Oxkarbazepin
Oxkarbazepin
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Apydan, Apydan Extent, Oxcarbazepin Mylan, Oxcarbazepin......
Apydan, Apydan Extent, Oxcarbazepin Mylan, Oxcarbazepine STADA, TrileptalATC-Koder
N03AF02
N03AF02Substanser
oxkarbazepin
oxkarbazepinBedömning
En del av de antiepileptika som använts länge och därmed är väldokumenterade har visats öka risken något för fosterskador. Det saknas studier för att kunna bedöma om riskökningarna gäller även för oxkarbazepin. Kvinnor i fertil ålder, som behöver behandling med antiepileptika, bör upplysas om den något ökade risken för fosterskador.
Om man inte kan avsluta behandlingen före graviditet, bör lägsta möjliga dosering som ger anfallskontroll eftersträvas och om möjligt ska monoterapi väljas. Behandling av epilepsi ska inte avbrytas under graviditeten.
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Gemensamt för antiepileptika
I olika studier har användning av vissa antiepileptika satts i samband med en två till tre gånger ökad risk för att barnet skall födas med någon missbildning [1-7]. Speciellt märks en ökning av frekvensen läppgomspalt samt av hjärtfel och för vissa antiepileptika neuralrörsdefekter [1-3]. Den totala risken för en allvarlig missbildning är i litteraturen beskriven till cirka 6 procent. I en nyligen publicerad europeisk registerstudie har man påvisat en sjunkande trend av missbildningar troligen beroende på e......
Referenser
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Weston J, Bromley R, Jackson CF, Adab N, Clayton-Smith J, Greenhalgh J et al. Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child. Cochrane Database Syst Rev. 2016;11:CD010224.
Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Perucca E et al. Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry. Lancet Neurol. 2018;17(6):530-538.
Hernández-Díaz S, Smith CR, Shen A, Mittendorf R, Hauser WA, Yerby M et al. Comparative safety of antiepileptic drugs during pregnancy. Neurology. 2012;78:1692-9.
Wide K, Winbladh B, Källén B. Major malformations in infants exposed to antiepileptic drugs in utero, with emphasis on carbamazepine and valproic acid: a nation-wide, population-based register study. Acta Paediatr 2004;93:174-6.
Artama M, Ritvanen A, Gissler M, Isojarvi J, Auvinen A. Congenital structural anomalies in offspring of women with epilepsy _ a population-based cohort study in Finland. Int J Epidemiol 2006;35:280-7.
Petersen I, Collings SL, McCrea RL, Nazareth I, Osborn DP, Cowen PJ et al. Antiepileptic drugs prescribed in pregnancy and prevalence of major congenital malformations: comparative prevalence studies. Clin Epidemiol. 2017;9:95-103.
Marxer CA, Rüegg S, Rauch MS, Panchaud A, Meier CR, Spoendlin J. A review of the evidence on the risk of congenital malformations and neurodevelopmental disorders in association with antiseizure medications during pregnancy. Expert Opin Drug Saf. 2021;20(12):1487-1499.
Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Perucca E et al. Declining malformation rates with changed antiepileptic drug prescribing: An observational study. Neurology. 2019;93(9):e831-e840.
Razaz N, Tomson T, Wikström AK, Cnattingius S. Association Between Pregnancy and Perinatal Outcomes Among Women With Epilepsy. JAMA Neurol. 2017;74(8):983-991.
Robert E, Guibaud P. Maternal valproic acid and congenital neural tube defects. Lancet 1982;2:937.
Jentink J, Loane MA, Dolk H, Barisic I, Garne E, Morris JK et al. Valproic acid monotherapy in pregnancy and major congenital malformations. N Engl J Med. 2010;362:2185-93.
Hernandez-Diaz S, Huybrechts KF, Desai RJ, Cohen JM, Mogun H, Pennell PB et al. Topiramate use early in pregnancy and the risk of oral clefts: A pregnancy cohort study. Neurology. 2018;90(4):e342-e351.
