Practical guidance and considerations for transitioning patients from oxcarbazepine or carbamazepine to eslicarbazepine acetate--Expert opinion.

Details

Serval ID
serval:BIB_2F3B6BAF95D7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Practical guidance and considerations for transitioning patients from oxcarbazepine or carbamazepine to eslicarbazepine acetate--Expert opinion.
Journal
Epilepsy and Behavior : Eandb
Author(s)
Peltola J., Holtkamp M., Rocamora R., Ryvlin P., Sieradzan K., Villanueva V.
ISSN
1525-5069 (Electronic)
ISSN-L
1525-5050
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
50
Pages
46-49
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
There is currently a lack of guidance on methodology and special considerations for transitioning patients from oxcarbazepine (OXC) or carbamazepine (CBZ) to eslicarbazepine acetate (ESL), if deemed clinically necessary. An advisory panel of epilepsy experts was convened to share their experience on the use of adjunctive ESL in clinical practice and to provide practical recommendations to help address this gap. When changing over from OXC to ESL, an OXC:ESL dose ratio of 1:1 should be employed to calculate the ESL target dose, and the changeover can take place overnight. No changes to comedication are required. Since CBZ has a different mechanism of action to ESL and is a stronger inducer of cytochrome P450 (CYP) enzymes, the transitioning of patients from CBZ to ESL requires careful consideration on a patient-by-patient basis. In general, a CBZ:ESL dose ratio of 1:1.3 should be employed to calculate the ESL target dose, and patients should be transitioned over a minimum period of 1-2weeks. Special considerations include adjustment of titration schedule and target dose in elderly patients and those with hepatic or renal impairment and potential adjustment of comedications metabolized by CYP enzymes. In summary, due to structural distinctions between ESL, OXC, and CBZ, which affect mechanism of action and tolerability, there are clinical situations in which it may be appropriate to consider transitioning patients from OXC or CBZ to ESL. Changing patients over from OXC to ESL is generally more straightforward than transitioning patients from CBZ to ESL, which requires careful consideration.
Keywords
Anticonvulsants/therapeutic use, Attitude of Health Personnel, Carbamazepine/analogs & derivatives, Carbamazepine/therapeutic use, Dibenzazepines/therapeutic use, Drug Substitution/adverse effects, Drug Substitution/methods, Drug Therapy, Combination, Epilepsy/drug therapy, Humans, Voltage-Gated Sodium Channel Blockers/therapeutic use
Pubmed
Web of science
Create date
13/10/2015 18:01
Last modification date
20/08/2019 13:13
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