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Riluzole serum concentrations in patients with ALS

Associations with side effects and symptoms

From the Department of Neurology (Drs. Groeneveld, Kalmijn, Veldink, Wokke, and van den Berg) and Julius Center for Health Sciences and Primary Care (Dr. Kalmijn), University Medical Center Utrecht, and Department of Clinical Pharmacy (Drs. van Kan and Guchelaar), Academic Medical Center, University of Amsterdam, the Netherlands.

Address correspondence and reprint requests to Dr. L.H. van den Berg, Department of Neurology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; e-mail: l.h.vandenberg{at}neuro.azu.nl

Riluzole exerts a dose-dependent effect on survival of patients with ALS and, although serum levels show a high interindividual variability, is usually prescribed in a fixed dose. In this study, riluzole serum levels and area under the curve per kilogram of body weight (AUC/kg) of 169 patients with ALS showed a high interindividual variability. Patients with high serum levels and AUC/kg more often had diarrhea but less often had fasciculations and muscle stiffness. It may therefore be advantageous to raise the riluzole dose in patients with low riluzole serum concentrations without the risk of serious side effects.

Received February 12, 2003. Accepted in final form June 16, 2003.

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