Holmes LB, Hernandez-Diaz S. Newer anticonvulsants: lamotrigine, topiramate and gabapentin. Birth Defects Res A Clin Mol Teratol. 2012;94:599-606.
Vajda FJ, Graham J, Roten A, Lander CM, O'Brien TJ, Eadie M. Teratogenicity of the newer antiepileptic drugs--the Australian experience. J Clin Neurosci. 2012;19:57-9.
Rasalam AD, Hailey H, Williams JH, Moore SJ, Turnpenny PD, Lloyd DJ, Dean JC. Characteristics of fetal anticonvulsant syndrome associated autistic disorders. Dev Med Child Neurol 2005;47:551-5.
Bromley R, Weston J, Adab N, Greenhalgh J, Sanniti A, McKay AJ et al. Treatment for epilepsy in pregnancy: neurodevelopmental outcomes in the child. Cochrane Database Syst Rev. 2014;10:CD010236.
Wide K, Winbladh B, Tomson T et al. Psychomotor development and minor anomalies in children exposed to antiepileptic drugs in utero: a prospective population-based study. Dev Med Child Neurol 2000;42:87-92.
Dean JCS, Hailey H, Moore SJ, Lloyd DJ, Turnpenny PD, Little J. Long term health and neurodevelopment in children exposed to antiepileptic drugs before birth. J Med Genet 2002;39:251-9.
Cohen MJ, Meador KJ, Browning N, May R, Baker GA, Clayton-Smith J et al. Fetal antiepileptic drug exposure: Adaptive and emotional/behavioral functioning at age 6years. Epilepsy Behav. 2013;29:308-15.
Meador KJ, Baker GA, Browning N, Cohen MJ, Bromley RL, Clayton-Smith J et al. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study. Lancet Neurol. 2013;12:244-52.
Cummings C, Stewart M, Stevenson M, Morrow J, Nelson J. Neurodevelopment of children exposed in utero to lamotrigine, sodium valproate and carbamazepine. Arch Dis Child. 2011;96:643-7.
Baker GA, Bromley RL, Briggs M, Cheyne CP, Cohen MJ, García-Fiñana M et al. IQ at 6 years after in utero exposure to antiepileptic drugs: a controlled cohort study. Neurology. 2015;84(4):382-90.
Christensen J, Pedersen L, Sun Y, Dreier JW, Brikell I, Dalsgaard S. Association of Prenatal Exposure to Valproate and Other Antiepileptic Drugs With Risk for Attention-Deficit/Hyperactivity Disorder in Offspring. JAMA Netw Open. 2019;2(1):e186606.
Bromley RL, Baker GA. Fetal antiepileptic drug exposure and cognitive outcomes. Seizure. 2017;44:225-231.
Veroniki AA, Rios P, Cogo E, Straus SE, Finkelstein Y, Kealey R et al. Comparative safety of antiepileptic drugs for neurological development in children exposed during pregnancy and breast feeding: a systematic review and network meta-analysis. BMJ Open. 2017;7(7):e017248.
Wide K, Winbladh B, Tomson T et al. Body dimensions of infants exposed to antiepileptic drugs in utero: observations spanning 25 years. Epilepsia 2000;41:854-61.
Hernández-Díaz S, McElrath TF, Pennell PB, Hauser WA, Yerby M, Holmes LB et al. Fetal growth and premature delivery in pregnant women on antiepileptic drugs. Ann Neurol. 2017;82(3):457-465.
Almgren M, Källén B, Lavebratt C. Population-based study of antiepileptic drug exposure in utero--influence on head circumference in newborns. Seizure. 2009;18:672-5.
Holmes LB, Mittendorf R, Shen A, Smith CR, Hernandez-Diaz S. Fetal effects of anticonvulsant polytherapies: different risks from different drug combinations. Arch Neurol. 2011;68:1275-81.
Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Perucca E et al. Dose-dependent teratogenicity of valproate in mono- and polytherapy: an observational study. Neurology. 2015;85(10):866-72.
Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Sabers A, et al. Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry. Lancet Neurol. 2011 Jun 5. [Epub ahead of print]
Vajda FJ, O'Brien TJ, Lander CM, Graham J, Roten A, Eadie MJ. Teratogenesis in repeated pregnancies in antiepileptic drug-treated women. Epilepsia. 2013;54:181-6.
Blotière PO, Raguideau F, Weill A, Elefant E, Perthus I, Goulet V et al. Risks of 23 specific malformations associated with prenatal exposure to 10 antiepileptic drugs. Neurology. 2019;93(2):e167-e180.
- Weston J, Bromley R, Jackson CF, Adab N, Clayton-Smith J, Greenhalgh J et al. Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child. Cochrane Database Syst Rev. 2016;11:CD010224.
- Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Perucca E et al. Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry. Lancet Neurol. 2018;17(6):530-538.
- Hernández-Díaz S, Smith CR, Shen A, Mittendorf R, Hauser WA, Yerby M et al. Comparative safety of antiepileptic drugs during pregnancy. Neurology. 2012;78:1692-9.
- Wide K, Winbladh B, Källén B. Major malformations in infants exposed to antiepileptic drugs in utero, with emphasis on carbamazepine and valproic acid: a nation-wide, population-based register study. Acta Paediatr 2004;93:174-6.
- Artama M, Ritvanen A, Gissler M, Isojarvi J, Auvinen A. Congenital structural anomalies in offspring of women with epilepsy _ a population-based cohort study in Finland. Int J Epidemiol 2006;35:280-7.
- Petersen I, Collings SL, McCrea RL, Nazareth I, Osborn DP, Cowen PJ et al. Antiepileptic drugs prescribed in pregnancy and prevalence of major congenital malformations: comparative prevalence studies. Clin Epidemiol. 2017;9:95-103.
- Marxer CA, Rüegg S, Rauch MS, Panchaud A, Meier CR, Spoendlin J. A review of the evidence on the risk of congenital malformations and neurodevelopmental disorders in association with antiseizure medications during pregnancy. Expert Opin Drug Saf. 2021;20(12):1487-1499.
- Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Perucca E et al. Declining malformation rates with changed antiepileptic drug prescribing: An observational study. Neurology. 2019;93(9):e831-e840.
- Razaz N, Tomson T, Wikström AK, Cnattingius S. Association Between Pregnancy and Perinatal Outcomes Among Women With Epilepsy. JAMA Neurol. 2017;74(8):983-991.
- Robert E, Guibaud P. Maternal valproic acid and congenital neural tube defects. Lancet 1982;2:937.
- Jentink J, Loane MA, Dolk H, Barisic I, Garne E, Morris JK et al. Valproic acid monotherapy in pregnancy and major congenital malformations. N Engl J Med. 2010;362:2185-93.
- Hernandez-Diaz S, Huybrechts KF, Desai RJ, Cohen JM, Mogun H, Pennell PB et al. Topiramate use early in pregnancy and the risk of oral clefts: A pregnancy cohort study. Neurology. 2018;90(4):e342-e351.
- Holmes LB, Hernandez-Diaz S. Newer anticonvulsants: lamotrigine, topiramate and gabapentin. Birth Defects Res A Clin Mol Teratol. 2012;94:599-606.
- Vajda FJ, Graham J, Roten A, Lander CM, O'Brien TJ, Eadie M. Teratogenicity of the newer antiepileptic drugs--the Australian experience. J Clin Neurosci. 2012;19:57-9.
- Rasalam AD, Hailey H, Williams JH, Moore SJ, Turnpenny PD, Lloyd DJ, Dean JC. Characteristics of fetal anticonvulsant syndrome associated autistic disorders. Dev Med Child Neurol 2005;47:551-5.
- Bromley R, Weston J, Adab N, Greenhalgh J, Sanniti A, McKay AJ et al. Treatment for epilepsy in pregnancy: neurodevelopmental outcomes in the child. Cochrane Database Syst Rev. 2014;10:CD010236.
