Autoinduction and steady-state pharmacokinetics of carbamazepine and its major metabolites

Br J Clin Pharmacol. 1992 Jun;33(6):611-5. doi: 10.1111/j.1365-2125.1992.tb04089.x.

Abstract

1. The effect of carbamazepine (CBZ) dose change on mean plasma concentrations of CBZ, its two metabolites and apparent steady-state clearance was studied in 77 affectively ill patients receiving CBZ at doses of 100-1200 mg day-1. 2. Autoinduction of CBZ metabolism appeared to be complete within 1 week of starting CBZ therapy or dose change, and its degree was linearly related to CBZ daily dose. 3. Curvilinear plots were obtained for steady-state concentrations of CBZ and its -10,11-epoxide metabolite, and for the ratio of CBZ-10,11-epoxide to CBZ level, versus daily dose of CBZ. 4. On the contrary, steady-state concentration of CBZ-10,11-diol increased proportionately with the dose. This indicates that there is no dose dependency in absorption of CBZ, and that dose-dependent autoinduction of CBZ metabolism is the main cause of the curvilinear relationship between dose and steady-state concentration of CBZ and its intermediary metabolite, CBZ-10,11-epoxide.

MeSH terms

  • Adult
  • Carbamazepine / administration & dosage
  • Carbamazepine / analogs & derivatives
  • Carbamazepine / metabolism
  • Carbamazepine / pharmacokinetics*
  • Female
  • Humans
  • Male
  • Middle Aged

Substances

  • Carbamazepine
  • 10,11-dihydro-10,11-dihydroxy-5H-dibenzazepine-5-carboxamide
  • carbamazepine epoxide