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Anticonvulsants Decrease Metabolism of Chemotherapy Drugs

KEY POINT

Patients on enzyme-inducing anticonvulsant agents (barbiturates, phenytoin, or carbamazepine) should be switched to other agents while receiving chemotherapy for acute lymphoblastic leukemia (ALL). The medications increase the systemic clearance of corticosteroids, vincristine (Oncovin—Lilly), etoposide (VePesid—Bristol-Myers Squibb Oncology), teniposide (Vumon—Bristol-Myers Squibb Oncology), and methotrexate, leading to decreased effectiveness against ALL. They have no effect on cytarabine (Cytosar-U—Pharmacia).

SOURCES

Relling MV et al. Adverse effect of anticonvulsants on efficacy of chemotherapy for acute lymphoblastic leukaemia. Lancet. 2000;356:285–90.