Which medications in the drug class Anticonvulsants are used in the treatment of Unconjugated Hyperbilirubinemia?

Updated: May 21, 2019
  • Author: Hisham Nazer, MBBCh, FRCP, DTM&H; Chief Editor: BS Anand, MD  more...
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Answer

Anticonvulsants

These drugs induce hepatic-enzyme metabolism, decreasing serum bilirubin levels. They are used to avoid potentially devastating neurologic sequelae in Crigler-Najjar syndrome type 1 and for the management of neurologic symptoms in Crigler-Najjar syndrome type 2.

Phenobarbital

Phenobarbital increases the conjugation and excretion of bilirubin. It reduces serum bilirubin levels by at least 25%.

The drug functions by means of phenobarbital-responsive enhancer module that stimulates the gene for UGT 1A1 to induce production of bilirubin-conjugating enzyme. It does not, however, directly act on the UGT enzyme, as previously thought.

Phenobarbital is used to treat Crigler-Najjar syndrome type 2 and as an adjunct to phototherapy in some cases of Crigler-Najjar syndrome type 1. In addition, it has been shown to be effective in the treatment and prevention of neonatal hyperbilirubinemia.


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