},
  issn         = {{0013-9580}},
  keywords     = {{Anticonvulsants; Antiepileptic drugs; Drug monitoring; Epilepsy; Pharmacokinetics; Pregnancy outcome}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{480--485}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Epilepsia}},
  title        = {{Serum concentration/dose ratio of topiramate during pregnancy}},
  url          = {{http://dx.doi.org/10.1111/j.1528-1167.2008.01776.x}},
  doi          = {{10.1111/j.1528-1167.2008.01776.x}},
  volume       = {{50}},
  year         = {{2009}},
}