TY - JOUR
T1 - Treating epilepsy patients with investigational anti-COVID-19 Drugs
T2 - Recommendations by the Israeli chapter of the ILAE
AU - Ekstein, Dana
AU - Noyman, Iris
AU - Fahoum, Firas
AU - Herskovitz, Moshe
AU - Linder, Ilan
AU - Zeev, Bruria Ben
AU - Eyal, Sara
N1 - Publisher Copyright:
© 2020 Israel Medical Association. All rights reserved.
PY - 2020/11
Y1 - 2020/11
N2 - The coronavirus disease-2019 (COVID-19) and its management in patients with epilepsy can be complex. Prescribers should consider potential effects of investigational anti-COVID-19 drugs on seizures, immunomodulation by anti-seizure medications (ASMs), changes in ASM pharmacokinetics, and the potential for drug-drug interactions (DDIs). The goal of the Board of the Israeli League Against Epilepsy (the Israeli Chapter of the International League Against Epilepsy, ILAE) was to outline the main principles of the pharmacological treatment of COVID-19 in patients with epilepsy. This guide was based on current literature, drug labels, and drug interaction resources. We summarized the available data related to the potential implications of anti-COVID-19 co-medication in patients treated with ASMs. Our recommendations refer to drug selection, dosing, and patient monitoring. Given the limited availability of data, some recommendations are based on general pharmacokinetic or pharmacodynamic principles and might apply to additional future drug combinations as novel treatments emerge. They do not replace evidence-based guidelines, should those become available. Awareness to drug characteristics that increase the risk of interactions can help adjust anti-COVID-19 and ASM treatment for patients with epilepsy.
AB - The coronavirus disease-2019 (COVID-19) and its management in patients with epilepsy can be complex. Prescribers should consider potential effects of investigational anti-COVID-19 drugs on seizures, immunomodulation by anti-seizure medications (ASMs), changes in ASM pharmacokinetics, and the potential for drug-drug interactions (DDIs). The goal of the Board of the Israeli League Against Epilepsy (the Israeli Chapter of the International League Against Epilepsy, ILAE) was to outline the main principles of the pharmacological treatment of COVID-19 in patients with epilepsy. This guide was based on current literature, drug labels, and drug interaction resources. We summarized the available data related to the potential implications of anti-COVID-19 co-medication in patients treated with ASMs. Our recommendations refer to drug selection, dosing, and patient monitoring. Given the limited availability of data, some recommendations are based on general pharmacokinetic or pharmacodynamic principles and might apply to additional future drug combinations as novel treatments emerge. They do not replace evidence-based guidelines, should those become available. Awareness to drug characteristics that increase the risk of interactions can help adjust anti-COVID-19 and ASM treatment for patients with epilepsy.
KW - Anti-COVID-19 medications
KW - Anti-epileptic drugs
KW - Clinically-relevant drug-drug interactions
KW - Cytochrome P450
KW - Pharmacokinetics
UR - http://www.scopus.com/inward/record.url?scp=85097035497&partnerID=8YFLogxK
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C2 - 33249784
AN - SCOPUS:85097035497
SN - 1565-1088
VL - 22
SP - 665
EP - 672
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 11
ER -
