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EPILEPSY

How safe is switching antiepileptic drug manufacturers?

A nationwide German study of prescription data has demonstrated that switching to an antiepileptic drug from a different manufacturer increases the risk of seizure relapse. This finding sparks a debate about the reason for seizure worsening after switching and whether or not it is a pharmacological issue.

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References

  1. Lang, J. D. et al. Switching the manufacturer of anti-epileptic drugs is associated with higher risk of seizures. Ann. Neurol. https://doi.org/10.1002/ana.25353 (2018).

    Article  PubMed  Google Scholar 

  2. Davit, B. M. et al. Comparing generic and innovator drugs: a review of 12 years of bioequivalence data from the United States Food and Drug Administration. Ann. Pharmacother. 43, 1583–1597 (2009).

    Article  CAS  Google Scholar 

  3. Krauss, G. L. et al. Assessing bioequivalence of generic antiepilepsy drugs. Ann. Neurol. 70, 221–228 (2011).

    Article  CAS  Google Scholar 

  4. Labiner, D. M. et al. Generic antiepileptic drugs and associated medical resource utilization in the United States. Neurology 74, 1566–1574 (2010).

    Article  CAS  Google Scholar 

  5. Andermann, F. et al. Compulsory generic switching of antiepileptic drugs: high switchback rates to branded compounds compared with other drug classes. Epilepsia 48, 464–469 (2007).

    Article  CAS  Google Scholar 

  6. Ting, T. J. et al. Generic lamotrigine versus brand-name Lamictal bioequivalence in patients with epilepsy: a field test of the FDA bioequivalence standard. Epilepsia 56, 1415–1424 (2015).

    Article  CAS  Google Scholar 

  7. Privitera, M. D. et al. Generic-to-generic lamotrigine switches in people with epilepsy: the randomised controlled EQUIGEN trial. Lancet Neurol. 15, 365–372 (2016).

    Article  CAS  Google Scholar 

  8. Gollwitzer, S. et al. Nonadherence to antiepileptic drugs in Germany: a retrospective, population-based study. Neurology 87, 466–472 (2016).

    Article  CAS  Google Scholar 

  9. Kesselheim, A. S. et al. Variations in pill appearance of antiepileptic drugs and the risk of nonadherence. JAMA Intern. Med. 173, 202–208 (2013).

    Article  Google Scholar 

  10. Holtkamp, M. & Theodore, W. H. Generic antiepileptic drugs — safe or harmful in patients with epilepsy? Epilepsia 59, 1273–1281 (2018).

    Article  Google Scholar 

Download references

Acknowledgements

The author holds the Friedrich-von-Bodelschwingh Endowed Professorship for Clinical and Experimental Epileptology at the Department of Neurology, Charité–Universitätsmedizin Berlin funded by the v. Bodelschwingh Foundation. The funder had no influence on this work.

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Correspondence to Martin Holtkamp.

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The author has received speaker’s honoraria and/or consultancy fees from Bial, Desitin, Eisai, LivaNova, Novartis and UCB.

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Holtkamp, M. How safe is switching antiepileptic drug manufacturers?. Nat Rev Neurol 15, 8–9 (2019). https://doi.org/10.1038/s41582-018-0108-6

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