Table 2.
Affected Drug Classes | |||||
---|---|---|---|---|---|
AEDs Susceptible to Interactions | AEDs | Antidepressants and Antipsychotics | Oral Contraceptives | Antimicrobal Drugs | Various (e.g. Warfarin, Antineoplastic Drugs, Immuno-Suppressants) |
Enzyme inducers that will decrease serum concentrations of affected drugs | |||||
Carbamazepine, phenobarbital, phenytoin, primidone | Benzodiazepines, ethosuximide, lamotrigine, oxcarbazepine, pregabalin, rufinamide, stiripentol, tiagabine, topiramate, zonisamide, valproic acid, |
Typical: Chlorpromazine, haloperidol Atypical: Aripiprazol, clozapine, olanzapine, quetiapine, risperidone, ziprasidone Antidepressants: Clomipramine Imipramine |
Estrogen component of combination pills | Doxycycline, indinavir, itraconazole, metronidazol, praziquantel | Warfarin
Antineoplastic agents
(e.g. cyclophosphamide,
irinotecan, methotrexate,
tamoxifen)
Immuno-suppressants:
Ciclosporin, tacrolimus Varia: Cortisol derivatives, dextropropoxyphene, dihydropyridine calcium antagonists, fentanyl, statines, methadone, theophylline, thyroxine |
Eslicarbazepine and oxcarbazepine | Lamotrigine, phenobarbital, phenytoin, (mainly induction) | Estrogen component of combination pills | |||
Felbamate | Carbamazepine Clobazam | ||||
Topiramate | Phenytoin (in some cases) | Estrogen component of combination pills (topiramate doses >200 mg/day) | Carboanhydrase inhibitors, digoxin, hydrochlortiazide, metformin, pioglitazone, | ||
Enzyme inhibitors that will increase serum concentrations of affected drugs | |||||
Valproic acid | Carbamazepine, ethosuximide, lamotrigine, phenobarbital, rufinamide | Amitriptyline, nortriptyline | Carbapenem antibiotics: Imipenem, meropenem, panipenem | Cisplatin,etoposide | |
Felbamate | Clonazepam phenobarbital, phenytoin, valproic acid | Estrogen component of combination pills | Warfarin | ||
Rufinamide | Carbamazepine, clobazam, phenytoin, phenobarbital, valproic acid | Estrogen component of combination pills | Triazolam | ||
Stiripentol | Carbamazepine, clobazam, phenytoin, phenobarbital, valproic acid | Various potential interactions* |
AEDs=Antiepileptic drugs. The list is not all-including but relevant examples are given. Several references are used, see text for details and selected reviews, [7-13] and the spc of the various drugs. Oral contraceptives and warfarin are described in more detail in Table 4. * In vitro studies suggest a potential for interactions with most drug classes metabolized by CYP3A4, 1A2, 2C19.
In vitro studies suggest a potential for interactions with most drug classes metabolized by CYP3A4, 1A2, 2C19.