Highlights Common etiology for carbamazepine (CBZ) toxicity is coadministration of other medications such as levetiracetam (LEV). Adjuvant use of antiepileptic drugs with varying mechanisms of action is the mainstay in refractory epilepsy management. This study showed that neither CBZ, nor LEV treatment is devoid of hepatotoxicity. The adverse effects in CBZ were greater than LEV, or CBZ + LEV adjunctive treatment.