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Pharmacokinetic variability and complex two-way interactions with cenobamate in patients with refractory epilepsy - PubMed

3 hours ago
  • #cenobamate
  • #pharmacokinetics
  • #refractory-epilepsy
  • Cenobamate (CNB) is a new antiseizure medication for add-on therapy in adults with refractory epilepsy.
  • The study investigated pharmacokinetic variability and interactions of CNB with other antiseizure medications (ASMs).
  • Data from 258 patients showed significant intraindividual and interpatient variability in CNB concentration/dose (C/D) ratios.
  • Strong enzyme inducers and inhibitors affected mean CNB C/D ratios by -9% and +14%, respectively.
  • CNB initiation led to significant changes in C/D ratios of desmethylclobazam (+233%), phenobarbital (+36%), lamotrigine (-28%), and carbamazepine (-26%).
  • The study highlights complex, unpredictable two-way interactions in polytherapy with CNB and emphasizes the usefulness of therapeutic drug monitoring (TDM).