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Hormone replacement therapy with estrogens may reduce lamotrigine serum concentrations : A matched case–control study

Reimers, Arne LU orcid (2017) In Epilepsia 58(1). p.6-9
Abstract

Lamotrigine (LTG) is an antiepileptic drug that is metabolized via glucuronidation. Since the glucuronidizing enzyme is inducible by estrogens, LTG serum concentrations may fall by 50–60% when combined with hormonal contraceptives that contain ethinyl estradiol (EE). Little is known about a possible interaction between estrogens used for hormone replacement therapy (HRT) and LTG, and the few available data are conflicting. Data from serum samples analyzed for LTG were therefore retrieved from a routine therapeutic drug monitoring database. Users of HRT and EE were identified and matched with controls for age and dose. No enzyme-inducing or enzyme-inhibiting comedication was allowed. LTG serum concentration-to-dose ratios (CDRs) were... (More)

Lamotrigine (LTG) is an antiepileptic drug that is metabolized via glucuronidation. Since the glucuronidizing enzyme is inducible by estrogens, LTG serum concentrations may fall by 50–60% when combined with hormonal contraceptives that contain ethinyl estradiol (EE). Little is known about a possible interaction between estrogens used for hormone replacement therapy (HRT) and LTG, and the few available data are conflicting. Data from serum samples analyzed for LTG were therefore retrieved from a routine therapeutic drug monitoring database. Users of HRT and EE were identified and matched with controls for age and dose. No enzyme-inducing or enzyme-inhibiting comedication was allowed. LTG serum concentration-to-dose ratios (CDRs) were calculated. Case groups and their respective control groups were compared by the Mann-Whitney U test. Seventy-nine HRT users (dose range 1–4 mg/day) and 200 EE users (dose range 20–40 μg/day), as well as 158 and 400 matching controls, respectively, could be included. Both EE users and HRT users had significantly lower mean LTG CDRs than their respective matched controls. These results suggest that HRT with estrogens may reduce serum LTG concentrations.

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Please use this url to cite or link to this publication:
author
publishing date
type
Contribution to journal
publication status
published
keywords
Estrogen, Hormone replacement therapy, Interaction, Menopause
in
Epilepsia
volume
58
issue
1
pages
6 - 9
publisher
Wiley-Blackwell
external identifiers
  • pmid:27805259
  • scopus:84996799409
ISSN
0013-9580
DOI
10.1111/epi.13597
language
English
LU publication?
no
additional info
Publisher Copyright: Wiley Periodicals, Inc. © 2016 International League Against Epilepsy
id
a989eaa7-1183-444d-9aa5-17526de8b8e9
date added to LUP
2024-08-31 14:44:30
date last changed
2025-06-22 17:16:19
@article{a989eaa7-1183-444d-9aa5-17526de8b8e9,
  abstract     = {{<p>Lamotrigine (LTG) is an antiepileptic drug that is metabolized via glucuronidation. Since the glucuronidizing enzyme is inducible by estrogens, LTG serum concentrations may fall by 50–60% when combined with hormonal contraceptives that contain ethinyl estradiol (EE). Little is known about a possible interaction between estrogens used for hormone replacement therapy (HRT) and LTG, and the few available data are conflicting. Data from serum samples analyzed for LTG were therefore retrieved from a routine therapeutic drug monitoring database. Users of HRT and EE were identified and matched with controls for age and dose. No enzyme-inducing or enzyme-inhibiting comedication was allowed. LTG serum concentration-to-dose ratios (CDRs) were calculated. Case groups and their respective control groups were compared by the Mann-Whitney U test. Seventy-nine HRT users (dose range 1–4 mg/day) and 200 EE users (dose range 20–40 μg/day), as well as 158 and 400 matching controls, respectively, could be included. Both EE users and HRT users had significantly lower mean LTG CDRs than their respective matched controls. These results suggest that HRT with estrogens may reduce serum LTG concentrations.</p>}},
  author       = {{Reimers, Arne}},
  issn         = {{0013-9580}},
  keywords     = {{Estrogen; Hormone replacement therapy; Interaction; Menopause}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{1}},
  pages        = {{6--9}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Epilepsia}},
  title        = {{Hormone replacement therapy with estrogens may reduce lamotrigine serum concentrations : A matched case–control study}},
  url          = {{http://dx.doi.org/10.1111/epi.13597}},
  doi          = {{10.1111/epi.13597}},
  volume       = {{58}},
  year         = {{2017}},
}