Pharmacokinetic considerations in prescribing antiepileptic drugs

Each antiepileptic drug has a characteristic pharmacokinetic profile, and the unique properties of each must be considered when selecting the optimal agent for a particular patient. Detailed pharmacologic data are obtained during the preapproval evaluation of a drug, particularly in early phase studies in healthy volunteers. Each drug is then evaluated in the target population in later phase trials and in certain populations, such as children and individuals with various types of organ failure. Key considerations are bioavailability, protein binding, metabolism and elimination, and drug interactions. Important pharmacokinetic considerations in the selection and use of these drugs are presented in this review, with examples from currently available drugs.