Influence of sex, age, weight, and carbamazepine dose on serum concentrations, concentration ratios, and level/dose ratios of carbamazepine and its metabolites. 1994

H Liu, and M R Delgado
Department of Research, Texas Scottish Rite Hospital for Children, University of Texas Southwestern Medical Center, Dallas 75219.

We have conducted a comprehensive study in a group of epileptic children (25 boys and 30 girls) receiving carbamazepine (CBZ) monotherapy. The influence of sex, age, weight, and CBZ daily dose on serum CBZ, carbamazepine-10,11-epoxide (CBZ-E), and trans-10,11-dihydroxy-10,11-dihydro-carbamazepine (CBZ-H) concentrations, concentration ratios, and level/dose ratios were investigated. Compared with girls, boys required significantly larger CBZ dose and showed higher CBZ apparent clearances and lower level/dose ratios of CBZ and its metabolites. There were no significant differences between boys and girls in serum concentrations, concentration ratios, and free fractions of CBZ and its metabolites, although there were trends that boys had slightly higher concentration ratios. The relationship analysis suggested that there was a dose-dependent autoinduction of CBZ metabolism, and CBZ metabolism was decreased as patients mature, as measured by weight and age. Age showed a significant positive relationship with the free fractions of CBZ and its metabolites, indicating decreased protein binding of CBZ and its metabolites with the increase of age. Serum CBZ concentration is not a reliable index of CBZ dose, as there is only a weak correlation between them. Serum CBZ-H concentration showed strong positive correlations with CBZ dose and might be a valuable index in assessing patient compliance. The influence of sex, body weight, age, and CBZ dose on CBZ and its metabolites should be taken into consideration in further clinical studies.

UI MeSH Term Description Entries
D008297 Male Males
D001835 Body Weight The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms. Body Weights,Weight, Body,Weights, Body
D002220 Carbamazepine A dibenzazepine that acts as a sodium channel blocker. It is used as an anticonvulsant for the treatment of grand mal and psychomotor or focal SEIZURES. It may also be used in the management of BIPOLAR DISORDER, and has analgesic properties. Amizepine,Carbamazepine Acetate,Carbamazepine Anhydrous,Carbamazepine Dihydrate,Carbamazepine Hydrochloride,Carbamazepine L-Tartrate (4:1),Carbamazepine Phosphate,Carbamazepine Sulfate (2:1),Carbazepin,Epitol,Finlepsin,Neurotol,Tegretol
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D004827 Epilepsy A disorder characterized by recurrent episodes of paroxysmal brain dysfunction due to a sudden, disorderly, and excessive neuronal discharge. Epilepsy classification systems are generally based upon: (1) clinical features of the seizure episodes (e.g., motor seizure), (2) etiology (e.g., post-traumatic), (3) anatomic site of seizure origin (e.g., frontal lobe seizure), (4) tendency to spread to other structures in the brain, and (5) temporal patterns (e.g., nocturnal epilepsy). (From Adams et al., Principles of Neurology, 6th ed, p313) Aura,Awakening Epilepsy,Seizure Disorder,Epilepsy, Cryptogenic,Auras,Cryptogenic Epilepsies,Cryptogenic Epilepsy,Epilepsies,Epilepsies, Cryptogenic,Epilepsy, Awakening,Seizure Disorders
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000375 Aging The gradual irreversible changes in structure and function of an organism that occur as a result of the passage of time. Senescence,Aging, Biological,Biological Aging

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