• Santi Purna Sari Clinical Pharmacy Laboratory, Faculty of Pharmacy, Universitas Indonesia, Depok 16424, Indonesia.
  • Natasha Kurnia Salma S Clinical Pharmacy Laboratory, Faculty of Pharmacy, Universitas Indonesia, Depok 16424, Indonesia.
  • Alfina Rianti Pharmacy Division, Fatmawati Hospital, Jakarta 12430, Indonesia.


Objective: This study aimed to monitor the side effects of carbamazepine, phenytoin, and valproic acid, and combinations of these drugs in adult
patients with epilepsy, to raise awareness of the importance of drug side effect monitoring in hospitals.
Methods: In this prospective study, descriptive data were collected from patients who met the inclusion criteria of complete samples. Primary data
were obtained using questionnaires, secondary data were collected from medical records, and analyses were performed using the Naranjo algorithm.
Results: Among the 54 included patients, 38 (70.37%) of them experienced drug side effects, and the most frequently observed side effect occurred
in 48.15% of study subjects.
Conclusion: No correlation was identified between side effects and age (p=0.903) or gender (p=1.000).

Keywords: Carbamazepine, Naranjo algorithm, Phenytoin, Side effects, Valproic acid.


1. World Health Organization. 2016. Epilepsy. Available from: http:// [Last accessed on
2017 Feb 09].
2. Directorate of Community Pharmacy and Clinic. Pharmaceutical
Services for People with Epilepsy Disorder. Jakarta: Indonesian
Ministry of Health; 2009.
3. Medicines and Healthcare Products Regulatory Agency. Formulation
Switching of Antiepileptic Drugs: A Report on the Recommendations
of the Commission on Human Medicines. Available from: http://www.
con341226.pdf. [Last accessed on Jul 2013].
4. Shaw SJ, Hartman AL. The controversy over generic antiepileptic
drugs. J Pediatr Pharmacol Ther 2010;15:81-93.
5. Blix HS, Viktil KK, Moger TA, Reikvam A. Drugs with narrow
therapeutic index as indicators in the risk management of hospitalised
patients. Pharm Pract 2010;8:50-5.
6. Ruths S, Viktil KK, Blix HS. Classification of drug-related problems
2003-2010. Pharm Care Netw Eur Found 2007;127:3073-6.
7. Dasari JR, Vurumadla S, Prasad OP. A case report on phenytoin induced
ataxia. Asian J Pharm Clin Res 2016;9:5-6.
8. Ramesh A, Srikanth MS, Sarayu P, Reddy S, Keshava BS. Drug
interaction induced phenytoin toxicity: A case report. Asian J Pharm
Clin Res 2014;7:221-2.
9. Mathur S, Ramesh SS, Satish KM. Utilization pattern of antiepileptic
drugs and their adverse effects, in a teaching hospital. Asian J Pharm
Clin Res 2010;3:55-9.
10. National Agency of Drug and Food Control, Republic of Indonesia.
Guidelines for Monitoring of Drug Side Effects (MESO) for Health
Personnel; 2012. p. 1-35. Available from:
11. MHRA. Guidance on Adverse Drug Reactions. 2015. Available from:
12. Wells BG, DiPiro JT, Schwinghammer TL, DiPiro CV. Pharmacotherapy
Handbook. New York: McGraw-Hill; 2015.
13. Sheorajpanday RV, De Deyn PP. Epileptic fits and epilepsy in the elderly:
General reflections, specific issues and therapeutic implications. Clin
Neurol Neurosurg 2007;109:727-43.
14. Notoatmodjo S. Health Research Methodology. Jakarta: Rineka Cipta; 2010.
15. Mifsud J. Gender differences in epilepsy: Perceived or real? J Malta
Coll Pharm Pract 2014;28-30.
16. Christensen J, Kjeldsen MJ, Andersen H, Friis ML, Sidenius P. Gender
differences in epilepsy. Epilepsia 2005;46:956-60.
17. Brown SW. Epidemiology of epilepsy in persons with intellectual
disabilities. In: Epilepsy and Intellectual Disabilities Cham.
United Kingdom: Springer; 2016. p. 35-50.
18. Ikra V, Neilan RA, Lisiswanti R, Vaisal I. Epilepsi post stroke. J Medula
19. St Louis EK. Minimizing AED adverse effects: Improving quality
of life in the interictal state in epilepsy care. Curr Neuropharmacol
20. Shvarts V, Chung S. Epilepsy, antiseizure therapy, and sleep cycle
parameters. Epilepsy Res Treat 2013;2013:670682.
21. EhealthMe. Phenytoin and Fatigue-from FDA Reports; 2017. Available
22. Nanau RM, Neuman MG. Adverse drug reactions induced by valproic
acid. Clin Biochem 2013;46:1323-38.
23. Anderson PO, Knoben JE, Troutman WG. Handbook of Clinical Drug
Data. 10th ed. USA: McGRAW-HILL Medical Publishing Division; 2002.
24. Priyo S. Data Analysis in Medicine Industry. 1st ed. Jakarta: PT. Raja
Grafindo Persada; 2016.
25. Silverthorn DU. Human Physiology. 5th ed. San Francisco: Pearson
Benjamin Cummings; 2010.
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How to Cite
Sari, S. P., Salma S, N. K., & Rianti, A. (2018). MONITORING OF ANTICONVULSANT DRUG SIDE EFFECTS IN OUTPATIENTS WITH EPILEPSY. International Journal of Applied Pharmaceutics, 10(1), 303-306.
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