Goodman &Gilman's: The Pharmacological Basis of Therapeutics, 13e >Pharmacotherapy of the

Epilepsies
Laurence L. Brunton, Randa Hilal-Dandan, Björn C. Knollmann+
Table 17–3Interactions of Anti-Seizure Drugs with Hepatic Microsomal Enzymes

DRUG INDUCES INHIBITS METABOLIZED BY

CYP UGT CYP UGT CYP UGT

Brivaracatam No No No No 2C19/2C9 No

Carbamazepine 1A2/2C9/ 3A4 Yes No No 1A2/2C8/3A4 No

Clobazam No No No No 3A4 No

Clonazepam No No No No 3A4 No

Eslicarbazepine 3A4 No No No No Yes

Ethosuximide No No No No 3A4 No

Ezogabine No No No No No Yes

Felbamate 3A4 No 2C19 No 3A4/2E1 ?

Gabapentin No No No No No No

Lacosamide No No No No 2C19 ?

Lamotrigine No No No No No UGT1A4

Levetiracetam No No No No No No

Oxcarbazepine 3A4/5 UGT1A4 2C19 Weak No Yes

Perampanel No No Weak Weak 3A4/3A5 Yes

Phenobarbital 2C9/3A4/ 1A2 Yes No No 2C9/19/2E1 Yes

Phenytoin 2C9/3A4/ 1A2 Yes 2C9 No 2C9/19 No

Pregabalin No No No No No No

Primidone 2C/3A Yes Yes No 2C9/19 No

Rufinamide 3A4 (weak) No 2E1 (weak) No No No

Stiripentol No No 1A2/3A4/2C19/2D6 No No No

Tiagabine No No No No 3A4 No

Topiramate 3A4 (>200 mg/day) No 2C19 No Yes No

Valproate No No 2C9/3A4? Yes 2C9/2C19/2A6/2B6 UGT1A3/2B7

Vigabatrin No No No No No No
 Zonisamide No No No No 3A4 No

CYP, cytochrome P450; UGT, uridine diphosphate-glucuronosyltransferase. (Data modified from Johannessen and Johannessen, 2010 and Wheles and Vasquez, 2010, Epilepsy Currents, 10:1–6 and Cawello,
2015, Clin Pharmacokinetic, 54: 904–914.)

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