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Effect of Felbamate on Phenytoin and Carbamazepine Serum Concentrations

Summary: Felbamate (FBM) is a novel antiepileptic drug (AED) undergoing clinical trials in the United States. During a double‐blind, cross‐over clinical trial, patients received concomitant phenytoin (PHT) and carbamazepine (CBZ). Dosages of PHT and CBZ were adjusted to maintain serum concentrations ±20 and ±25% of baseline values. All patients required a PHT dosage decrease of 10–30% during active FBM treatment to maintain stable concentrations. CBZ serum concentrations decreased significantly in patients receiving active FBM. The mean decrease was 1.3 u.g/ml and occurred in 30 of 32 patients. Therefore, FBM apparently causes a bidirectional effect on the serum concentrations of PHT and CBZ when all three drugs are taken concomitantly.