Epilepsy Drugs

Epilepsy Drugs

CARBAMAZEPINE (Tegretol, Tegretol XR, Carbatrol)

  • Tegretol tab 200 mg, chewtab 100 mg
  • Tegretol XR 100, 200, 400 mg tab
  • Carbatrol 100,200, 300 mg capsule
  • Suspension 100mg/ ml

Used for partial seizures and generalized tonic clonic seizures. It can make absence and myoclonic seizures worse.

Common and rare side effects are summarized in the table.

It induces liver enzymes. The cytochrome P450 enzyme complex is induced by Carbamazepine. Due to this feature, it can cause drug and drug interactions. It can decrease the levels of some medications due to increased metabolism caused by cytochrome p450 enzyme induction. Some of the medications which may decrease due to this interactions are antipsychotics, antifungals, oral contraceptives, neuromuscular blockers, cyclosporine, warfarin, some antiepileptic drugs, theophylline, tricyclic antidepressants, and narcotics.

Certain medications can increase carbamazepine levels resulting in toxicity. Some of these medications are antifungal agents, cimetidine, diltiazem, erythromycin, clarithromycin, fluoxetine, omeprazole, propoxyphene, and verapamil.

Long term side effects are osteoporosis, bone marrow and liver failure, and hyponatremia. Patients on carbamazepine should be encouraged to use Vit D and Calcium supplementation to prevent osteoporosis in the long term. Routine blood tests shoud be performed every 6 months to check liver enzymes, electrolytes, and complete blood cell count as long as one is on this medication.

You can get more information from its official web site: http://www.carbamazepine.com/index.html

OXCARBAZEPINE (TRILEPTAL)

  • Available as Tab 150, 300 and 600 mg, syrup 300mg/5mL

Used for treatment of partial seizures and generalized tonic clonic seizures.

It may make myoclonic and absence seizures worse.

Common and rare side effects are described in the table.

The drug-drug interactions are possible. While some of AEDS such as phenytoin, carbamazepine, phenobarbital, and verapamil lower blood levels of oxacarbazepine, on the other hand oxacarbazepine can lower blood levels of oral contraceptives, felodipine, and lamotrigine.

PHENYTOIN (DILANTIN, PHENYTEK)

  • Cap ER 30 mg, 100 mg
  • Chewtab 50 mg
  • Suspension 125 mg/ ml
  • Fosfenytoin injectable 50 mg PE/mL

Used for treatment of partial seizures and generalized tonic clonic seizures.

It may make myoclonic and absence seizures worse.

Common and rare side effects are in described in the table.

With the long term use osteoporosis is seen. Patients on phenytoin should be placed on Vit D and calcium supplementation to prevent osteoporosis. Other consequences with long term use are cerebellar atrophy, peripheral neuropathy, and folate deficiency.

Drug interactions are seen due to enzyme induction of cytochrome p 450 enzymes in the liver.

Certain medications such as cimetidine, amiodarone, diltiazem, felbamate, flucanazole, fluoxetine, isoniazid, omeprazole, phenobarbital, tcilodipine can increase phenytoin levels.

Phenytoin can lower levels of following medications: Antipsychotics, antifungal agents, carbamazepine, cyclosporine, felbamate, lamotrigine, narcotics, neuromuscular blockers, oral contraceptives, steroids, tiagabine, theophylline, topiramate, tricyclics, valproic acid, and warfarin.

You can gather more information about the drug from this website: http://www.phenytek.com/index2.htm

PHENOBARBITAL

  • Available as Tab 30, 60mg, Elixir 20mg/5mL, Injectable form 200mg/mL

Used for treatment of partial seizures and generalized tonic clonic seizures.

Common and rare side effects are summarized in the table.

Long term side effects are osteoporosis, Dupuytren’s comtracture, frozen shoulder, and decreased libido.

Drug interactions are significant due to induction of cytochrome p 450 enzymes. Phenobarbital can lower levels of antipsychotics, antifungals, oral contraceptives, theophylline, warfarin, tricyclics, steroids, valproic acid, topiramate, phenytoin, felbamate.

Some medications such as phenytoin, valproic acid, and felbamate can increase phenobarbital levels.

VALPROIC ACID (DEPAKOTE, DEPAKENE)

  • Available as
  • Valproic acid ( Depakene): Cap 250 mg, Suspension 250 mg/5 ml
  • Valproate Sodium ( Depacon) Injectable 100 mg/ml
  • Divalproex Sodium ( Depakote) Tab 125, 250, 500 mg Cap 125 mg
  • Depakote ER Tab 250, 500 mg

Used for partial seizures, primary generalized tonic clonic seizures, typical and atypical absences, atonic and myoclonic seizures

Common and rare side effects are summarized in table

Long term potential side effects are weight gain and polycystic ovarian syndrome.

