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. Author manuscript; available in PMC: 2014 Jan 6.
Published in final edited form as: Epilepsia. 2008 Dec;49(0 9):10.1111/j.1528-1167.2008.01926.x. doi: 10.1111/j.1528-1167.2008.01926.x

Table 3.

Physiologic changes during pregnancy: Effects on drug dispositiona

Parameter Consequences
↑Total body water, extracellular fluid Altered drug distribution
↑Fat stores ↓Elimination of lipid soluble drugs
↑Cardiac output ↑Hepatic blood flow leading to ↑elimination
↑Renal blood flow and glomerular flow rate ↑Renal clearance of unchanged drug
Altered CYP3A4 activity and UGT activity Altered systemic absorption & hepatic elimination
↓Maternal albumin Altered free fraction; increased availability of drug for hepatic extraction
a

From Pennell, 2003.