Drug-drug interaction of Capparis spinosa

In vitro data show that levetiracetam and its main metabolites obtained within the therapeutic dose range are neither inhibitors of cytochrome P450, cyclooxygenase or uridine diphosphate-glucosidase in human liver, nor substrates with high affinity. Therefore, pharmacokinetic interaction is not easy to occur. In addition, levetiracetam did not affect the glucosidase effect of valproic acid in vitro. The plasma protein binding rate of levetiracetam is low ([10%), and it is difficult to produce clinically meaningful interactions because it competes with other drugs for protein binding sites. Clinical pharmacokinetic studies (phenytoin sodium, valproate sodium, oral contraceptives, digoxin, warfarin and probenecid) and placebo-controlled clinical trials evaluated the potential pharmacokinetic interactions between drugs through pharmacokinetic screening. Drug interaction between levetiracetam and other antiepileptic drugs (AEDs) Levetiracetam phenytoin sodium (3000 mg daily) has no effect on the pharmacokinetics of phenytoin sodium in patients with refractory epilepsy. The application of phenytoin does not affect the pharmacokinetics of this product. Levetiracetam sodium valproate (1500 mg twice daily) did not change the pharmacokinetics of sodium valproate in healthy volunteers. Sodium valproate 500 mg twice a day will not change the absorption rate or degree of levetiracetam, nor will it change its plasma clearance rate or urine excretion. It also does not affect the exposure level and excretion of the main metabolite ucb L057. The serum concentrations of levetiracetam and other antiepileptic drugs (carbamazepine, gabapentin, lamotrigine, phenobarbital, phenytoin, deoxyphenobarbital and sodium valproate) obtained from placebo-controlled clinical studies were evaluated. The data showed that levetiracetam did not affect the plasma concentration of other antiepileptic drugs. These commonly used antiepileptic drugs also do not affect the pharmacokinetic characteristics of this product. The effect of antiepileptic drugs When children take enzyme-induced antiepileptic drugs, the apparent total clearance rate of this product in the body increases by about 22%. But there is no need to adjust dosage. Levetiracetam did not affect the plasma concentrations of carbamazepine, sodium valproate, topiramate or lamotrigine. Other drug interactions Levetiracetam (500 mg twice daily) does not affect the pharmacokinetics of oral contraceptives containing 0.03 mg ethinylestradiol and 0. 15 mg levonorgestrel, or the contents of luteinizing hormone and progesterone, indicating that this product does not affect the efficacy of contraceptives. The application of oral contraceptives does not affect the pharmacokinetic characteristics of this product. The administration of levetiracetam (1000 mg, twice daily) did not affect the pharmacokinetics and pharmacodynamics (ECG) characteristics of digoxin at a daily dose of 0.25 mg. The application of digoxin does not affect the pharmacokinetic characteristics of this product. Taking levetiracetam (1000 mg twice a day) and warfarin will not affect the pharmacokinetics of warfarin R and S forms. The coagulation time was not affected by levetiracetam. The application of warfarin does not affect the pharmacokinetic characteristics of this product. Probenecid (500mg, 4 times a day), a renal tubular secretion blocker, can inhibit the renal clearance rate of the main metabolites of levetiracetam, but it is not the pharmacokinetic characteristics of levetiracetam (1000mg, 2 times a day), and the concentrations of these metabolites are very low. Other drugs that need to be excreted through renal tubules will also affect the renal clearance rate of metabolites. At present, there is no study on the combination of levetiracetam and probenecid, and the effect of levetiracetam combined with other active secretory drugs (such as non-steroidal anti-inflammatory drugs, sulfonamides and methotrexate) on the curative effect is not clear.