The drug interactions are as follows: Felbamate and fluoxetine can increase levels of valproic acid. Phenobarbital, phenytoin, carbamazepine and lamotrigine can lower levels of valproic acid. It can increase levels of carbamezepine, epoxide, felbamate, lamotrigine, phenobarbital, and free phenytoin levels.

ZONISAMIDE (ZONEGRAN)

  • Available as Cap 25, 100 mg

Used for partial seizures, generalized tonic clonic seizures, and myoclonic seizures

Common and rare side effects are summarized in the table.

Carbamazepine, phenobarbital, and phenytoin can lower zonisamide levels. Grapefuit juice can lower zonisamide levels.

ETHOSUXIMIDE(ZARONTIN)

  • Available as Cap 250 mg/ Syrup 250mg/5 ml

Used for absence seizures.

Gastrointestinal distress, drowsiness, and sleep disturbance are the most common side effects.

Carbamazepine, phenytoin, and phenobarbital can lower ethosuximide levels.

FELBAMATE (FELBATOL)

  • Available as Tab 400 and 600 mg, Suspension 600mg/5 ml

Used for partial seizures, primary generalized tonic clonic seizures, typical and atypical absences, atonic, and myoclonic seizures associated with Lennox-Gastaut syndrome.

Common and rare side effects are summarized in the table.

Felbamate can increase levels of Phenobarbital, phenytoin, valproic acid, and carbamazepine metabolite levels. Phenobarbital, phenytoin, and carbamazepine can lower levels of felbamate.

LAMOTRIGINE (LAMICTAL)

  • Available as Tab 25,100,150,200 mg Chewtabs 2,25mg

Used for partial seizures, primary generalized tonic clonic seizures, typical and atypical absences, atonic and myoclonic seizures associated with Lennox-Gastaut syndrome.

Common and rare side effects are summarized in the table.

Phenytoin, phenobarbital, carbamazepine and primidone, and oral contraceptives can lower lamotrigine levels. Valproic acid can increase lamotrigine levels.

TIAGABINE (GABITRIL)

  • Available as Tab 5,10,15 mg

Used for partial and generalized tonic clonic seizures

Phenytoin, phenobarbital, carbamazepine and primidone can lower tiagabine levels.

Occasionally it can cause spike and wave stupor.

GABAPENTIN (NEURONTIN)

  • Available as Cap 100,300,400 mg

Used for partial seizures.

Not recommended in treatment of primary generalized epilepsy.

No drug interactions have been reported.

PREGABALIN (LYRICA)

  • Available as Cap 25, 50,75,100,150 and 225 mg

Used for treatment of partial seizures.

Not recommended in treatment of primary generalized epilepsy.

Common and rare side effects are summarized in Table.

No reported drug- drug interactions.

LEVETIRACETAM(KEPPRA,KEPPRA XR)

  • Available as 
  • Tab 250,500,750, 1000 mg
  • Keppra XR Tab 500 mg
  • Solution 100mg/mL

Used for partial seizures, primary generalized tonic clonic seizures, typical and atypical absences, and myoclonic seizures

Common and rare side effects are summarized in the table.

No reported drug and drug interactions.

TOPIRAMATE (TOPAMAX)

  • Available as Tab 25, 50, 100, 200 mg Sprinkle 15,25 mg

Used for partial seizures, primary generalized tonic clonic seizures, typical and atypical absences, atonic, and myoclonic seizures associated with Lennox-Gastaut syndrome.

Should not be used in patients with kidney stones.

Common and rare side effects are summarized in the table.

Can decrease levels of oral contraceptives. Phenytoin, phenobarbital, and carbamazepine can lower topiramate levels.

LACOSAMIDE (VIMPAT)

  • Available as Tab 50, 100, 150 and 200 mg and Syrup 10mg/ml

Used to treat partial seizures and secondarily generalized tonic clonic seizures.

Common and rare side effect are summarized in the table.

No reported drugand drug interactions.

RUFINAMIDE (BANZEL)

  • Available as Tab 200, 400 mg

Used to treat partial seizures and seizures with Lennox-Gastaut syndrome.

Common and rare side effects are summarized in the table.

It can decrease levels of carbamazepine and lamotrigine, and can increase phenytoin levels. Its level can be decreased by phenytoin, phenobarbital, and carbamazepine.

Leave a Reply

Your email address will not be published. Required fields are marked *

Copyright © 2011 Epilepsy Doctor. The contents of epilepsyphysician.com are for informational purposes only. The content of this website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. You should always seek the advice of your physician or other qualified health provider with your questions regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the website.