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- Title
Age-related Alteration of Carbamazepine-serum Protein Binding in Man.
- Authors
KOYAMA, HIKARU; SUGIOKA, NOBUYUKI; UNO, AKIRA; MORI, SATORU; NAKAJIMA, KENJI
- Abstract
To determine whether biological maturation influences the kinetics of carbamazepineserum protein binding, the carbamazepine free fraction (%) was investigated in the serum of 66 patients, ranging from 4 to 83 years, with epilepsy or trigeminal neuralgia, treated with carbamazepine alone or carbamazepine in combination with phenytoin, phenobarbital, and/or valproic acid, over a relatively long period. Biochemical parameters such as levels of albumin and non-glycated albumin showed a significant relationship with carbamazepine free fraction (r=-0.521, P < 0.001 for albumin; r=-0.700, P < 0.001 for non-glycated albumin). Non-glycated albumin was more strongly correlated with carbamazepine free fraction. The biochemical parameters showed a significant relationship with age (r=-0.243, P < 0.1 for albumin; r= 0.666, P < 0.001 for glycated albumin; r=-0.459, P < 0.001 for non-glycated albumin; r= 0.640, P < 0.001 for carbamazepine free fraction). Glycated albumin (%), non-glycated albumin and carbamazepine free fraction (%) were strongly correlated with age, whereas albumin showed only a weak correlation with age. To evaluate the effects of ageing on carbamazepine-serum protein binding, the patients were divided into three groups according to age: children, 4-15 years; adults, 16-64 years; elderly, 65-83 years. Albumin and non-glycated albumin were much lower, and glycated albumin (%) and carbamazepine free fraction (%) much higher in the elderly group than in the other two groups. The results of this study showed that the major ligand of carbamazepine in the serum was non-glycated albumin, which decreased with age. These observations suggested that in elderly patients, the elevation of free carbamazepine concentrations in the serum caused by reduced non-glycated albumin levels, induces increases in the sensitivity of the pharmacological effects of carbamazepine and the risk of drug interactions.
- Publication
Journal of Pharmacy & Pharmacology, 1999, Vol 51, Issue 9, p1009
- ISSN
0022-3573
- Publication type
Article
- DOI
10.1211/0022357991773474