J Korean Neurol Assoc.  2022 May;40(2):121-126. 10.17340/jkna.2022.2.2.

Consideration for Coronavirus Disease 2019 Drug Treatment in Patients with Epilepsy on Antiepileptic Drugs

Affiliations
  • 1Department of Neurology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
  • 2Department of Neurology, Kangbuk Samsung Hospital, Seoul, Korea
  • 3Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
  • 4Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
  • 5Department of Neurology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
  • 6Department of Neurology, Konkuk University School of Medicine, Seoul, Korea
  • 7Department of Pediatrics, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea
  • 8Department of Pediatrics, Severance Children’s Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 9Department of Neurology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 10Department of Neurology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
  • 11Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
  • 12Department of Neurology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
  • 13Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 14Department of Neurology, Kyung Hee University Medical Center, School of Medicine, Kyung Hee University, Seoul, Korea
  • 15Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Abstract

Several medications are approved to treat coronavirus disease 2019 (COVID-19) in Korea including nirmatrelvir/ritonavir, remdesivir, and regdanvimab. There is potential drug-drug interaction between antiepileptic drugs (AEDs) and the medications used to treat COVID-19. Several AEDs such as phenytoin, carbamazepine, phenobarbital, and primidone are strong cytochrome P450 inducers and can inhibit the drugs used for COVID-19. Particularly, these drugs are contraindicated with nirmatrelvir/ritonavir (Paxlovid®). There is a weaker drug-drug interaction between the AEDs and remdesivir. No significant interaction has been reported between the AEDs and molnupiravir. Pharmacokinetic interactions of the AEDs are important in effective management of COVID-19 in patients with epilepsy.

Keyword

COVID-19; Epilepsy; Anticonvulsants; Drug interactions
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