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Rare cases of hepatic fibrosis have been reported, particularly in patients consuming alcohol, which enhances the drug’s conversion to etretinate, a more hepatotoxic metabolite

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Given that the majority of clearance of rufinamide is via a non-CYP-dependent route, the observed decreases in blood levels seen with carbamazepine, phenytoin, phenobarbital, and primidone are unlikely to be entirely attributable to induction of a P450 enzyme