Influence of Additional Therapy with Zonisamide (Excegran) on Protein Binding and Metabolism of Carbamazepine

Taketsuga Minami, Ichiro Ieiri, Kenji Ohtsubo, Yoshihiro Hirakawa, Kohji Ueda, Shun Higuchi, Toshinobu Aoyama

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Summary: The influence of comedication with zonisamide (ZNS) on protein binding and carbamazepine (CBZ) metabolism was studied in 16 pediatric epileptic patients. Correlations were evaluated between ZNS daily dose and individual change of level per dose ratio (L/D ratio), free fraction, and carbamazepine‐10,11‐epoxide/CBZ level ratio (CBZEKBZ). Statistical significant negative correlation was observed between LID ratio and ZNS daily dose. Despite alteration in the L/D ratio, the free fraction of CBZ was unaltered in combination with ZNS. To assess the effect of addition of ZNS on CBZ metabolism, the CBZE/CBZ level ratio was compared; this ratio showed a tendency to increase with increase in ZNS dose. Consequently, ZNS is considered to have a significant effect on CBZ metabolism but not on protein binding.

Original languageEnglish
Pages (from-to)1023-1025
Number of pages3
Issue number5
Publication statusPublished - Sep 1994


All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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