Population pharmacokinetics of oxcarbazepine: a systematic review

Expert Rev Clin Pharmacol. 2021 Jul;14(7):853-864. doi: 10.1080/17512433.2021.1917377. Epub 2021 Jul 19.

Abstract

Introduction: Oxcarbazepine is commonly used as first-line treatment for partial and generalized tonic-clonic seizures. Owing to the high pharmacokinetic variability, several population pharmacokinetic models have been developed for oxcarbazepine to explore potential covariates that affect its pharmacokinetic variation.

Areas covered: This review summarizes the published population pharmacokinetic studies of oxcarbazepine in children and adults available in PubMed and Embase databases. The quality of the retrieved studies was evaluated, and significant covariates that may have an impact on the dosage regimen of oxcarbazepine were explored.

Expert opinion: The pharmacokinetics of oxcarbazepine was founded to be affected by body weight and co-administration with enzyme inducers. Pediatric patients require a higher dose per kilogram than adults because children generally have a higher clearance than adults. Moreover, to maintain the target concentration, patients co-administrate with enzyme inducers need a higher dose than monotherapy due to higher clearance in those patients. Because limited information is available for exposure-response relationship, additional pharmacokinetic/pharmacodynamics investigations of oxcarbazepine need to be conducted to optimize the dosage regimen in clinical practice.

Keywords: Epilepsy; individualized drug therapy; nonlinear mixed effect modeling; oxcarbazepine; population pharmaco-kinetic.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Age Factors
  • Anticonvulsants / administration & dosage*
  • Anticonvulsants / pharmacokinetics
  • Child
  • Dose-Response Relationship, Drug
  • Epilepsy / drug therapy*
  • Epilepsy / physiopathology
  • Humans
  • Models, Biological
  • Oxcarbazepine / administration & dosage*
  • Oxcarbazepine / pharmacokinetics

Substances

  • Anticonvulsants
  • Oxcarbazepine