▶Antiepileptics(topiramate)increase the risk of carbamazepine
toxicity when given withantiepileptics(carbamazepine).
oStudy
▶Antiepileptics(stiripentol)increase the concentration of
antiepileptics(carbamazepine, phenobarbital). Avoid in Dravet
syndrome.rStudy
▶Antiepileptics(carbamazepine)slightly decrease the exposure
toantiepileptics(eslicarbazepine, oxcarbazepine). Monitor and
adjust dose.oStudy
▶Antiepileptics(oxcarbazepine)are predicted to increase the
concentration ofantiepileptics(fosphenytoin). Monitor
concentration and adjust dose.oStudy
▶Antiepileptics(stiripentol)are predicted to increase the
concentration ofantiepileptics(fosphenytoin).rStudy
▶Antiepileptics(carbamazepine)affect the concentration of
antiepileptics(fosphenytoin, phenytoin)andantiepileptics
(fosphenytoin, phenytoin)decrease the concentration of
antiepileptics(carbamazepine). Monitor and adjust dose.r
Study
▶Antiepileptics(eslicarbazepine)increase the exposure to
antiepileptics(fosphenytoin, phenytoin)andantiepileptics
(fosphenytoin, phenytoin)decrease the exposure to
antiepileptics(eslicarbazepine). Monitor and adjust dose.
oStudy
▶Antiepileptics(valproate)affect the concentration of
antiepileptics(fosphenytoin, phenytoin)andantiepileptics
(fosphenytoin, phenytoin)decrease the concentration of
antiepileptics(valproate).rStudy
▶Antiepileptics(vigabatrin)decrease the concentration of
antiepileptics(fosphenytoin, phenytoin).nStudy
▶Antiepileptics(fosphenytoin)decrease the concentration of
antiepileptics(lamotrigine). Monitor and adjustlamotrigine
dose,p. 202.oStudy
▶Antiepileptics(phenobarbital, phenytoin, primidone)decrease
the concentration ofantiepileptics(lamotrigine). Monitor and
adjustlamotriginedose,p. 202.oStudy→Also see
TABLE 11p. 849
▶Antiepileptics(valproate)increase the exposure toantiepileptics
(lamotrigine). Adjustlamotriginedose and monitor rash,p. 202.
rStudy
▶Antiepileptics(lamotrigine)are predicted to increase the
concentration ofantiepileptics(oxcarbazepine)and
antiepileptics(oxcarbazepine)are predicted to decrease the
concentration ofantiepileptics(lamotrigine). Monitor side
effects and adjust dose.oStudy
▶Antiepileptics(carbamazepine, fosphenytoin)are predicted to
decrease the exposure toantiepileptics(perampanel). Monitor
and adjust dose.oStudy
▶Antiepileptics(oxcarbazepine)decrease the concentration of
antiepileptics(perampanel)andantiepileptics(perampanel)
increase the concentration ofantiepileptics(oxcarbazepine).