- Wide K, Winbladh B, Tomson T et al. Psychomotor development and minor anomalies in children exposed to antiepileptic drugs in utero: a prospective population-based study. Dev Med Child Neurol 2000;42:87-92.
- Dean JCS, Hailey H, Moore SJ, Lloyd DJ, Turnpenny PD, Little J. Long term health and neurodevelopment in children exposed to antiepileptic drugs before birth. J Med Genet 2002;39:251-9.
- Cohen MJ, Meador KJ, Browning N, May R, Baker GA, Clayton-Smith J et al. Fetal antiepileptic drug exposure: Adaptive and emotional/behavioral functioning at age 6years. Epilepsy Behav. 2013;29:308-15.
- Meador KJ, Baker GA, Browning N, Cohen MJ, Bromley RL, Clayton-Smith J et al. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study. Lancet Neurol. 2013;12:244-52.
- Cummings C, Stewart M, Stevenson M, Morrow J, Nelson J. Neurodevelopment of children exposed in utero to lamotrigine, sodium valproate and carbamazepine. Arch Dis Child. 2011;96:643-7.
- Baker GA, Bromley RL, Briggs M, Cheyne CP, Cohen MJ, García-Fiñana M et al. IQ at 6 years after in utero exposure to antiepileptic drugs: a controlled cohort study. Neurology. 2015;84(4):382-90.
- Christensen J, Pedersen L, Sun Y, Dreier JW, Brikell I, Dalsgaard S. Association of Prenatal Exposure to Valproate and Other Antiepileptic Drugs With Risk for Attention-Deficit/Hyperactivity Disorder in Offspring. JAMA Netw Open. 2019;2(1):e186606.
- Bromley RL, Baker GA. Fetal antiepileptic drug exposure and cognitive outcomes. Seizure. 2017;44:225-231.
- Veroniki AA, Rios P, Cogo E, Straus SE, Finkelstein Y, Kealey R et al. Comparative safety of antiepileptic drugs for neurological development in children exposed during pregnancy and breast feeding: a systematic review and network meta-analysis. BMJ Open. 2017;7(7):e017248.
- Wide K, Winbladh B, Tomson T et al. Body dimensions of infants exposed to antiepileptic drugs in utero: observations spanning 25 years. Epilepsia 2000;41:854-61.
- Hernández-Díaz S, McElrath TF, Pennell PB, Hauser WA, Yerby M, Holmes LB et al. Fetal growth and premature delivery in pregnant women on antiepileptic drugs. Ann Neurol. 2017;82(3):457-465.
- Almgren M, Källén B, Lavebratt C. Population-based study of antiepileptic drug exposure in utero--influence on head circumference in newborns. Seizure. 2009;18:672-5.
- Holmes LB, Mittendorf R, Shen A, Smith CR, Hernandez-Diaz S. Fetal effects of anticonvulsant polytherapies: different risks from different drug combinations. Arch Neurol. 2011;68:1275-81.
- Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Perucca E et al. Dose-dependent teratogenicity of valproate in mono- and polytherapy: an observational study. Neurology. 2015;85(10):866-72.
- Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Sabers A, et al. Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry. Lancet Neurol. 2011 Jun 5. [Epub ahead of print]
- Vajda FJ, O'Brien TJ, Lander CM, Graham J, Roten A, Eadie MJ. Teratogenesis in repeated pregnancies in antiepileptic drug-treated women. Epilepsia. 2013;54:181-6.
- Blotière PO, Raguideau F, Weill A, Elefant E, Perthus I, Goulet V et al. Risks of 23 specific malformations associated with prenatal exposure to 10 antiepileptic drugs. Neurology. 2019;93(2):e167-e180.
Författare
Karin Källén och Katarina Wide för Region Stockholm.
Karin Källén och Katarina Wide för Region Stockholm.Uppdaterat
Innehållet uppdaterat 2/20/2022
Uppgifterna från födelseregistret är hämtade 4/1/2018
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