Carbamazepine Antineoplastics

Figure 2.11 Reported concentrations of various PPCPs in treated potable water by several research groups. So far reported are the analgesic (1 = naproxen), antihypertensive (2 = clofibric acid, 3 = dehydronifedipine, 4 = gemfibrozil), reproductive (5 = ethinyl estradiol, 6 = nor-ethindrone), antineoplasts (7 = metyhotrexate, 8 = bleomycin), sedatives (9 = carbamazepine, 10 = diazepam), and antimicrobials (11 = penicillin). Concentrations compiled from Boyd et al. (2003) and Collier (2007).

These enzyme-inducing antiepileptics increase the metabolism of vincristine by the cytochrome P450 isoenzyme CYTBA4. However, in vitro studies have shown that phenytoin may potentiate the antineoplastic (antimitotic) effects of the vinca alkaloids. Thus, further study is required to determine the overall effect of phenytoin on the efficacy and toxicity of vincristine and other vinca alkaloids. Carbamazepine would be expected to reduce the efficacy of vincristine. 

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