| Cross-sensitivity of skin rashes with antiepileptic drug use. | |
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MedLine Citation:
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PMID: 18981374 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine rates of cross-sensitivity of rash among commonly used antiepileptic drugs (AEDs) in patients with epilepsy. METHODS: The incidence of AED-related rash was determined in 1875 outpatients (> or =12 years), taking carbamazepine (CBZ), clobazam (CLB), felbamate (FBM), gabapentin (GBP), levetiracetam (LEV), lamotrigine (LTG), oxcarbazepine (OXC), phenobarbital (PB), phenytoin (PHT), primidone (PRM), tiagabine (TGB), topiramate (TPM), vigabatrin (VGB), valproic acid (VPA), or zonisamide (ZNS). We compared rates of rash for each AED in patients with vs those without a rash to 1) another specific AED; 2) any other AED; 3) any two other AEDs; and 4) any non-epilepsy medication. RESULTS: A total of 14.3% (269/1,875) of patients had a rash attributed to at least one AED; 2.8% had a rash to two or more AEDs. Of patients who had a rash to CBZ and were also prescribed PHT (n = 59), 57.6% had a rash to PHT (abbreviated as CBZ --> PHT: 57.6%); of patients who had a rash to PHT and were also prescribed CBZ (n = 81), rate of rash was 42% (i.e., PHT --> CBZ: 42%). Other results: CBZ --> LTG: 20% (n = 50); LTG --> CBZ: 26.3% (n = 38); CBZ --> OXC: 33% (n = 15); OXC --> CBZ: 71.4% (n = 7); CBZ --> PB: 26.7% (n = 30); PB --> CBZ: 66.7% (n = 12); LTG --> PHT: 38.9% (n = 36); PHT --> LTG: 18.9% (n = 74); PB --> PHT: 53.3% (n = 15); PHT --> PB: 19.5% (n = 41); OXC --> LTG: 37.5% (n = 8); LTG --> OXC: 20% (n = 15). There was evidence of specific cross-sensitivity between CBZ and PHT, and between CBZ and PB. CONCLUSION: Cross-sensitivity rates between certain antiepileptic drugs (AEDs) are high, especially when involving carbamazepine and phenytoin. Specific cross-sensitivity rates provided here may be useful for AED selection and counseling in individual patients. |
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Authors:
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L J Hirsch; H Arif; E A Nahm; R Buchsbaum; S R Resor; C W Bazil |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Neurology Volume: 71 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2008 Nov |
Date Detail:
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Created Date: 2008-11-04 Completed Date: 2008-11-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 1527-34 Citation Subset: AIM; IM |
Affiliation:
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Associate Clinical Comprehensive Epilepsy Center, Columbia University, Neurological Institute, New York, NY 10032, USA. ljh3@columbia.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Anticonvulsants / adverse effects* Drug Eruptions* Exanthema / chemically induced* Humans Male Middle Aged Retrospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Anticonvulsants |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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