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Observational studies have shown with some drugs, such as phenytoin, that
higher doses, particularly at commencement, can increase the risk of
cutaneous eruptions.
Similarly, with lamotrigine, higher doses, particularly when the patient is
cotreated with sodium valproate, which inhibits the glucuronidation of
lamotrigine, lead to a higher frequency of serious cutaneous ADRs, including
SJS.
These clinical observations would suggest that genetic polymorphisms in drug
metabolic pathways can increase the risk of serious idiosyncratic reactions.
PATHOGENESIS OF DRUG HYPERSENSITIVITY
REACTIONS