Topiramate concentration in saliva: an alternative to serum monitoring

Miles, Michael V; Tang, Peter H; Glauser, Tracy A; Ryan, Melody A; Grim, Shellee A; Strawsburg, Richard H; deGrauw, Ton J; Baumann, Robert J

doi:10.1016/S0887-8994(03)00048-1

Next »Pediatric Neurology
Volume 29, Issue 2 , Pages 143-147, August 2003

Topiramate concentration in saliva: an alternative to serum monitoring

Michael V Miles, PharmD
- Pathology and Laboratory Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Pediatrics and Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; Pharmacy Practice and Science and Neurology, Cincinnati, Ohio, USA
- Communications should be addressed to: Dr. Miles; Division of Pathology and Laboratory Medicine, Cincinnati, Children’s; Hospital Medical Center; 3333 Burnet Ave; Cincinnati, OH 45229, USA.
Peter H Tang, PhD
- Pathology and Laboratory Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
Tracy A Glauser, MD
- Pediatrics and Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; Pharmacy Practice and Science and Neurology, Cincinnati, Ohio, USA
Melody A Ryan, Pharm D, BCPS, CGP
- Pharmacy Practice and Science and Neurology, University of Kentucky Chandler Medical Center, Lexington, KY, USA
Shellee A Grim, PharmD
- Pharmacy Practice and Science and Neurology, University of Kentucky Chandler Medical Center, Lexington, KY, USA
Richard H Strawsburg, MD
- Pediatrics and Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; Pharmacy Practice and Science and Neurology, Cincinnati, Ohio, USA
Ton J deGrauw, MD, PhD
- Pediatrics and Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; Pharmacy Practice and Science and Neurology, Cincinnati, Ohio, USA
Robert J Baumann, MD
- Pediatrics and Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; Pharmacy Practice and Science and Neurology, Cincinnati, Ohio, USA

Received 21 November 2002; accepted 21 January 2003.

Abstract

This study examines the relationship between serum and saliva topiramate concentrations, and attempts to determine if saliva may be a useful alternative to serum for therapeutic monitoring. Saliva and blood specimens were collected from 31 epilepsy patients (mean age 10.5 ± 6.0 years; range 2.5 years to 24.8 years), and topiramate concentrations were determined by fluorescence polarization immunoassay. One patient’s results were omitted because the saliva concentration was below the limit of quantitation of the assay. A strong correlation exists between serum and saliva topiramate concentrations (adjusted r² = 0.97, n = 30, P < 0.0001). The mean fraction of saliva to serum concentration is 89.8% ± 12.1% (range 62.9% to 112.7%). The results of this study support the use of saliva as a viable alternative to serum for monitoring topiramate therapy. Topiramate concentration in saliva: an alternative to serum monitoring.

Keywords: Topiramate, Anticonvulsant monitoring, Saliva, Antiepileptic Drug, concentration