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Table 6 Interaction of selected therapeutic classes with antiepileptic drugs [115, 117, 127132]

From: Antiepileptic drugs in critically ill patients

Therapeutic class Selected examples Antiepileptic drugs
Psychotropic agents Fluoxetine, sertraline, trazodone ↑ Phenytoin
Trazodone, fluoxetine, risperidone ↑ Carbamazepine
Sertraline ↑ Valproic acid
Antimicrobials Erythromycin, clarithromycin, ketoconazole, fluconazole ↑ Carbamazepine
Ritonavir
Sulfonamides ↑ Phenytoin
Carbapenems (imipenem, doripenem, meropenem, ertapenem) ↓ Valproic acid
Cardiovascular agents Amiodarone ↑ Phenytoin (a dose reduction of approximately 25% is recommended)
Diltiazem ↑ Carbamazepine, phenytoin (risk of toxicity)
Clopidogrel ↑ Phenytoin
Analgesics Acetaminophen ↓ Lamotrigine
Immunosuppressants Methotrexate ↓ Valproic acid, carbamazepine
  1. ↑ and ↓ indicate increased and decreased levels and/or effects, respectively