Table 1.

Summary of the pharmacokinetics of antiepileptic drugs

DrugsMetabolismRoute of EliminationRenal Toxicity
Inducers of cytochrome P450 enzymes
 PhenobarbitalInducer of CYP3AHepatic/renalInterstitial nephritis, anemia, hypovitaminosis D
 PhenytoinInducer of CYP3A, metabolized by CYP2C9Renal <5%Acute interstitial nephritis, decrease ADH release
 CarbamazepineInducer of CYP3AHepaticAcute interstitial nephritis, hyponatremia (SIADH)
 LamotrigineInduces CYP34AHepaticAcute interstitial nephritis
 TopiramateWeak inducer of CYP3A4RenalRenal tubular acidosis, nephrolithiasis
Inhibitors of cytochrome P450 enzymes
 ValproateHepatic (CYP450) metabolism, inhibits CYP2C9HepaticTubulointerstitial nephritis, Fanconi syndrome
 FelbamateInhibit CYP450RenalRare incidence of renal stone
No drug interactions
 LevetiracetamNoneRenalHypokalemia, hypomagnesemia
  • CYP, cytochrome p450; ADH, antidiuretic hormone; SIADH, syndrome of inappropriate antidiuretic hormone secretion.