For Anti-Epileptic Drug Dosing in Renal Dysfunction and Dialysis, focus on Topiramate: requires ~50% dose reduction; 70% renally cleared, Ethosuximide/phenobarbital: ~30% renally excreted; extend dosing interval, and Phenytoin: not removed by hemodialysis; supportive treatment for overdose when choosing therapy, counseling about risk, planning monitoring, and deciding when closer follow-up or escalation is needed.

Topiramate: requires ~50% dose reduction, 70% renally cleared; Ethosuximide/phenobarbital: ~30% renally excreted, extend dosing interval; Phenytoin: not removed by hemodialysis, supportive treatment for overdose; Uremia reduces protein binding → higher &quot,free&quot, drug fraction → toxicity at therapeutic total levels; Lamotrigine: 60% protein-bound, hemodialysis significantly drops plasma levels