Valproic acid Clearance in Epileptic Adult with Monotherapy and Polytherapy at Maharaj Nakhon SI Thammarat Hospital
Keywords:
Valproic acid, Pharmacokinetics, ClearanceAbstract
Background: Pharmacokinetics of valproic acid (VPA) is interindividual variability across difference patient age groups, races and when used concurrently with enzyme inducing drugs that potentially increase VPA clearance.
Objective: To determine and compare population valproic clearance in adult patient receiving monotherapy versus polytherapy antiepileptics.
Material and Method: A 6 years retrospective data, from January 2017 to December 2022 were collected from electronic database and routine therapeutic drug monitoring data of Maharaj Nakhon Si Thammarat Hospital.The study included patients aged between 18 - 60 years used VPA (Depakine Chrono®) as monotherapy > 3 days or concurrent used enzyme-inducing antiepileptics: phenytoin (PHT), phenobarbital (PB) and carbamazepine (CBZ) > 10 days.
Results: Of the total 225 patients, 113 were in monotherapy group (51 men 62 women) and 112 in polytherapy (59 men 53 women) Mean clearance (ml/kg/hr) was 8.91 + 2.78 for monotherapy group and 16.84 + 4.42 for polytherapy group with significantly difference (p < 0.001). Within the polytherapy subgroup, mean clearance (ml/kg/hr) was 17.20 + 4.36 for VPA + PHT (85 case), 15.98 + 4.79 VPA + PB (15 case), 16.67 for VPA + CPZ (1case), and 16.62 + 5.27 for VPA + PHT+PB (13 case) subgroup, respectively.
Conclusion: In adults, VPA clearance was significantly lower in monotherapy users compared to those co-administered with enzyme inducer (PHT, PB, CBZ). These findings suggest VPA clearance in specific population that applicable for individualization VPA dosage regimen regarding ethnicity and comedication.
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เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใด ๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นลิขสิทธิ์ของมหาราชนครศรีธรรมราชเวชสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากวารสารมหาราชนครศรีธรรมราชเวชสาร ก่อนเท่านั้น
