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Changes in Primidone/Phenobarbitone Ratio During Pregnancy and the Puerperium

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Summary

Plasma concentrations of primidone and its metabolite phenobarbitone were monitored in 9 pregnant epileptic patients treated with primidone (and in 3 cases other antiepileptic drugs) given at constant doses throughout pregnancy and the Puerperium. Phenobarbitone plasma concentrations were monitored in another 6 patients given phenobarbitone itself. A trend towards increasing primidone plasma concentrations during the second quarter of pregnancy was evident in all patients, with a concomitant significant decrease in primidone-derived phenobarbitone plasma concentrations. A trend towards a lowering of plasma concentrations of phenobarbitone administered as such was confirmed.

These results suggest the usefulness of a careful monitoring of primidone and primidone-derived phenobarbitone during pregnancy and the Puerperium. Discrepancies of findings with primidone and phenobarbitone are discussed in view of the possible mechanism involved.

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References

  • Bardy, A.H.; Teramo, K. and Hiilesmaa, V.K.: Apparent plasma clearances of Phenytoin, phenobarbitone, primidone and carbamazepine during pregnancy: Results of the prospective Helsinki study; in Janz et al. (Eds) Epilepsy, Pregnancy and the Child, pp. 141–145 (Raven Press, New York 1982).

    Google Scholar 

  • Batlino, D.; Avanzini, G.; Bossi, L.; Canger, R.; Como, M.L.; Croci, D. and Spina, S.: Monitoring of antiepileptic drugs plasma levels during pregnancy and Puerperium; in Janz et al. (Eds) Epilepsy. Pregnancy and the Child, pp. 147–154 (Raven Press, New York 1982).

    Google Scholar 

  • Baumel, I.P.; Gallagher, B.B. and Mattson, R.H.: Phenylethyl-malonamide (PEMA): An important metabolite of primidone. Archives of Neurology 27: 34–41 (1972).

    Article  PubMed  CAS  Google Scholar 

  • Dam, M.; Christiansen, J.; Munk, O. and Mygind, K.I.: Antiepileptic drug metabolism in pregnancy. Clinical Pharmacokinetics 4: 53–62 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Davis, M.; Simmons, C.J.; Dordoni, B.; Maxwell, J.D. and Williams, R.: Induction of hepatic enzymes during normal pregnancy. Journal of Obstetrics and Gynecology 80: 690–694 (1973).

    CAS  Google Scholar 

  • Eadie, M.J.; Lander, C.M. and Tyrer, J.H.: Plasma drug level monitoring in pregnancy. Clinical Pharmacokinetics 2: 427–436 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Kochenour, N.K.; Emery, M.G. and Sawchuk, R.J.: Phenytoin metabolism in pregnancy. Obstetrical Gynecology 56: 577–582 (1980).

    CAS  Google Scholar 

  • Krauer, B. and Krauer, F.: Drugs kinetics in pregnancy. Clinical Pharmacokinetics 2: 167–181 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Kupferberg, H.J.: Quantitative estimation of diphenylhydantoin and phenobarbital in plasma by gas-liquid chromatography. Clinica Chimica Acta 29: 283–288 (1970).

    Article  CAS  Google Scholar 

  • Lander, C.M.; Edwards, V.E.; Eadie, M.J. and Tyrer, J.H.: Plasma anticonvulsant concentrations during pregnancy. Neurology 27: 128–131 (1977).

    Article  PubMed  CAS  Google Scholar 

  • Landon, M.J. and Kirkley, M.: Metabolism of diphenylhydantoin (Phenytoin) during pregnancy. British Journal of Obstetrics and Gynaecology 86: 125–132 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Mygind, K.I.; Dam, M. and Christiansen, J.: Phenytoin and phenobarbitone plasma clearance during pregnancy. Acta Ncurologica Scandinavica 54: 160–166 (1976).

    Article  CAS  Google Scholar 

  • Nau, H.; Schmidt, D.; Beck-Mannagetta, G.; Rating, D.; Koch, S. and Helge, H.: Pharmacokinetics of primidone and metabolites during human pregnancy; in Janz et al. (Eds) Epilepsy, Pregnancy and the Child, pp. 121–129 (Raven Press, New York 1982).

    Google Scholar 

  • Olesen, O.V. and Dam, M.: The metabolic conversion of primidonc (Mysolinc) to phenobarbitone in patients under long-term treatment. Acta Neurologica Scandinavica 43: 348–356 (1967).

    Article  PubMed  CAS  Google Scholar 

  • Oxley, J.; Hedbige, S.; Laidlaw, J.; Wadsworth, J. and Richens, A.: A comparative study of phenobarbitone and primidone in the treatment of epilepsy; in Johannessen et al. (Eds) Anti-epileptic Therapy: Advances in Drug Monitoring, pp. 237–242 (Raven Press, New York 1980).

    Google Scholar 

  • Philbert, A. and Dam, M.: Antiepileptic drug disposition during pregnancy: Review of the literature; in Janz et al. (Eds) Epilepsy, Pregnancy and the Child, pp. 109–114 (Raven Press, New York 1982).

    Google Scholar 

  • Reith, H. and Schäfer. H.: Antiepileptika während Schwangerschaft und Stillzeit. Pharmacokinetische Daten. Deutsche Medizinische Wochenschrift 104: 818–823 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Rey, E.; D’Athis, P.H.; Giraux. P.; De Lauture, D.; Turquais, J.M.; Chavinic. J. and Olive, G.: Pharmacokinetics of clorazepate in pregnant and non-pregnant women. European Journal of Clinical Pharmacology 15: 175–180 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Rourke, J.E.; Marshall, L.D. and Shelley, T.F.: A single rapid assay of estrogen in pregnancy. American Journal of Obstetrics and Gynecology 100: 331–333 (1968).

    PubMed  CAS  Google Scholar 

  • Sherwin, A.L.; Loynd, J.S.; Bock, G.W. and Sokolowski, C.D.: Effects of age, sex, obesity and pregnancy on diphenylhydantoin levels. Epilepsia 15: 507–521 (1974).

    Article  PubMed  CAS  Google Scholar 

  • Siegel, S.: The cases of two related samples; in Siegel (Ed.) Nonparametric Statistics for the Behavioural Sciences, pp. 75–87 (McGraw-Hill, Kogakusha 1956).

    Google Scholar 

  • Tephly, T.R. and Mannering, G.J.: Inhibition of drug metabolism by Steroids. Molecular Pharmacology 4: 10–14 (1968).

    PubMed  CAS  Google Scholar 

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Battino, D., Binelli, S., Bossi, L. et al. Changes in Primidone/Phenobarbitone Ratio During Pregnancy and the Puerperium. Clin Pharmacokinet 9, 252–260 (1984). https://doi.org/10.2165/00003088-198409030-00006

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