Carbamazepineserum levels are reduced to some extent by the concurrent use of phenobarbital, but the levels of its active metabolite are unchanged; seizure control remains unaffected. Primidone seems to interact similarly. In children, phenobarbital clearance is decreased by carbamazepine. This interaction seems to be of little clinical importance as seizure control is not affected. However, it would be prudent to monitor phenobarbital levels in children also given carbamazepine as changes in clearance may affect dose requirements.
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