From the Research
Combining felbamate, clobazam (Onfi), and brivaracetam with levofloxacin (Levaquin) or cefadroxil may pose significant risks, particularly with levofloxacin, which may lower seizure threshold and increase the risk of adverse effects. When considering the use of antibiotics in patients taking these antiepileptic medications, it is crucial to weigh the potential benefits against the risks of drug interactions.
- The primary concern with levofloxacin is its potential to lower the seizure threshold, which could increase the risk of seizures in patients with epilepsy 1.
- Cefadroxil, on the other hand, generally has fewer interactions with these antiepileptic drugs compared to levofloxacin, making it a potentially safer choice if an antibiotic is needed.
- Clobazam and brivaracetam both have CNS depressant effects that could be additive when combined with antibiotics that cross the blood-brain barrier, potentially leading to increased sedation, confusion, or other adverse effects 2, 3.
- The most recent study on drug interactions highlights the importance of considering pharmacokinetic and pharmacodynamic interactions when combining medications, particularly in patients with epilepsy 4.
- Patients should not adjust their medication regimen without consulting their healthcare provider, who may need to monitor drug levels, adjust dosages, or consider alternative antibiotics depending on the infection being treated.
- Any new symptoms like increased seizure activity, excessive sedation, or confusion should be reported immediately to a healthcare provider.
- In clinical practice, it is essential to prioritize the patient's safety and adjust treatment regimens accordingly, taking into account the potential risks and benefits of combining felbamate, clobazam, and brivaracetam with levofloxacin or cefadroxil 5, 1.