Unfortunately, many medicines for epilepsy can interact with common prescription and over-the-counter medicines. Epilepsy drugs can prevent some medicines from working normally, and other medicines can have the same effect on epilepsy drugs. Either situation can be dangerous.
"There are just so many possible drug interactions with epilepsy medications," says John M. Pellock, MD, spokesman for the American Epilepsy Society and chairman of child neurology at Virginia Commonwealth University. "You couldn't list them all." So the key is to talk openly with your doctor about any possible risks in your case.
Experts suggest the following for avoiding drug interactions with epilepsy drugs.
- Be honest. Tell your doctor, dentist, and pharmacist about all the medicines, supplements, vitamins, and herbs you use. Go into appointments with a list so you don't forget anything.
- Don't assume that "natural" means safe. Many herbal medicines and supplements can interact with medicines for epilepsy. "For instance, St. John's wort can interact with several anticonvulsant medicines," says Pellock.
- Be careful with birth control pills. Some medicines for seizures can prevent birth control pills from working. Epilepsy drugs known to have this effect include Carbatrol, Dilantin, phenobarbital, Mysoline, Trileptal, and Topamax.
- Take special precautions if you're older. Older people are not only more likely to have epilepsy than other adults, but they're also more likely to be on long-term medication for other conditions like high blood pressure, diabetes, or heart problems. That increases your risk of interactions.
- Watch your diet. Oddly enough, some foods -- like grapefruit -- can interact with epilepsy medicines. Ask your doctor for a list of any foods you should avoid.
More generally, you should not make radical changes to your eating habits. "Some of these popular diets can cause havoc in people with epilepsy," says Pellock. "That's not just from the weight loss, but from the extreme diet changes they make to achieve it."
- Keep your doctor up to date. If you need to start taking medicines for another condition -- or have to change any of your doses -- talk to your doctor before you start.