-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 will affect the metabolism of the Pill are Perampanel, phenobarbitone, phenytoin, carbamazepine and oxcarbazepine. They all decrease the effectiveness of the Pill and will lead to an increase in pregnancies and also an increase in teratogenic effects in the pregnancies.

Drugs that are safe to use in combination with the Pill is Lamotrigine, Valproate, Gabapentin, Leviteracetam and Vigabatrin.

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

Yes, oral contraceptives can decrease the serum levels of drugs such as Lamotrigine and Valproate.

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

Neonates metabolises the drugs slower, thus they should have lower dosages. Kids and children have a faster metabolism and they metabolise the drugs faster, thus they should receive a higher dosage. Geriatric patients have slower metabolism and decreased renal function that is why they should receive lower dosages.

-In which cases is plasma blood level monitoring indicated?   

Where protein binding takes place, this can also be in diseases that affect protein binding. It can include liver diseases, hypoalbuminemia, burns, pregnancy and malnutrition.