Dwayne has recently started on carbamazepine to treat seizures. he comes to see you and you note that while his carbamazepine levels had been in the therapeutic range, they are now low. the possible cause for the low carbamazepine levels include

Carbamazepine is an anticonvulsant sedate used to treat seizures. It is additionally used to treat bipolar turmoil and other psychiatric conditions. The conceivable reason for the low level of Carbamazepine is the auto-initiates digestion, promoting lower levels regardless of good consistency

Tobacco would be the answer . good luck!