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?

1. Phenobarbital
2. Oxacarbezpine
3. Topiramate
4. Carbamazepine
5. Phenytoin

Oral contraception effectiveness is reduced by these medications. The following drugs are safe to take with the Pill: Valproate, Lamotrigine, Gabapentin, Levetiracetam and Vigabatrin.

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

Yes. Valproate and lamotrigine plasma concentrations are reduced by oral contraceptives.

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

The metabolism of these drugs is slow in neonates. In children, these drugs are metabolized faster than in adults. Since elderly people's kidney function is impaired, they should be given a lower dose.

In which cases is plasma blood level monitoring indicated?

1. During pregnancy
2. When breakthrough seizures occur
3. To guide dose adjustment
4. When an interacting medication is added or removed from the patient's regime 
5. To assess adherence
6. To determine whether adverse effects are related to drug levels.