奥卡西平治疗妊娠期癫痫的安全性研究进展

Progress in the safety of oxcarbazepine in the treatment of epilepsy in pregnancy

奥卡西平(Oxcarbazepine,OXC)是一种新型抗癫痫药物(Antiepileptic drug,AED)。受解剖和生理学变化的影响,妊娠期OXC的血浆清除率明显增加,在产后逐渐恢复正常,故在妊娠期及产后应进行血药浓度监测,及时调整药物剂量。与一代AED相比,OXC的安全性较好,致畸风险较低。尽管OXC及其代谢物可通过胎盘、母乳进入胎儿及新生儿体内,但对后代的神经发育没有明显影响。本文从OXC妊娠期及产后的药代动力学变化,血药浓度监测及剂量调节,对后代、胎盘及母乳喂养的影响等方面进行综述。

Oxcarbazepine(OXC)is a new antiepileptic drug(AED).Influenced by anatomical and physiological changes,the plasma clearance rate of OXC increases significantly during pregnancy and gradually returns to normal in the postpartum period;therefore,blood concentration monitoring should be performed during pregnancy and the postpartum period to adjust the drug dosage in a timely manner.OXC has a more favourable safety profile and a lower risk of teratogenicity than the first-generation AED.Although OXC and its metabolites can be exposed to the foetus and neonate through the placenta and breast milk,there is no significant effect on the neurodevelopment of the offspring.In this review,the pharmacokinetic changes of OXC during pregnancy and postpartum,blood concentration monitoring and dose adjustment,effects on the offspring,and effects on the placenta and breastfeeding are summarized.