Carbamazepine/oxcarbazepine
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Reactions 886 - 26 Jan 2002 S Carbamazepine/oxcarbazepine Hyponatraemia and leucopenia: case report Hyponatraemia and leucopenia developed in a 57-year-old woman during treatment with carbamazepine, and later with oxcarbazepine, for the control of complex partial seizures that had developed following head trauma. Seven years after the woman had started treatment with oral carbamazepine 400mg 3 times daily, blood tests revealed leucopenia with WBC counts ranging from 1900 to 4000/µl and hyponatraemia with serum sodium levels ranging from 121 to 133 mg/dl. Treatment with carbamazepine was discontinued approximately 10 years later when her WBC count was 1900/µl. At that time valproate semisodium was started. Although her WBC count improved, seizure control was not achieved and her dosage of valproate semisodium was reduced and oxcarbazepine 300mg twice daily was added. Three weeks later, valproate semisodium was stopped. One week after starting treatment with oxcarbazepine, the women developed hyponatraemia and leucopenia. 51 days after starting oxcarbazepine, the woman’s WBC count had decreased to 2100/µl and her serum sodium level was 127 mg/ dl. She began phenytoin and her dosage of oxcarbazepine was decreased to 150mg twice daily. Ten days later, she presented with fever, dizziness, lack of energy and numbness of both arms. She was hospitalised and her BP was 88/50mm Hg, her WBC count was 1800/µl and her serum sodium level was 118 mg/dl. Oxcarbazepine was discontinued immediately and she began treatment with gabapentin and empirical antibacterial treatment for neutropenic fever and aspiration pneumonia. Her WBC count improved after filgrastim treatment on hospital days 3 and 4, and her serum sodium level normalised. Her WBC count stabilised at 3100/µl 12 days after stopping oxcarbazepine. Phenytoin was discontinued and the woman was maintained on gabapentin monotherapy. Author comment: ‘This case illustrates a significant duplication of adverse effects between carbamazepine and oxcarbazepine therapy.’ Ryan M, et al. Hyponatremia and leukopenia associated with oxcarbazepine following carbamazepine therapy. American Journal of Health-System Pharmacy 58: 1637-1639, 1 Sep 2001 - USA 800878860 1 Reactions 26 Jan 2002 No. 886 0114-9954/10/0886-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine/oxcarbazepine
Reactions 886 - 26 Jan 2002
SCarbamazepine/oxcarbazepine
Hyponatraemia and leucopenia: case reportHyponatraemia and leucopenia developed in a 57-year-old
woman during treatment with carbamazepine, and later withoxcarbazepine, for the control of complex partial seizures thathad developed following head trauma.
Seven years after the woman had started treatment with oralcarbamazepine 400mg 3 times daily, blood tests revealedleucopenia with WBC counts ranging from 1900 to 4000/µland hyponatraemia with serum sodium levels ranging from121 to 133 mg/dl. Treatment with carbamazepine wasdiscontinued approximately 10 years later when her WBCcount was 1900/µl. At that time valproate semisodium wasstarted. Although her WBC count improved, seizure controlwas not achieved and her dosage of valproate semisodium wasreduced and oxcarbazepine 300mg twice daily was added.Three weeks later, valproate semisodium was stopped.
One week after starting treatment with oxcarbazepine, thewomen developed hyponatraemia and leucopenia. 51 daysafter starting oxcarbazepine, the woman’s WBC count haddecreased to 2100/µl and her serum sodium level was 127 mg/dl. She began phenytoin and her dosage of oxcarbazepine wasdecreased to 150mg twice daily. Ten days later, she presentedwith fever, dizziness, lack of energy and numbness of botharms. She was hospitalised and her BP was 88/50mm Hg, herWBC count was 1800/µl and her serum sodium level was 118mg/dl. Oxcarbazepine was discontinued immediately and shebegan treatment with gabapentin and empirical antibacterialtreatment for neutropenic fever and aspiration pneumonia.Her WBC count improved after filgrastim treatment onhospital days 3 and 4, and her serum sodium level normalised.Her WBC count stabilised at 3100/µl 12 days after stoppingoxcarbazepine. Phenytoin was discontinued and the womanwas maintained on gabapentin monotherapy.
Author comment: ‘This case illustrates a significantduplication of adverse effects between carbamazepine andoxcarbazepine therapy.’Ryan M, et al. Hyponatremia and leukopenia associated with oxcarbazepinefollowing carbamazepine therapy. American Journal of Health-System Pharmacy58: 1637-1639, 1 Sep 2001 - USA 800878860
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Reactions 26 Jan 2002 No. 8860114-9954/10/0886-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
