| Antimicrobial | Anticonvulsant | Antimicrobial Effect | Anticonvulsant Effect |
|---|---|---|---|
| Itraconazole | Carbamazepine | None | ↓ level |
| Phenytoin | ↓ level | ↑ level | |
| Fluconazole | Phenytoin | ↓ level | ↑ level |
| Ketoconazole | Phenytoin | ↓ level | ↑ level |
| Chloramphenicol | Phenytoin | None | ↑ toxicity |
| Clindamycin | Diazepam | None | ↑ effect |
| Doxycycline | Phenobarbital | ↓ absorption, ↓ serum terminal half-life |
↑ level |
| Ciprofloxacin | Phenytoin | None | ↑ or ↓ |
| Isoniazid | Carbamazepine | None | ↑ level |
| Phenytoin | None | ↑ level | |
| Erythromycin | Carbamazepine | None | ↑ level, toxicity |
| Phenytoin | None | ↑ level | |
| Valproate | None | ↑ level | |
| Clarithromycin | Carbamazepine | None | ↑ level, toxicity |
| Phenytoin | None | ↑ level | |
| Valproate | None | ↑ level | |
| Mefloquine | Valproate | None | ↓ level |
| Metronidazole | Phenobarbital | ↓ level | |
| Phenytoin | ↓ level | ||
| Pentamidine | Valproate | ↑ risk of pancreatitis | None |
| Nelfinavir | Carbamazepine | ↓ level | ↑ level |
| Clonazepam | ↓ level | ↑ level | |
| Phenobarbital | ↓ level | ↑ level | |
| Phenytoin | ↓ level | ↑ level | |
| Ritonavir | Carbamazepine | ↓ level | ↑ level |
| Clonazepam | ↓ level | ↑ level | |
| Phenobarbital | ↓ level | ↑ level | |
| Phenytoin | ↓ level | ↑ level | |
| Saquinavir | Carbamazepine | ↓ level | ↑ level |
| Clonazepam | ↓ level | ↑ level | |
| Phenobarbital | ↓ level | ↑ level | |
| Phenytoin | ↓ level | ↑ level | |
| Rifamycins | Phenytoin | None | ↓ level |
| Sulfonamides | Phenytoin | None | ↑ level |
| Sulfamethoxazole- trimethoprim |
Phenytoin | None | ↑ level |
| Zalcitabine (ddC) | Valproate | ↑ risk of pancreatitis | None |
↓= decreased; ↑= increased
Data from P Hantson, F Leonard, JM Maloteaux, P Mahieu. How epileptogenic are the recent antibiotics? Acta Clin Belg 1999; 54: 80-87; DN Gilbert, RC Moellering, MA Sande. Guide to Antimicrobial Therapy. Hyde Park, VT: Antimicrobial Therepy, 2000; 129-133.
