caa a22 4500 477057691 CHVBK 20180405111351.0 cr unu---uuuuu 170330e19960701xx s 000 0 eng 10.1007/s002280050132 doi (NATIONALLICENCE)springer-10.1007/s002280050132 Selective liver enzyme induction by carbamazepine and phenytoin in Chinese epileptics [Elektronische Daten] [B. Tomlinson, R. P. Young, M. C. Y. Ng, P. J. Anderson, R. Kay, J. A. J. H. Critchley] Objective: Anticonvulsant drugs are known inducers of cytochrome P450 liver enzymes and it has been suggested that this induction increases susceptibility to paracetamol-induced hepatotoxicity. Methods: We measured the percentage urinary recovery of paracetamol and its metabolites after a dose of 20 mg kg−1, and the excretion of 6ß-hydroxycortisol as a ratio to urinary free cortisol(6ßOHF/F) in Chinese epileptic patients maintained on long term therapy with carbamazepine (n = 6) or phenytoin (n = 6). Results: Compared to the healthy controls (n = 20), patients on phenytoin had significantly lower recoveries of mercapturic acid, cysteine and sulphate metabolites, but a higher recovery of glucuronide metabolites of paracetamol. The recoveries of paracetamol metabolites in patients on carbamazepine were not different from controls. In contrast, the 6ßOHF/F was signi ficantly higher in patients on carbamazepine (3-fold) or phenytoin (2-fold) compared to controls. Healthy control Chinese subjects metabolised paracetamol in a similar way to that reported in Caucasians, indicating that the risk for hepatotoxicity would be the same. Our findings in a group of Chinese patients on phenytoin were also similar to those previously reported in Caucasians on this drug. The apparent differences in the pattern of isoenzyme induction between the groups on phenytoin and carbamazepine require verification in larger studies. The data do not suggest an increased risk of paracetamol-induced hepatotoxicity in Chinese patients on anticonvulsants. Springer-Verlag Berlin Heidelberg, 1996 Key words Anticonvulsants nationallicence Paracetamol nationallicence liver enzyme induction nationallicence cytochrome P450 induction nationallicence Chinese nationallicence 6ß-hydroxycortisol nationallicence Tomlinson B. Department of Clinical Pharmacology, The Chinese University of Hong Kong, Shatin, Hong Kong aut Young R. P. Department of Clinical Pharmacology, The Chinese University of Hong Kong, Shatin, Hong Kong aut Ng M. C. Y. Department of Clinical Pharmacology, The Chinese University of Hong Kong, Shatin, Hong Kong aut Anderson P. J. Department of Clinical Pharmacology, The Chinese University of Hong Kong, Shatin, Hong Kong aut Kay R. Department of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong aut Critchley J. A. J. H. Department of Clinical Pharmacology, The Chinese University of Hong Kong, Shatin, Hong Kong aut https://doi.org/10.1007/s002280050132 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002280050132 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tomlinson B. Department of Clinical Pharmacology, The Chinese University of Hong Kong, Shatin, Hong Kong aut NATIONALLICENCE 700 1- Young R. P. Department of Clinical Pharmacology, The Chinese University of Hong Kong, Shatin, Hong Kong aut NATIONALLICENCE 700 1- Ng M. C. Y. Department of Clinical Pharmacology, The Chinese University of Hong Kong, Shatin, Hong Kong aut NATIONALLICENCE 700 1- Anderson P. J. Department of Clinical Pharmacology, The Chinese University of Hong Kong, Shatin, Hong Kong aut NATIONALLICENCE 700 1- Kay R. Department of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong aut NATIONALLICENCE 700 1- Critchley J. A. J. H. Department of Clinical Pharmacology, The Chinese University of Hong Kong, Shatin, Hong Kong aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer