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  • 5 - Predictability of metabolic antiepileptic drug interactions

  • from Part II - Pharmacokinetic interactions
    • By Edoardo Spina, Section of Pharmacology, Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Messina, Italy, Emilio Perucca, Clinical Pharmacology Unit, University of Pavia, Pavia, Italy, Rene Levy, Department of Pharmaceutics, University of Washington, Seattle, WA, USA
  • Edited by Jerzy Majkowski, Blaise F. D. Bourgeois, Harvard University, Massachusetts, Philip N. Patsalos, Institute of Neurology, London, Richard H. Mattson, Yale University, Connecticut
  • Book:
    Antiepileptic Drugs
    Published online:
    07 September 2009
    Print publication:
    26 May 2005, pp 57-92

  • Summary

    Knowledge of the main enzyme systems involved in the biotransformation of antiepileptic drugs (AEDs) is essential for understanding the principles and mechanisms of metabolically based drug interactions involving these drugs. In recent years, the major cytochrome P450 (CYP) isoenzymes have been characterized at the molecular level and their different substrates, inhibitors and inducers have been identified. Drug interactions involving CYP isoforms and other drug-metabolizing enzymes may result from one of two processes, enzyme induction or inhibition. The potential for metabolic drug interactions is an important aspect to be considered during the development of new drugs. Initially, the simplest approach to the in vitro study of drug metabolism was through use of purified enzymes. Prediction of interactions that may affect the test drug requires knowledge of the enzyme systems and knowledge of the influence of other drugs on such enzyme systems.