caa a22 4500 469026286 CHVBK 20180323132730.0 cr unu---uuuuu 170328e19920601xx s 000 0 eng 10.1007/BF01962699 doi (NATIONALLICENCE)springer-10.1007/BF01962699 Johannessen Svein The National Centre for Epilepsy, N-1301, Sandvika, Norway aut Pharmacokinetics of valproate in pregnancy: Mother-foetus-newborn [Elektronische Daten] [Svein Johannessen] An increased risk of seizures during and immediately after labour has been observed in epileptic women, and it is recognized that serum levels of antiepileptic drugs may decrease in pregnancy. Several studies have suggested that total valproate levels fall, but that free fractions increase during pregnancy. Recent findings suggest that the actual metabolism of valproate is not altered by pregnancy and that the changes of the plasma clearance are due primarily to decreased protein binding. The levels of free drug will not change significantly as pregnancy advances. However, dose reduction after delivery may be necessary to avoid toxicity. Valproate and its metabolites undergo placental transfer. In the foetus the plasma level of valproate and the protein binding are higher than in maternal plasma, and the halflife of valproate following placental transfer is considerably longer than in adults. Only small amounts of valproate appear in breast milk and those are not likely to cause any problems. During pregnancy and the first month after delivery preferably both total and free valproate serum levels should be closely monitored to determine the lowest effective dose. Royal Dutch Association for Advancement of Pharmacy, 1992 Biological availability nationallicence Fetus nationallicence Lactation nationallicence Metabolism nationallicence Pharmacokinetics nationallicence Placental transfer nationallicence Protein binding nationallicence Pharmaceutisch Weekblad Kluwer Academic Publishers 14/3(1992-06-01), 114-117 0031-6911 14:3<114 1992 14 11096 https://doi.org/10.1007/BF01962699 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01962699 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Johannessen Svein The National Centre for Epilepsy, N-1301, Sandvika, Norway aut NATIONALLICENCE 773 0- Pharmaceutisch Weekblad Kluwer Academic Publishers 14/3(1992-06-01), 114-117 0031-6911 14:3<114 1992 14 11096 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer