Interdosage Fluctuations in Plasma Carbamazepine Concentration Determine Intermittent Side Effects

摘要: • Fluctuations in plasma carbamazepine concentrations were related to side effects five epileptics. One patient was receiving only carbamazepine; four plus phenobarbital sodium or phenytoin sodium. The patients studied during two 12-hour periods: given (1) twice daily (2) times daily. Concomitant medication regimens kept constant; administration single-blind. Plasma of carbamazepine, carbamazepine's epoxide metabolite, phenobarbital, and determined hourly; assessed simultaneously. 79% ± 29% higher than trough levels on a twice-daily dosage schedule 40% 13% four-times-a-day administration. appearance intensity followed the fluctuations thus substantially reduced four-times-daily regimen. intrapatient reproducibility good, whereas thresholds at which appeared ranged from 17 37 μmole/L.