Strategies for Optimizing Antiepileptic Drug Therapy in Elderly People

Thomas E. Lackner, Pharm.D., FASCP


Pharmacotherapy. 2002;22(3) 

In This Article

Economic Considerations

If limited financial resources threaten patient adherence to AED therapy, generic formulations should be considered. An extended-release generic phenytoin formulation produced by Mylan Laboratories is approved by the FDA and could be substituted for Dilantin Kapseals.[237] No other phenytoin formulations are considered interchangeable with Dilantin Kapseals. One generic formulation of carbamazepine is bioequivalent to Tegretol.[238] Some high-quality generic AEDs are available, but differences in pharmacokinetics between them and brand-name formulations and the narrow therapeutic index of these drugs may require dosage adjustments. For these reasons, repeated product interchange should be avoided. Careful patient monitoring, including SDC measurement when appropriate, is advised before and after changing AED formulations.