Phenytoin and carbamazepine decreased oral bioavailability of praziquantel

P R Bittencourt, C M Gracia, R Martins, A G Fernandes, H W Diekmann, W Jung
Neurology 1992, 42 (3): 492-6
Antiepileptic drugs, especially carbamazepine and phenytoin, are potent liver enzyme inducers. Since praziquantel, the drug used to treat neurocysticercosis, undergoes extensive liver first-pass metabolism, we carried out a prospective study to verify whether there was a decrease in oral bioavailability induced by carbamazepine and phenytoin. Carbamazepine and phenytoin significantly decreased concentrations of praziquantel, due to increased clearance secondary to induction of first pass-liver metabolism. The magnitude of the decrease is surprisingly high and may be responsible for failures of treatment.

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