Clinically important drug interactions in epilepsy: Interactions between antiepileptic drugs and other drugs

Philip N. Patsalos, Emilio Perucca

Research output: Contribution to journalArticlepeer-review

Abstract

Antiepileptic drugs (AEDs) are commonly prescribed for long periods, up to a lifetime, and many patients will require treatment with other agents for the management of concomitant or intercurrent conditions. When two or more drugs are prescribed together, clinically important interactions can occur. Among old-generation AEDs, carbamazepine, phenytoin, phenobarbital, and primidone are potent inducers of hepatic enzymes, and decrease the plasma concentration of many psychotropic, immunosuppressant, antineoplastic, antimicrobial, and cardiovascular drugs, as well as oral contraceptive steroids. Most new generation AEDs do not have clinically important enzyme inducing effects. Other drugs can affect the pharmacokinetics of AEDs; examples include the stimulation of lamotrigine metabolism by oral contraceptive steroids and the inhibition of carbamazepine metabolism by certain macrolide antibiotics, antifungals, verapamil, diltiazem, and isoniazid. Careful monitoring of clinical response is recommended whenever a drug is added or removed from a patient's AED regimen.

Original languageEnglish
Pages (from-to)473-481
Number of pages9
JournalThe Lancet Neurology
Volume2
Issue number8
DOIs
Publication statusPublished - Aug 1 2003

ASJC Scopus subject areas

  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Clinically important drug interactions in epilepsy: Interactions between antiepileptic drugs and other drugs'. Together they form a unique fingerprint.

Cite this