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anticonvulsant medications common drug interactions medication drug interaction carbamazepine increased metabolism of carbamazepine decreased levels with phenobarbital, phenytoin, and valproic acid enhances metabolism of phenobarbital enhances metabolism of primidone into phenobarbital reduces concentration and effectiveness of haloperidol carbamazepine metabolism inhibited by propoxyphene and erythromycin lamotrigine when used concurrently with carbamazepine, may increase levels of 10,11 epoxide an active metabolic of carbamazepine half-life of lamotrigine is reduced to 15 hours when used concurrently with carbamazepine, phenobarbital, or primidone reduces valproic acid concentration phenobarbital increased levels as much as 40 of phenobarbital when valproic acid administered concurrently phenobarbital levels may be increased when concurrently administering phenytoin phenobarbital has a variable reaction with phenytoin levels phenytoin phenytoin levels may increase with concurrent use of chloramphenicol, cimetidine, dicumarol, disulfiram, isoniazid, and sulfonamides free phenytoin levels may increase with concurrent use of valproic acid and phenylbutazone decreased total levels of phenytoin may occur with sulfisoxazole, salicylates, and tolbutamide decreased phenytoin levels with concurrent use of carbamazepine decreased carbamazepine levels with concurrent use of phenytoin increased or decreased levels of phenytoin when concurrently administered with phenobarbital when concurrently used with theophylline, phenytoin levels may be lowered and theophylline metabolized more rapidly may decrease effectiveness of oral contraceptives enhances metabolism of corticosteroids valproic acid increases level of phenobarbital inhibits metabolism of phenytoin rare development of absence status epilepticus associated with concurrent use of clonazepam reprinted with permission from rosenthal et al.

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