Using nirmatrelvir/ritonavir in patients with epilepsy: An update from the Israeli chapter of the International League Against Epilepsy

Iris Noyman; Dana Ekstein; Firas Fahoum; Moshe Herskovitz; Ilan Linder; Bruria Ben Zeev; Sara Eyal

doi:10.1111/epi.17212

Using nirmatrelvir/ritonavir in patients with epilepsy: An update from the Israeli chapter of the International League Against Epilepsy

Iris Noyman, Dana Ekstein, Firas Fahoum, Moshe Herskovitz, Ilan Linder, Bruria Ben Zeev, Sara Eyal

Medical School for International Health

Research output: Contribution to journal › Comment/debate

9 Scopus citations

Abstract

Presented herein are recommendations for use of nirmatrelvir/ritonavir in patients with epilepsy, as issued by the Steering Committee of the Israeli chapter of the International League Against Epilepsy. The recommendations suggest that patients on moderate-to-strong enzyme-inducing antiseizure medications (ASMs) and everolimus should not be treated with nirmatrelvir/ritonavir; rectal diazepam may be used as an alternative to buccal midazolam; doses of ASMs that are cytochrome P450 (CYP3A4) substrates might be adjusted; and patients treated with combinations of nirmatrelvir/ritonavir and ASMs that are CYP3A4 substrates or lamotrigine should be monitored for drug efficacy and adverse drug reactions.

Original language	English
Pages (from-to)	1276-1278
Number of pages	3
Journal	Epilepsia
Volume	63
Issue number	5
DOIs	https://doi.org/10.1111/epi.17212
State	Published - 1 May 2022

Keywords

COVID-19
CYP3A4
antiepileptic drugs
antiseizure medications
drug–drug interactions

ASJC Scopus subject areas

Neurology
Clinical Neurology

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10.1111/epi.17212

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title = "Using nirmatrelvir/ritonavir in patients with epilepsy: An update from the Israeli chapter of the International League Against Epilepsy",

abstract = "Presented herein are recommendations for use of nirmatrelvir/ritonavir in patients with epilepsy, as issued by the Steering Committee of the Israeli chapter of the International League Against Epilepsy. The recommendations suggest that patients on moderate-to-strong enzyme-inducing antiseizure medications (ASMs) and everolimus should not be treated with nirmatrelvir/ritonavir; rectal diazepam may be used as an alternative to buccal midazolam; doses of ASMs that are cytochrome P450 (CYP3A4) substrates might be adjusted; and patients treated with combinations of nirmatrelvir/ritonavir and ASMs that are CYP3A4 substrates or lamotrigine should be monitored for drug efficacy and adverse drug reactions.",

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author = "Iris Noyman and Dana Ekstein and Firas Fahoum and Moshe Herskovitz and Ilan Linder and {Ben Zeev}, Bruria and Sara Eyal",

note = "Publisher Copyright: {\textcopyright} 2022 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.",

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AU - Ekstein, Dana

AU - Fahoum, Firas

AU - Herskovitz, Moshe

AU - Linder, Ilan

AU - Ben Zeev, Bruria

AU - Eyal, Sara

PY - 2022/5/1

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AB - Presented herein are recommendations for use of nirmatrelvir/ritonavir in patients with epilepsy, as issued by the Steering Committee of the Israeli chapter of the International League Against Epilepsy. The recommendations suggest that patients on moderate-to-strong enzyme-inducing antiseizure medications (ASMs) and everolimus should not be treated with nirmatrelvir/ritonavir; rectal diazepam may be used as an alternative to buccal midazolam; doses of ASMs that are cytochrome P450 (CYP3A4) substrates might be adjusted; and patients treated with combinations of nirmatrelvir/ritonavir and ASMs that are CYP3A4 substrates or lamotrigine should be monitored for drug efficacy and adverse drug reactions.

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KW - CYP3A4

KW - antiepileptic drugs

KW - antiseizure medications

KW - drug–drug interactions

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Using nirmatrelvir/ritonavir in patients with epilepsy: An update from the Israeli chapter of the International League Against Epilepsy

Abstract

Keywords

ASJC Scopus subject areas

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