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Variation in lamotrigine plasma concentrations with hormonal contraceptive monthly cycles in patients with epilepsy.

Author(s): Contin M, Albani F, Ambrosetto G, Avoni P, Bisulli F, Riva R, Tinuper P, Baruzzi A

Affiliation(s): Neurology Clinic, Department of Neurological Sciences, University of Bologna, Bologna, Italy. manuela.contin@unibo.it

Publication date & source: 2006-09, Epilepsia., 47(9):1573-5.

Publication type: Randomized Controlled Trial

PURPOSE: This is the first report comparing intrasubject lamotrigine (LTG) plasma concentrations between hormonal contraceptive (HC) intake and week-off phases in epilepsy patients receiving combined LTG and HC treatment. We describe the variation in LTG plasma concentrations with hormonal contraceptive (HC) monthly intake cycles in a series of eight patients with epilepsy. METHODS: Venous blood samples were prospectively drawn from patients before their first morning dose of LTG, once between days 18 and 21 of HC intake and once between days 5 and 7 of the HC-free week. RESULTS: Median LTG plasma concentrations were significantly higher during the HC washout week than during the phase of HC intake (p = 0.02). The median value of intrasubject percentage increase was 27%, with a wide interpatient variability. CONCLUSIONS: These findings are in line with a preliminary report on healthy volunteers. Standardization of blood sampling in relation to HC intake cycles is advisable when planning LTG therapeutic monitoring in patients receiving HC.

Page last updated: 2006-11-04

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