Clinically relevant anti-epileptic drug interactions

F. Pisani, E. Perucca, R. Di Perri

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Anti-epileptic drugs frequently interact due to pharmacokinetic features (induction or inhibition of metabolism, production of active metabolites, low therapeutic indices) and the need for prolonged treatment with possible addition of other drugs to treat concomitant diseases. The most important pharmacokinetic interactions are those that inhibit phenytoin, carbamazepine and phenobarbitone metabolism and thus increase their toxicity. Drugs inhibiting metabolism include antibiotic macrolides, chloramphenicol, isoniazide, some sulphonamides, propoxyphene, cimetidine, valproic acid and sulthiame. Anti-epileptic drugs can induce hepatic microsomal enzymes and, therefore, may increase metabolism of corticosteroids, oral contraceptives, oral anticoagulants, cardiovascular agents, antibiotics, chemotherapeutic agents, psychotropic drugs and non-opiate analgesics, thereby reducing their efficacy. Advantageous pharmacodynamic interactions include synergism of ethosuximide plus valproic acid and of carbamazepine plus valproic acid. A pharmacodynamic mechanism may be responsible for the reduced sensitivity of chronically treated epileptics to some neuromuscular blockers.

Original languageEnglish
Pages (from-to)1-15
Number of pages15
JournalJournal of International Medical Research
Volume18
Issue number1
Publication statusPublished - 1990

Fingerprint

Drug interactions
Drug Interactions
Metabolism
Valproic Acid
Pharmacodynamics
Pharmacokinetics
Carbamazepine
Pharmaceutical Preparations
Ethosuximide
Dextropropoxyphene
Anti-Bacterial Agents
Neuromuscular Blocking Agents
Enzyme inhibition
Cardiovascular Agents
Psychotropic Drugs
Cimetidine
Sulfonamides
Macrolides
Phenytoin
Chloramphenicol

Keywords

  • anti-epileptic drugs
  • Drug interactions

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Clinically relevant anti-epileptic drug interactions. / Pisani, F.; Perucca, E.; Di Perri, R.

In: Journal of International Medical Research, Vol. 18, No. 1, 1990, p. 1-15.

Research output: Contribution to journalArticle

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