@article {Ohman:June 2008:0013-9580:1075,
author = "Ohman, Inger",
author = "Beck, Olof",
author = "Vitols, Sigurd",
author = "Tomson, Torbjorn",
title = "Plasma concentrations of lamotrigine and its 2-N-glucuronide metabolite during pregnancy in women with epilepsy",
journal = "Epilepsia",
volume = "49",
year = "June 2008",
abstract = "Summary Objective: To further characterize pregnancy-induced alterations in the pharmacokinetics of lamotrigine (LTG). Methods: Fifteen women treated with LTG were studied during 17 pregnancies. Complete trough blood samples from all trimesters and baseline > 1 month after delivery were available for 12 pregnancies (Group A), whereas, five contributed with samples only from the third trimester and baseline (Group B). High-performance liquid chromatography (HPLC) was used to determine LTG plasma concentrations, and liquid chromatography-mass spectrometry to assay the main metabolite 2-N-lamotrigine glucuronide (2-N-GLUC) in plasma. Results: In group A, the mean dose/plasma concentration ratio (D/C) of LTG at baseline after pregnancy was 66.5 ± 17.9 (± SD) L/day and approximately 250% higher in late pregnancy. The mean lamotrigine-2-N-glucuronide/lamotrigine plasma concentration ratio (2-N-GLUC/LTG) was 0.349 ± 0.141 (± SD) at baseline and 147% higher in late pregnancy. Taking group A and B together, the 2-N-GLUC/LTG ratio was 175% higher in the third trimester compared to baseline. Conclusion: Our study confirms a significant decline in LTG plasma levels during pregnancy in women on monotherapy with LTG. An increased 2-N-GLUC/LTG ratio suggests that this decline may be related to an increased metabolism of LTG by glucuronidation.",
pages = "1075-1080(6)",
url = "http://www.ingentaconnect.com/content/bsc/epi/2008/00000049/00000006/art00016"
doi = "doi:10.1111/j.1528-1167.2007.01471.x"
}