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.