New Guidelines Issued for Combining HIV, Seizure Meds

WEDNESDAY, Jan. 4 (HealthDay News) — Physicians need to take
care when prescribing seizure medication to HIV/AIDS patients to prevent
harmful interactions between drugs, experts warn.

The cautionary note from the American Academy of Neurology (AAN) has
led to the issuance of a new AAN guideline, which was developed in
consultation with the International League Against Epilepsy.

“It is important that patients know exactly which drugs they are taking
and provide that information to all prescribing health care providers
caring for them,” lead guideline author Dr. Gretchen L. Birbeck, of
Michigan State University in East Lansing, said in an AAN news
release.

“Doctors may need to watch and adjust drug doses in people with
HIV/AIDS who take seizure drugs,” added Birbeck, who is also an AAN
fellow.

Seizures and related disorders are not uncommon among HIV patients,
according to Birbeck and colleagues. It is estimated that at least 10
percent of HIV patients experience seizures, they noted.

In the new guideline, which is published in the Jan. 4 online editions
of both Neurology and Epilepsia, the research team cautioned
that effectiveness of either set of drugs can be compromised when specific
seizure medications are taken alongside certain HIV/AIDS treatments.
Increased toxicity is another potential issue.

For example, levels of certain seizure medications — such as
phenytoin, phenobarbital and carbamazepine — actually drop off when they
come in contact with seizure drugs. The risk: an HIV drug regimen might
fail, the authors pointed out.

One way Birbeck’s team hopes to mitigate against such risk is to
outline the correct dosages of seizure drugs. They noted that dangerous
drug interactions may be avoidable if medications are prescribed in the
right amounts.

The team also acknowledged that the threat of harmful drug interactions
is highest where drug choices are the most curtailed. That means that
patients in poorer countries, where most HIV/AIDS patients now live, are
particularly vulnerable to this dynamic.

“Future research should target epilepsy and HIV/AIDS drug combinations
where choices are limited, such as in developing countries, to better
understand the risk of these drug interactions,” Birbeck said in the news
release.

More information

For more on seizures, visit the Epilepsy Foundation.

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