Weekly methotrexate may reduce valproate levels causing relapse of genetic generalized epilepsy

• Seizures have been observed in epilepsy patients receiving high dose intravenous or intrathecal Methotrexate (Mtx) therapy for the treatment of leukemias, due to reduction in valproic acid (VPA) levels. • Prolonged low dose weekly Mtx exposure can also produce reduction in VPA levels causing seizu...

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Autores principales: Cherian, Ajith, Shetty, Sharath Chandra, Divya, K.P., Pavuluri, Harini
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8187960/
https://www.ncbi.nlm.nih.gov/pubmed/34142078
http://dx.doi.org/10.1016/j.ebr.2021.100457
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author Cherian, Ajith
Shetty, Sharath Chandra
Divya, K.P.
Pavuluri, Harini
author_facet Cherian, Ajith
Shetty, Sharath Chandra
Divya, K.P.
Pavuluri, Harini
author_sort Cherian, Ajith
collection PubMed
description • Seizures have been observed in epilepsy patients receiving high dose intravenous or intrathecal Methotrexate (Mtx) therapy for the treatment of leukemias, due to reduction in valproic acid (VPA) levels. • Prolonged low dose weekly Mtx exposure can also produce reduction in VPA levels causing seizure relapse as reported in this case. • Mtx competes with VPA for binding to albumin as a result of which a larger proportion of VPA become unbound and is rapidly metabolized by the liver causing decline in VPA levels. • Awareness about pharmacological interactions of anti-epileptic drugs (AEDs) is essential in epilepsy management.
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spelling pubmed-81879602021-06-16 Weekly methotrexate may reduce valproate levels causing relapse of genetic generalized epilepsy Cherian, Ajith Shetty, Sharath Chandra Divya, K.P. Pavuluri, Harini Epilepsy Behav Rep Article • Seizures have been observed in epilepsy patients receiving high dose intravenous or intrathecal Methotrexate (Mtx) therapy for the treatment of leukemias, due to reduction in valproic acid (VPA) levels. • Prolonged low dose weekly Mtx exposure can also produce reduction in VPA levels causing seizure relapse as reported in this case. • Mtx competes with VPA for binding to albumin as a result of which a larger proportion of VPA become unbound and is rapidly metabolized by the liver causing decline in VPA levels. • Awareness about pharmacological interactions of anti-epileptic drugs (AEDs) is essential in epilepsy management. Elsevier 2021-05-07 /pmc/articles/PMC8187960/ /pubmed/34142078 http://dx.doi.org/10.1016/j.ebr.2021.100457 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Cherian, Ajith
Shetty, Sharath Chandra
Divya, K.P.
Pavuluri, Harini
Weekly methotrexate may reduce valproate levels causing relapse of genetic generalized epilepsy
title Weekly methotrexate may reduce valproate levels causing relapse of genetic generalized epilepsy
title_full Weekly methotrexate may reduce valproate levels causing relapse of genetic generalized epilepsy
title_fullStr Weekly methotrexate may reduce valproate levels causing relapse of genetic generalized epilepsy
title_full_unstemmed Weekly methotrexate may reduce valproate levels causing relapse of genetic generalized epilepsy
title_short Weekly methotrexate may reduce valproate levels causing relapse of genetic generalized epilepsy
title_sort weekly methotrexate may reduce valproate levels causing relapse of genetic generalized epilepsy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8187960/
https://www.ncbi.nlm.nih.gov/pubmed/34142078
http://dx.doi.org/10.1016/j.ebr.2021.100457
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