What are the enzyme-inducing AEDs?

The four major enzyme-inducing AEDs (carbamazepine, phenytoin, phenobarbital and primidone) stimulate the metabolism and reduce the serum concentration of most other concurrently administered AEDs, most notably valproic acid [23, 24], tiagabine [25], ethosuximide [26], lamotrigine [27, 28], topiramate [29].

What are enzyme-inducing drugs?

Medications which induce liver enzymes include: Antifungals: griseofulvin. Antibiotics: rifampicin and rifabutin. Anti-epileptics: carbamazepine, eslicarbazepine, phenytoin, phenobarbital, primidone, oxcarbazepine, topiramate.

Is topiramate an enzyme inhibitor?

It induces enzymes such as CYP3A4 and inhibits enzymes such as CYP2C19 and those of the beta-oxidation pathway. Topiramate is not devoid of potential interaction properties: it decreases the plasma concentrations of ethinylestradiol, induces CYP3A4 and inhibits CYP2C19.

Is valproate an enzyme inhibitor?

Much of the evidence indicating that valproic acid is an inhibitor of cytochrome P450 enzymes derives from clinical observations. Valproic acid has been reported to inhibit the drug oxidation and elevate the plasma levels of several drugs including phenytoin, phenobarbital, diazepam and lorazepam [9–12].

How does enzyme induction with antiepileptic drugs work?

These agents are well known to reduce the duration and action of many lipid‐ and non–lipid‐soluble drugs, including anticoagulants, cytotoxics, analgesics, antiretrovirals, glucocorticoids, statins, antihypertensives, oral contraceptives, psychoactive drugs, immunosuppressants, and of course, other AEDs.

Can a enzyme inducer be used for epilepsy?

Accordingly, it has been suggested that, given the range of effective and well-tolerated AEDs now available, enzyme inducers perhaps should not be regarded as drugs of first choice in newly diagnosed epilepsy ( Mintzer & Mattson, 2009 ).

How are antiepileptic drugs used in clinical practice?

Antiepileptic drugs (AEDs) are widely used as long-term adjunctive therapy or as monotherapy in epilepsy and other indications and consist of a group of drugs that are highly susceptible to drug interactions.

What are the effects of antiepileptic drugs on liver enzymes?

The study included epileptic patients receiving one of the following antiepileptic drugs (carbamazepine, sodium valproate or phenytoin) from at least 6 months. 2.3. Exclusion criteria