{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:10:22Z","timestamp":1787497822058,"version":"build-2736575974"},"reference-count":70,"publisher":"The Pediatric Pharmacy Association","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,24]]},"abstract":"<jats:p>\n                    Lacosamide (LCM) and perampanel (PER) are antiepileptic drugs eliminated, in part, by cytochrome P450 (CYP) 3A4. However, clinical reports of their interactions are limited. Here, we report the case of a 12-year-old girl with a history of infantile epileptic spasms syndrome, treated with LCM, PER, valproic acid (VPA), and levetiracetam (LEV), who was diagnosed with\n                    <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                    pneumonia and prescribed clarithromycin (CAM). Owing to impaired consciousness, serum drug concentrations were measured on multiple occasions during hospitalization. Markedly elevated serum concentrations of LCM (2.3 \u00d7 baseline) and PER (4.4 \u00d7 baseline) were observed after initiation of CAM. These concentrations were normalized after CAM was discontinued. Serum concentrations of LEV and VPA remained unchanged. According to the Drug Interaction Probability Scale, interaction was considered probable, with a total score of 5. Clarithromycin likely induced a pharmacokinetic interaction via CYP3A4 inhibition, leading to increased serum concentrations of LCM and PER. Although the concomitant use of CAM with these agents is not contraindicated, the findings of this case suggest caution is warranted. When macrolide therapy is necessary, alternative agents with weaker CYP3A4 inhibition, such as azithromycin, may be preferable.\n                  <\/jats:p>","DOI":"10.5863\/jppt-25-00087","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:30:38Z","timestamp":1774571438000},"source":"Crossref","is-referenced-by-count":1,"title":["Elevated Serum Concentrations of Lacosamide and Perampanel in a Pediatric Patient Following Coadministration of Clarithromycin for Mycoplasma pneumoniae Pneumonia"],"prefix":"10.5863","author":[{"given":"Shotaro","family":"Meguro","sequence":"first","affiliation":[{"name":"Department of Pharmacy (SM, TI, SO), Nihon University Itabashi Hospital, Itabashi-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (SM, TI, SO), Nihon University Itabashi Hospital, Itabashi-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wakako","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (WI, EM, TK, KM, SW), Division of Pediatrics, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiko","family":"Momoki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (WI, EM, TK, KM, SW), Division of Pediatrics, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadayasu","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (WI, EM, TK, KM, SW), Division of Pediatrics, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kengo","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (WI, EM, TK, KM, SW), Division of Pediatrics, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (WI, EM, TK, KM, SW), Division of Pediatrics, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susumu","family":"Ootsuka","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (SM, TI, SO), Nihon University Itabashi Hospital, Itabashi-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3883","reference":[{"issue":"1","key":"JPPT-25-00087-b01","series-title":"Expert Rev Neurother","first-page":"33","article-title":"Lacosamide: pharmacology, mechanisms of action and pooled efficacy and safety data in partial-onset seizures","volume":"9","author":"Beydoun","year":"2009","unstructured":"Beydoun A, D\u2019Souza J, Hebert D, Doty P. Lacosamide: pharmacology, mechanisms of action and pooled efficacy and safety data in partial-onset seizures. Expert Rev Neurother. 2009;9(1):33\u201342."},{"key":"JPPT-25-00087-b02","series-title":"Seizure","first-page":"54","article-title":"Efficacy and safety of perampanel in epilepsy: a systematic review and meta-analysis of randomised controlled trials","volume":"102","author":"Lavu","year":"2022","unstructured":"Lavu A, Aboulatta L, Abou-Setta AM, et al. Efficacy and safety of perampanel in epilepsy: a systematic review and meta-analysis of randomised controlled trials. Seizure. 2022;102:54\u201360."},{"key":"JPPT-25-00087-b03","series-title":"Front Pharmacol","first-page":"694381","article-title":"Safety and tolerability of lacosamide in patients with epilepsy: a systematic review and meta-analysis","volume":"12","author":"Yang","year":"2021","unstructured":"Yang C, Peng Y, Zhang L, Zhao L. Safety and tolerability of lacosamide in patients with epilepsy: a systematic review and meta-analysis. Front Pharmacol. 2021;12:694381."},{"key":"JPPT-25-00087-b04","series-title":"Front Pharmacol","first-page":"1139514","article-title":"Efficacy and tolerability of perampanel in patients with seizures in real-world clinical practice: a systematic review and meta-analysis","volume":"14","author":"Hou","year":"2023","unstructured":"Hou L, Yang J, Zhang X, et al. Efficacy and tolerability of perampanel in patients with seizures in real-world clinical practice: a systematic review and meta-analysis. Front Pharmacol. 2023;14:1139514."},{"key":"JPPT-25-00087-b05","series-title":"Front Neurol","first-page":"1307296","article-title":"The efficacy and safety of third-generation antiseizure medications and non-invasive brain stimulation to treat refractory epilepsy: a systematic review and network meta-analysis study","volume":"14","author":"Yang","year":"2024","unstructured":"Yang Y, Shangguan Y, Wang X, et al. The efficacy and safety of third-generation antiseizure medications and non-invasive brain stimulation to treat refractory epilepsy: a systematic review and network meta-analysis study. Front Neurol. 2024;14:1307296."},{"issue":"3","key":"JPPT-25-00087-b06","series-title":"Curr Neuropharmacol","first-page":"254","article-title":"Antiepileptic drug interactions - principles and clinical implications","volume":"8","author":"Johannessen","year":"2010","unstructured":"Johannessen SI, Landmark CJ. Antiepileptic drug interactions - principles and clinical implications. 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