Carbamazepine Label Gets Warning for Asian Patients

By Kirn, Timothy F. | Clinical Psychiatry News, March 2008 | Go to article overview

Carbamazepine Label Gets Warning for Asian Patients


Kirn, Timothy F., Clinical Psychiatry News


Patients of Asian ancestry are at significantly increased risk for fatal skin reactions when treated with carbamazepine and should first undergo genetic testing to assess their risk before initiating therapy, according to an alert issued by the Food and Drug Administration.

People found to carry the human leukocyte antigen--B*1502 allele should forgo treatment with carbamazepine, unless the expected benefit clearly outweighs the risk, according to the FDA's alert. The fatal skin reactions, which include Stevens-Johnson syndrome and toxic epidermal necrolysis, occur more commonly in patients with the human leukocyte antigen--B*1502 allele. People with ancestry across broad areas of Asia, including South Asian Indians, account for almost all carriers of this allele.

The test for the allele is commercially available.

The prevalence of the HLA-B*1502 allele may be 10%-15% of the populations of China, Taiwan, Thailand, Malaysia, Indonesia, and the Philippines. In South Asia, including India, the prevalence is thought to be 2%-4%, according to a new boxed warning added to carbamazepine labeling.

The prevalence of the allele in patients of Japanese and Korean descent is thought to be less than 1%.

Overall, the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis associated with carbamazepine use is thought to be 1 patient to 6 patients per 10,000 users in countries with a primarily white population. However, the rate may be 10 times higher in Asian countries, according to the FDA.

One case-control study from Taiwan reported that 59 of 60 patients who developed Stevens-Johnson syndrome or toxic epidermal necrolysis associated with carbamazepine had the allele. That compared with a 4% incidence of the allele in patients who tolerated carbamazepine. The findings suggested an absolute risk of 5% in persons positive for the allele (Pharmacogenet. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Carbamazepine Label Gets Warning for Asian Patients
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.