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Expected changes in plasma concentrations when an AED is added to a pre-existing regimen

Expected changes in plasma concentrations when an AED is added to a pre-existing regimen Hot

 
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Expected changes in plasma concentrations when an AED is added to a pre-existing regimen

AED addedPBPHTPRMETSCBZVPAOXCLTGGBPTPMTGBLEVZNSVGBFBM
PB-PHT ↑↓NCCPETS ↓↓CBZ ↓↓VPA ↓↓H-OXC ↓LTG ↓↓TPM ↓↓TGB ↓↓ZNS ↓↓FBM ↓↓
PHTPB ↑-PRM ↓ PB ↑ETS ↓↓CBZ ↓↓VPA ↓↓H-OXC ↓LTG ↓↓TPM ↓↓TGB ↓↓ZNS ↓↓FBM ↓↓
PRMNCCPPHT ↑↓-ETS ↓↓CBZ ↓↓VPA ↓↓?LTG ↓↓TPM ↓↓TGB ↓↓ZNS ↓↓FBM ↓↓
ETSNE-VPA ↓NENENENENENENENENE
CBZPHT I↓PRM ↓ PB ↑ETS ↓↓-VPA ↓↓H-OXC ↓LTG ↓↓TPM ↓↓TGB ↓↓ZNS ↓↓NEFBM ↓↓
VPAPB ↑↑PHT ↓*PB ↑↑ETS I↓CBZ-E ↑-LTG ↑↑TPM ↓EENE
OXCPB ↑PHT ↑??CBZ ↓-LTG ↓NE??NE?NE?
LTGNENENE-NENENENENE
GBPNENENENE-NENENENENE
TBPPHT ↑NEVPA ↓??NE-?NE?NE?
TGBNENENENENE-NENENENE
LEVNENENENE-NENENE
ZNSNENECBA ↑↓?NENENENE-NE?
VGBPB ↓PHT ↓PRM ↓ PB ↓NECBZ ↑NENENENENENENE-NE
FBMPB ↑↑PHT ↑↑??CBZ ↓ CBZ-E ↑VPA ↑↑NE??NE?-

PB = Phenobarbital; PHT = phenytoin; PRM = Primidone; ETS = Ethosuximide; CBZ = Carbamazepine; VPA = Valproic acid; OXC = Oxcarbazepine; LTG = Lamotrigine
GBP = Gabapentin; TPM = Topiramate; TGB = Tiagabine; LEV = Levetiracetam; ZNS = Zonisamide; VGB = Vigabatrin; FBM = felbamate
H-OXO = 10-hydroxy-oxcarbazepine(active metabolite of OXC); CBZ-E = Cabamazepine 10,11 epoxide
NE = None Expected; * Free (pharmacologically active) concentration may increase; NCCP = not commonly coprescribed; ↔ = No change; ↓ = a minor (or inconsistent) decrease in plasma concentration; 
↓↓ = a clinically significant decrease in plasma concentration;  = a minor (or inconsistent) increase in plasma concentration; ↑ = a clinically significant increase in plasma concentration.  

Source: Patsalos PN, Perucca E (2003) Clinically important drug interactions in epilepsy: general features and interactions between antiepileptic drugs.Lancet Neurol 2 (6):347-56. PMID: 12849151.

http://icnapedia.org/wiki/epilepsy/aed-plasma-concentration-changes
APA Style
Expected changes in plasma concentrations when an AED is added to a pre-existing regimen. (n.d.). In ICNApedia. Retrieved March 25,2017 16:43:36 from http://icnapedia.org/wiki/epilepsy/aed-plasma-concentration-changes
MLA Style
"Expected changes in plasma concentrations when an AED is added to a pre-existing regimen." ICNApedia: The Child Neurology Knowledge Environment, Inc. October 07, 2013. Web. March 25,2017 16:43:36
AMA Style
ICNApedia contributors. Expected changes in plasma concentrations when an AED is added to a pre-existing regimen. ICNApedia, The Child Neurology Knowledge Environment. October 07, 2013. Available at: http://icnapedia.org/wiki/epilepsy/aed-plasma-concentration-changes.Accessed March 25,2017 16:43:36.

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