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A Clinician's Guide To Oral Extended-Release Drug Delivery Systems in Epilepsy

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A Clinician's Guide to Oral Extended-Release Drug

Delivery Systems in Epilepsy


James W. Wheless, MD  and Stephanie J. Phelps, PharmD

Clinical Effectiveness: Oral administration will remain the dominant route of AED delivery to treat
epilepsy, and oral Extended Release systems are a valuable tool for achieving improved adherence and
seizure control, and reduced toxicity.

Patient acceptance: Extended-release formulations can allow for reduction in dose frequency, which
may enhance convenience and thereby improve adherence.

Patient adherence: The main benefit is that use of ER formulations improves adherence, which may
reduce downstream direct and indirect costs associated with care and hospitalization. However, formal
studies on the financial impact of ER formulations are lacking and are needed.

Bioequivalence: There are clear benefits for the use of ER formulations compared with IR formulations,
and that ER formulations should be used for most patients with epilepsy, when appropriate for the
patient, and when available for their prescribed medication.

Cost: In general, compared with IR formulations, the manufacturing process and development of ER
formulations are more technologically complex and time-consuming, consequently translating into
higher production costs.

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