Monitoring salivary lamotrigine concentrations

J Clin Neurosci. 2006 Nov;13(9):902-7. doi: 10.1016/j.jocn.2005.12.037. Epub 2006 Oct 17.

Abstract

Lamotrigine concentrations were measured simultaneously (as far as was feasible) in stimulated and unstimulated saliva samples, and in plasma, from seven adult volunteers over a 32 h period following a single 50 mg dose of the drug, and in 20 children and adolescents during the course of routine antiepileptic therapy. In individuals there was a close correlation between the measurements at least 2 h after ingestion of the drug. Concentrations in stimulated and unstimulated saliva were similar; the stimulation produced little change in the saliva secretion rate. The saliva-to-plasma concentration ratio increased linearly by 0.78% for each 1 mg/L plasma lamotrigine concentration, with a mean value of 48.8% at a plasma lamotrigine concentration of 10 mg/L. With appropriate precautions as to the timing of saliva collections, and a single plasma lamotrigine concentration measurement to calibrate the salivary values in the individual, salivary lamotrigine concentration measurement appears to be a practicable approach to therapeutic drug monitoring. This has significant implications for the elucidation of the pharmacokinetics of lamotrigine in the paediatric population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anticonvulsants / analysis
  • Anticonvulsants / blood
  • Anticonvulsants / pharmacokinetics
  • Biological Assay / methods
  • Child
  • Child, Preschool
  • Drug Administration Schedule
  • Epilepsy / drug therapy*
  • Female
  • Humans
  • Infant
  • Lamotrigine
  • Male
  • Middle Aged
  • Monitoring, Physiologic / methods
  • Plasma / chemistry
  • Saliva / chemistry*
  • Time Factors
  • Triazines / analysis*
  • Triazines / blood
  • Triazines / pharmacokinetics

Substances

  • Anticonvulsants
  • Triazines
  • Lamotrigine