Method of administration of gamma hydroxybutyrate with monocarboxylate transporters
One embodiment of the present invention is to improve the safety and efficacy of the administration of GHB or a salt thereof to a patient. It has been discovered that the concomitant administration of an MCT inhibitor, such as diclofenac, valproate, or ibuprofen, will affect GHB administration. For example, it has been discovered that diclofenac lowers the effect of GHB in the body, thereby potentially causing an unsafe condition. Furthermore, it has been discovered that valproate increases the effect of GHB on the body, thereby potentially causing an unsafe condition.
1. A method for the treatment of cataplexy in narcolepsy or excessive daytime sleepiness in narcolepsy in a patient, the method comprising: administering a reduced daily dosage amount of gamma-hydroxybutyrate (GHB) or a salt thereof to a patient who is concomitantly administered divalproex sodium; wherein the patient is suffering from cataplexy in narcolepsy or excessive daytime sleepiness in narcolepsy; wherein the manufacturer's recommended starting daily dosage amount of GHB or salt thereof in the absence of concomitant administration of divalproex sodium is between 4.5 g to 9 g; and wherein the reduced daily dosage amount of GHB or salt thereof compensates for pharmacokinetic (PK) and/or pharmacodynamic (PD) changes caused by the divalproex sodium.
2. The method of claim 1 , wherein the PD interactions are measured by Cognitive Drug Research (CDR) system tasks or Karolinska Sleepiness Scale (K55).
3. The method of claim 2 , wherein the CDR system tasks are selected from the group consisting of Simple Reaction Time (SRT), Digit Vigilance (DV), Choice Reaction time (CRT), tracking distance from target, and Numeric Working Memory (NWM).
4. The method of claim 1 , wherein the PK changes are measured by one or more parameters selected from the group consisting of plasma concentration, C max , C n , C 24 , Tmax, and Area Under the Curve (AUC).
5. The method of claim 4 , wherein the PK changes are measured by C max or AUC.
6. The method of claim 1 , further comprising monitoring the patient's response and adjusting the dose of GHB or salt thereof.
7. The method of claim 1 , wherein the manufacturer's recommended starting daily dosage amount of GHB or salt thereof in the absence of concomitant administration of divalproex sodium is 4.5 g.
8. The method of claim 1 , wherein the manufacturer's recommended starting daily dosage amount of GHB or salt thereof in the absence of concomitant administration of divalproex sodium is 6 g.
9. The method of claim 1 , wherein the manufacturer's recommended starting daily dosage amount of GHB or salt thereof in the absence of concomitant administration of divalproex sodium is 7.5 g.
10. The method of claim 1 , wherein the manufacturer's recommended starting daily dosage amount of GHB or salt thereof in the absence of concomitant administration of divalproex sodium is 9 g.
11. The method of claim 1 , wherein the daily dosage amount of GHB or salt thereof administered to the patient is reduced by about 15% to about 30%, compared to manufacturer's recommended starting daily dosage amount of GHB or salt thereof in the absence of concomitant administration of divalproex sodium.
12. The method of claim 1 , wherein the patient is currently taking divalproex sodium.