Abstract Treatment of epilepsy is often a lifetime. Several studies report the effect of anti epileptic drug (AED) to lipid profile. This study aims to assess the differences of lipid profile of epileptic patients receiving CYP-450 enzyme inducer and inhibitor monotherapy AED. This study was conducted in cross-sectional terms with consecutive sampling, from JuneOctober 2019, at Wahidin Sudirohusodo Regional Hospital, Hasanuddin University Hospital, and private practice. The independent variable were AEDs, consist of phenytoin, phenobarbital, carbamazepine, or valproic acid, while the dependent one was the lipid profile. Thirty-five samples were obtained using CYP-450 enzyme inducer AED, consisted of 11 samples using phenytoin, 11 samples using phenobarbital, 13 samples using carbamazepine, and 16 samples using CYP-450 enzyme inhibitor AED (valproic acid). The results showed higher level of total cholesterol, Low Density Lipoprotein (LDL), and High Density Lipoprotein (HDL) in the CYP-450 enzyme inducer AED group than the CYP-450 inhibitor one; there was no difference of triglyceride (TG) level, while higher level was shown in the CYP-450 enzyme inducer AED group.