Seizure medications

Anticonvulsants and pharmacogenetics

Also known as: Antiepileptics, Seizure medications

5 medications 6 brand products HLA-BCYP2C9CYP2C19

Why pharmacogenetics matter for anticonvulsants

Anticonvulsants treat epilepsy, bipolar disorder, trigeminal neuralgia, and neuropathic pain. The most consequential pharmacogenetic signal in this class is not about metabolism but about hypersensitivity: HLA-B*15:02 carriers have a dramatically elevated risk of Stevens-Johnson syndrome on carbamazepine and oxcarbazepine, and the FDA recommends pre-treatment screening in at-risk populations. Phenytoin and fosphenytoin also have CYP2C9-related dose considerations.

HLA-B*15:02 is common in people of East and Southeast Asian descent and rare elsewhere. Many US health systems now screen automatically when carbamazepine is ordered for patients from these populations.

Key genes in this class

HLA-B

Human Leukocyte Antigen B

HLA-B variants don't affect how drugs are metabolized. They affect your immune system's reaction to them. Specific HLA-B alleles are strongly linked to severe skin reactions to drugs like abacavir …

CYP2C9

Cytochrome P450 2C9

CYP2C9 metabolizes warfarin, phenytoin, celecoxib, and some NSAIDs. Variants that reduce its activity are most consequential for warfarin, where even small changes in drug clearance translate into very different doses …

CYP2C19

Cytochrome P450 2C19

CYP2C19 handles several SSRIs (citalopram, escitalopram, sertraline), proton pump inhibitors (omeprazole, esomeprazole), and the blood thinner clopidogrel. About 2 to 5 percent of people of European descent and 15 to …

Medications in this class with pharmacogenetic guidelines

Each link goes to the drug's full pharmacogenetics page with CPIC and FDA phenotype recommendations.

Brivaracetam CYP2C19 Carbamazepine HLA-B Clobazam CYP2C19 Fosphenytoin CYP2C9 / HLA-B Phenytoin CYP2C9 / HLA-B

Brand products in the Seizure medications class

Combined products and brand names for the medications above. Each links to a pharmacogenetic breakdown.

Which seizure medications is right for your genetics?

This page covers the pharmacogenetics of anticonvulsants in general. A Gene2Rx report tells you how your personal genotype interacts with every drug on this page.

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Informational only, not medical advice. Pharmacogenetic guidelines describe population-level patterns that inform prescribing decisions. Never start, stop, or change a medication without talking to your prescribing clinician.