Publication: Drug Design, Development and Therapy
Abstract
Lamotrigine pharmacokinetics vary substantially during pregnancy, but the underlying drivers were incompletely understood, complicating dosing for pregnant patients with epilepsy. This study analyzed 293 plasma concentrations from 128 Chinese peripregnancy epilepsy patients to build a population pharmacokinetic model using Phoenix NLME, with Monte Carlo simulations used to derive optimal dosing across gestational stages. Lamotrigine clearance increased significantly from five weeks of gestation onward (reaching up to 199% of early pregnancy values) before dropping sharply postpartum, with weight, pregnancy stage, and concomitant valproic acid identified as significant covariates. The model supports more precise, stage-specific lamotrigine dose adjustments for pregnant and postpartum patients with epilepsy, pending further external validation.
Author(s): Huo J, Liu Y, Yang J, Chen M, Yang L, Wang L, Zhang D, Liu T, Gao W, Dai H, Mei S, Zhao Z.
Published: 2025 年 11 月 20 日
Phoenix NLME：Dosing Across Pregnancy Stages
Phoenix NLME modeled how lamotrigine clearance shifts across pregnancy in this study, supporting stage-specific dosing for a vulnerable patient population. Phoenix NLME is the engine behind population PK/PD modeling, combining the flexibility of code with the ease of a guided interface, part of a Phoenix platform that has trained more than 9,000 people.
