Emilio Diaz
 |
In conclusion, increased plasma concentrations of CBZ found when Fluoxetine ( Prozac ) is added are not due to decreased formation of CBZE. In isolated perfused rat liver, there was no effect of Fluoxetine ( Prozac ) (n 8) or norFluoxetine ( Prozac ) (n 6) on the formation clearance of CBZE (12.8 /- 5.3 and 11.7 /- 3.8 ml/min, respectively) or the intrinsic metabolic clearance of CBZ (6.6 /- 2.7 and 6.3 /- 1.8 ml/min, respectively). The objective of the present study was to investigate the effect of Fluoxetine ( Prozac ) and its major metabolite, norFluoxetine ( Prozac ), on CBZE formation in isolated perfused rat liver, in vitro human liver (n 5) microsomes, and patients (n 14), after either CBZ monotherapy or polytherapy with Fluoxetine ( Prozac ). Evaluation of the effect of Fluoxetine ( Prozac ) on the formation of carbamazepine epoxide.Fluoxetine ( Prozac ) has been reported to increase carbamazepine (CBZ) plasma concentrations and cause adverse effects. In support of this, there was no difference in the ratio of CBZE to CBZ plasma concentrations in patients also receiving Fluoxetine ( Prozac ) when compared to patients on CBZ monotherapy; however, there was a trend toward a decrease in the apparent plasma clearance of CBZ. CBZ-10, 11 epoxide (CBZE), the major metabolite of CBZ, contributes to the clinical effect and toxicity of CBZ. Studies on human liver microsomes confirmed that neither Fluoxetine ( Prozac ) or norFluoxetine ( Prozac ) inhibited formation of CBZE until concentrations were > anastrozole generic allegra generic ropinirole hydrochloride 20 times those found clinically. Clinically, if Fluoxetine ( Prozac ) causes an increase in CBZ levels, CBZE plasma concentrations will increase proportionately and contribute to the toxicity..
|
