TableĀ 2

Hepatic metabolism of common antiepileptic medications and recommendations in hepatic impairment10

Antiepileptic medicationHepatic metabolismRecommendations in hepatic impairment
Benzodiazepines (clobazam, clonazepam)YesIf treatment is necessary, benzodiazepines with shorter half-lives are safer. Avoid in severe impairment
CarbamazepineYesMetabolism impaired
Eslicarbazepine acetateAvoid in severe impairment
LacosamideNoCaution in severe impairment
LamotrigineYesHalf dose in moderate impairment, quarter in severe impairment
LevetiracetamMinorHalf dose in severe impairment
OxcarbazepineNoCaution in severe impairment
PhenobarbitalYesAvoid in severe liver failure
PhenytoinYesReduce dose to avoid toxicity
RufinamideYesCaution in mildā€“moderate impairment, avoid in severe impairment
Sodium valproateYesAvoid
TopiramateYesUse with caution
ZonisamideYesAvoid in severe impairment