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  • Title: Changes in unbound and total valproic acid concentrations after replacement of carbamazepine with oxcarbazepine.
    Author: Battino D, Croci D, Granata T, Bernardi G, Monza G.
    Journal: Ther Drug Monit; 1992 Oct; 14(5):376-9. PubMed ID: 1448844.
    Abstract:
    Total and free valproic acid (VPA) concentrations were measured in patients switched from a combined VPA and carbamazepine (CBZ) to a combined VPA and oxcarbazepine (OXC) therapy, both administered in individualized daily doses. Four young epileptic patients (13-17 years old) were studied for a 12-week period, total and free VPA concentrations being analyzed just before and 4 h after the morning dose, at the end of VPA and CBZ therapy, and 2 and 10 weeks after CBZ was replaced by OXC. The expected increase in the level/dose (L/D) ratio of total VPA observed at the end of the study was preceded by a clear-cut increase in the L/D ratio of free VPA, which led to VPA-related side effects and required the retitration of VPA daily doses.
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