▶Capecitabineincreases the concentration ofantiepileptics
(fosphenytoin, phenytoin).rAnecdotal
▶Carbapenemsdecrease the concentration ofvalproate. Avoid.
rAnecdotal
▶Antiepileptics(carbamazepine, fosphenytoin, phenytoin)are
predicted to decrease the concentration ofcaspofungin. Adjust
caspofungindose,p. 372.oTheoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
toceritinib. Avoid.rStudy
▶Antiepileptics(phenobarbital, primidone)are predicted to affect
the efficacy ofchenodeoxycholic acid. Monitor and adjust dose.
oTheoretical
▶Antiepileptics(phenobarbital, primidone)decrease the
concentration ofchloramphenicol.oStudy
▶Intravenouschloramphenicolincreases the concentration of
antiepileptics(fosphenytoin, phenytoin)andantiepileptics
(fosphenytoin, phenytoin)affect the concentration of
intravenouschloramphenicol. Monitor concentration and
adjust dose.rStudy
▶Chlordiazepoxideaffects the concentration ofantiepileptics
(fosphenytoin, phenytoin).rStudy
▶Phenobarbitaldecreases the effects ofcholic acid. Avoid.
oStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)decrease the concentration of
ciclosporin.rStudy
▶Oxcarbazepinedecreases the concentration ofciclosporin.
rAnecdotal
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to alter the effects of
cilostazol.oTheoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tocinacalcet. Monitor and adjust dose.oStudy
▶Carbamazepineis predicted to increase the risk of
haematological toxicity when given with oralcladribine.
oTheoretical
▶Clobazampotentially affects the concentration ofantiepileptics
(fosphenytoin, phenytoin).rAnecdotal
▶Stiripentolincreases the concentration ofclobazam.r
Study
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)decrease the exposure toclomethiazole.
Monitor and adjust dose.oStudy→Also seeTABLE 11
p. 849
▶Clonazepampotentially affects the concentration of
antiepileptics(fosphenytoin, phenytoin).rAnecdotal
▶Antiepileptics(fosphenytoin, phenobarbital, phenytoin,
primidone)are predicted to decrease the exposure to
clozapine.oAnecdotal→Also seeTABLE 11p. 849
▶Carbamazepineis predicted to increase the risk of
myelosuppression when given withclozapine. Avoid.r
Anecdotal
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tocobicistat. Avoid.rTheoretical
▶Oxcarbazepineis predicted to decrease the concentration of
cobicistat.rTheoretical
▶Cobicistatis predicted to very slightly increase the exposure to
perampanel.nStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tocobimetinib. Avoid.rTheoretical
▶Antiepileptics(carbamazepine, eslicarbazepine, fosphenytoin,
oxcarbazepine, perampanel, phenobarbital, phenytoin,
primidone, rufinamide, topiramate)are predicted to decrease
the efficacy ofcombined hormonal contraceptives. For FSRH
guidance, seeContraceptives, interactionsp. 497.rStudy
▶Combined hormonal contraceptivesalter the exposure to
lamotrigine. Adjust dose.oStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tocorticosteroids(budesonide, deflazacort, dexamethasone,
fludrocortisone, hydrocortisone, methylprednisolone,
prednisolone, prednisone, triamcinolone). Monitor and adjust
dose.oStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
tocorticosteroids(fluticasone).qTheoretical
▶Antiepileptics(fosphenytoin, phenytoin)are predicted to alter
the anticoagulant effect ofcoumarins.oAnecdotal
▶Antiepileptics(phenobarbital, primidone)decrease the
anticoagulant effect ofcoumarins. Monitor INR and adjust
dose.oStudy
▶Carbamazepinedecreases the effects ofcoumarins. Monitor
and adjust dose.rStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to markedly decrease the
exposure tocrizotinib. Avoid.rStudy
▶Carbamazepineis predicted to decrease the exposure to
dabigatran. Avoid.rStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
todabrafenib. Avoid.oTheoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to moderately decrease
the exposure todaclatasvir. Avoid.rStudy
▶Oxcarbazepineis predicted to decrease the exposure to
daclatasvir. Avoid.rTheoretical
▶Danazolmoderately increases the concentration of
carbamazepine. Monitor and adjust dose.rStudy
▶Antiepileptics(fosphenytoin, phenobarbital, phenytoin,
primidone)are predicted to increase the risk of
methaemoglobinaemia when given withdapsone.r
Theoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
todarifenacin.oTheoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to decrease the exposure
todasabuvir. Avoid.rTheoretical
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to markedly decrease the
exposure todasatinib. Avoid.rStudy
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)are predicted to slightly decrease the
exposure todelamanid. Avoid.oStudy
▶Lamotrigineis predicted to increase the risk of hyponatraemia
when given withdesmopressin.rTheoretical
▶Antiepileptics(carbamazepine, eslicarbazepine, fosphenytoin,
oxcarbazepine, perampanel, phenobarbital, phenytoin,
primidone, rufinamide, topiramate)are predicted to decrease
the efficacy ofdesogestrel. For FSRH guidance, see
Contraceptives, interactionsp. 497.rTheoretical
▶Desogestrelis predicted to increase the exposure to
lamotrigine.oStudy
▶Diazepampotentially affects the concentration ofantiepileptics
(fosphenytoin, phenytoin). Monitor concentration and adjust
dose.rStudy
▶Diazoxidedecreases the concentration ofantiepileptics
(fosphenytoin, phenytoin)andantiepileptics(fosphenytoin,
phenytoin)are predicted to decrease the effects ofdiazoxide.
Monitor concentration and adjust dose.oAnecdotal
▶Antiepileptics(fosphenytoin, phenytoin)are predicted to
decrease the concentration ofdigoxin.oAnecdotal
▶Disulfiramincreases the concentration ofantiepileptics
(fosphenytoin, phenytoin). Monitor concentration and adjust
dose.rStudy→Also seeTABLE 12p. 850
▶Antiepileptics(carbamazepine, fosphenytoin, phenobarbital,
phenytoin, primidone)decrease the exposure todolutegravir.
Adjust dose.rStudy
▶Oxcarbazepineis predicted to decrease the exposure to
dolutegravir. Adjust dose.rTheoretical
▶Phenytoinis predicted to decrease the exposure toduloxetine.
oTheoretical
▶Carbamazepineis predicted to decrease the exposure to
edoxaban.oStudyBNFC 2018 – 2019 Antiepileptics—Antiepileptics 865
Interactions|Appendix 1A1