If carbamazepine is added to valproate, which side effect of valproate can increase?: (A) Thrombocytopenia, (B) Hepatotoxicity, (C) Hyperammonemia, (D) Pancreatitis
Answer is B. Valproate is metabolized by cytochrome P450 and produce a metabolite which is hepatotoxic Carbamazepine is enzyme inducer which cause the induction of its metabolism and produce more metabolite, thus causing hepatotoxicity