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. 2020;25(6):485–499. doi: 10.5863/1551-6776-25.6.485

Table 2.

Metabolism Pathways of Antiepileptic Medications1,71

AED CYP3A4 CYP 2C19 CYP 2C8/9 CYP 2B6 CYP 1A2 UGT
Brivaracetam Substrate
Carbamazepine Substrate* Inducer§ Substrate# Inducer Substrate#
Inducer§ Inducer Inducer
Clobazam Substrate* Substrate*,#,, Substrate*,#
Clonazepam Substrate
Diazepam Substrate* Substrate* Substrate
Eslicarbazepine Inducer Inhibitor
Ethosuximide Substrate
Everolimus Substrate
Felbamate Substrate Inhibitor
Inducer
Lacosamide Substrate Substrate Substrate
Lamotrigine Substrate
Inducer
Levetiracetam
Midazolam Substrate*
Oxcarbazepine Substrate Inhibitor Substrate
Inducer§
Perampanel Substrate Inhibitor Substrate Substrate Inhibitor
Inhibitor Inducer Inducer
Inducer
Phenobarbital Inducer§ Substrate Substrate Inducer
Inducer Inducer
Phenytoin Substrate# Substrate Substrate Inducer
Inducer§ Inducer§ Inhibitor
Inducer
Primidone Substrate Substrate Substrate Inducer
(active to PB) Inducer§ Inhibitor
Inducer Inducer
Rufinamide Inducer§
Stiripentol Substrate Substrate Inhibitor Inhibitor Inducer Substrate
Inhibitor Inhibitor Inhibitor
Inducer Inducer
Topiramate Inducer Inhibitor
Valproate Substrate Substrate Inhibitor Inhibitor
Inhibitor Inhibitor
Vigabatrin Inducer Inducer
Zonisamide Substrate Substrate#

AED, antiepileptic drug

* Pharmacologically active metabolite

Pharmacologically inactive metabolite

Weak effect of enzyme

§ Strong effect of enzyme

Major metabolic pathway

# Minor metabolic pathway