Abstract
Lamotrigine (LTG) has been associated with serious idiosyncratic reactions, including fulminant hepatic failure in children and adults (1–4). Recently Sen et al. (5) proposed treating hepatotoxicity induced by phenytoin (PHT), a drug that is 90% protein bound, by detoxification with the molecular adsorbents recirculating system (MARS). Because this blood-purification system is based on the principle of albumin dialysis, it is especially useful in cases of toxicity induced by highly protein bound drugs. LTG is eliminated primarily by glucuronide conjugation, and its plasma protein binding is 55% (6). We describe a woman with LTG-induced fulminant liver failure who recovered rapidly after MARS treatment.
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