Interactions between antiepileptic and chemotherapeutic drugs

摘要: Summary Cancer and epilepsy commonly co-occur, concomitant administration of antiepileptic (AEDS) chemotherapeutic drugs (CTDs) is necessary in many cases. Many are metabolised by the hepatic cytochrome P450 (CYP) isoenzyme system, coadministration AEDs CTDs can lead to clinically relevant interactions induction or inhibition enzymes shared metabolic pathways. These cause insufficient tumour seizure control unforeseen toxicity. Enzyme-inducing reduce effects taxanes, vinca alkaloids, methotrexate, teniposide, camptothecin analogues. Inhibition metabolism nitrosoureas etoposide valproic acid CTD Poor may result from combinations phenytoin with cisplatin corticosteroids, methotrexate. Increased toxicity occur when combined 5-fluorouracil. Use enzyme-inducing should be avoided patients cancer, particularly association chemotherapy. Generally, acid— although not free interactions—would agent first choice. Some newer system prove good alternatives.