• Which of the anti-epileptic drugs affect the metabolism of the Pill (oral contraceptive) and what are the implications of this? Which drugs are safe to use in combination with the Pill? 

Drugs that affect the metabolism of the pill(oral contraceptive): Carbamazepine, phenytoin, Oxcarbazepine, Topiramate and Phenobarbital. The implication is that it prevents pregnancies and decrease the effectiveness of the pills.

Drugs that are safe to use in combination with the pill: Valproate, Lamotrigine, Gabapentin, Levetiracetam and Vigabatrin. 

• Can oral contraceptives also affect the effectivity of the anti-epileptic drugs?

Yes, Oral contraceptives decreases the levels of the drugs namely: Lamotrigine and Valproate. 

• How does age affect the kinetics of these drugs (from neonates to old age)?

Neonates has slower metabolism and thus small doses should be given. Babies and children have a faster metabolism than adults therefore they jeed to be given higher doses. For elder patients, small dosages are given due to slow metabolism. 

• In which cases is plasma blood level monitoring indicated?

When the drugs contains enzyme inhibiting factors such as Valproate, Phenytoin, Phenobarbital and Lamotrigine. In the drug phenytoin, it is used because of the saturation of metabolism in the liver. Thus, plasma blood level monitoring should be indicated when taking pills.