Monitor and adjust dose.oStudy
▶Antiepileptics(phenobarbital, phenytoin, primidone)are
predicted to decrease the exposure toantiepileptics
(perampanel). Monitor and adjust dose.oStudy→Also
seeTABLE 11p. 849
▶Antiepileptics(phenytoin)increase the concentration of
antiepileptics(phenobarbital)andantiepileptics(phenobarbital)
affect the concentration ofantiepileptics(phenytoin).o
Study
▶Antiepileptics(fosphenytoin)increase the concentration of
antiepileptics(phenobarbital, primidone)andantiepileptics
(phenobarbital, primidone)affect the concentration of
antiepileptics(fosphenytoin).oStudy
▶Antiepileptics(oxcarbazepine)are predicted to increase the
concentration ofantiepileptics(phenytoin). Monitor
concentration and adjust dose.oStudy
▶Antiepileptics(stiripentol)are predicted to increase the
concentration ofantiepileptics(phenytoin). Avoid in Dravet
syndrome.rStudy
▶Antiepileptics(carbamazepine)potentially decrease the
concentration ofantiepileptics(primidone)andantiepileptics
(primidone)potentially decrease the concentration of
antiepileptics(carbamazepine). Adjust dose.oAnecdotal
▶Antiepileptics(phenytoin)increase the concentration of
antiepileptics(primidone)andantiepileptics(primidone)affect
the concentration ofantiepileptics(phenytoin).oStudy
▶Antiepileptics(stiripentol)are predicted to increase the
concentration ofantiepileptics(primidone).rTheoretical
▶Antiepileptics(valproate)affect the concentration of
antiepileptics(primidone). Monitor and adjust dose.r
Study
▶Antiepileptics(carbamazepine)slightly increase the clearance
ofantiepileptics(retigabine).oStudy
▶Antiepileptics(fosphenytoin, phenytoin)are predicted to slightly
increase the clearance ofantiepileptics(retigabine).o
Study
▶Antiepileptics(valproate)increase the exposure toantiepileptics
(rufinamide). Adjustrufinamidedose,p. 207.oStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)decrease the exposure toantiepileptics
(tiagabine). Monitor and adjusttiagabinedose,p. 211.o
Study
▶Antiepileptics(fosphenytoin, phenytoin)decrease the
concentration ofantiepileptics(topiramate)andantiepileptics
(topiramate)increase the concentration ofantiepileptics
(fosphenytoin, phenytoin). Monitor and adjust dose.o
Study
▶Antiepileptics(phenobarbital, primidone)are predicted to
decrease the concentration ofantiepileptics(topiramate).n
Study
▶Antiepileptics(phenobarbital)decrease the concentration of
antiepileptics(valproate)andantiepileptics(valproate)increase
the concentration ofantiepileptics(phenobarbital). Monitor
and adjust dose.oStudy
▶Antiepileptics(topiramate)increase the risk of toxicity when
given withantiepileptics(valproate).rStudy
▶Antiepileptics(carbamazepine)slightly to moderately decrease
the concentration ofantiepileptics(zonisamide)and
antiepileptics(zonisamide)affect the concentration of
antiepileptics(carbamazepine). Monitor and adjust dose.
oStudy
▶Antiepileptics(fosphenytoin, phenytoin)slightly to moderately
decrease the concentration ofantiepileptics(zonisamide).
Monitor and adjust dose.oStudy
▶Antiepileptics(phenobarbital, primidone)are predicted to
decrease the concentration ofantiepileptics(zonisamide).
Monitor and adjust dose.oStudy
▶Antiepileptics(topiramate)potentially increase the risk of
overheating and dehydration when given withantiepileptics
(zonisamide). Avoid in children.rTheoretical
▶Antifungals, azoles(itraconazole, ketoconazole, voriconazole)are
predicted to very slightly increase the exposure to
perampanel.nStudy
▶Antifungals, azoles(miconazole)increase the risk of
carbamazepine toxicity when given withcarbamazepine.
Monitor and adjust dose.rAnecdotal
▶Antifungals, azoles(miconazole)increase the risk of phenytoin
toxicity when given withfosphenytoin. Monitor and adjust
dose.rAnecdotal
▶Antifungals, azoles(miconazole)increase the risk of phenytoin
toxicity when given withphenytoin. Monitor and adjust dose.
rAnecdotal
▶Carbamazepineis predicted to decrease the efficacy of
antifungals, azoles(fluconazole)andantifungals, azoles
(fluconazole)increase the concentration ofcarbamazepine.
Avoid or monitorcarbamazepineconcentration and adjust
dose accordingly,p. 196.rTheoretical→Also seeTABLE 1
p. 847
▶Antifungals, azoles(fluconazole)increase the concentration of
antiepileptics(fosphenytoin, phenytoin). Monitor concentration
and adjust dose.oStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
toantifungals, azoles(isavuconazole). Avoid.rStudy
▶Fosphenytoinvery markedly decreases the exposure to
antifungals, azoles(itraconazole). Avoid and for 14 days after
stoppingfosphenytoin,p. 199.oStudy
BNFC 2018 – 2019 Antiepileptics—Antiepileptics 863
Interactions
|Appendix 1
A1