Carbamazepine
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Mood Stabilizer, Anticonvulsant
Carbamazepine
Tegretol
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Effects
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Interactions
Pharmacogenomic + mechanism interactions
Pharmacogenomic guideline recommendationsCPIC and Dutch Pharmacogenetics Working Group clinical guidelines
CPIC rec 8093545 [Strong]: If patient is carbamazepine-naïve and alternative agents are available, do not use carbamazepine. CPIC pair-level A (HLA-A, HLA-B and Carbamazepine and Oxcarbazepine) [PMID 23695185, 29392710]
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Clinical relevance: does this interaction matter in practice?trivialcritical
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CPIC rec 8093545 [Strong]: If patient is carbamazepine-naïve and alternative agents are available, do not use carbamazepine. CPIC pair-level A (HLA-A, HLA-B and Carbamazepine and Oxcarbazepine) [PMID 23695185, 29392710]
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Clinical relevance: does this interaction matter in practice?trivialcritical
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Experience (1 a little, 5 a lot)
Outcome (-100 worst, +100 best)
CPIC rec 8093547 [Strong]: If patient is carbamazepine-naïve, do not use carbamazepine. CPIC pair-level A (HLA-A, HLA-B and Carbamazepine and Oxcarbazepine) [PMID 23695185, 29392710]
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CPIC rec 8093547 [Strong]: If patient is carbamazepine-naïve, do not use carbamazepine. CPIC pair-level A (HLA-A, HLA-B and Carbamazepine and Oxcarbazepine) [PMID 23695185, 29392710]
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Clinical relevance: does this interaction matter in practice?trivialcritical
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CPIC rec 8093554 [Optional]: If patient is carbamazepine-naïve and alternative agents are not available, consider the use of carbamazepine with increased frequency of clinical monitoring. Discontinue therapy at first evidence of a cutaneous adverse reaction. CPIC pair-level A (HLA-A, HLA-B and Carbamazepine and Oxcarbazepine) [PMID 23695185, 29392710]
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CPIC rec 8093554 [Optional]: If patient is carbamazepine-naïve and alternative agents are not available, consider the use of carbamazepine with increased frequency of clinical monitoring. Discontinue therapy at first evidence of a cutaneous adverse reaction. CPIC pair-level A (HLA-A, HLA-B and Carbamazepine and Oxcarbazepine) [PMID 23695185, 29392710]
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CPIC rec 8093564 [Optional]: The latency period for drug-induced SJS/TEN is short with continuous dosing and adherence to therapy (~4-28 days), and cases usually occur within three months of dosing; therefore, if the patient has previously used carbamazepine consistently for longer than three months without incidence of cutaneous adverse reactions, cautiously consider use of carbamazepine in the future. CPIC pair-level A (HLA-A, HLA-B and Carbamazepine and Oxcarbazepine) [PMID 23695185, 29392710]
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Pharmacokinetic mechanismSubstrate / metabolism relationships from primary literature
FDA Drug Interactions Table: strong inducer of CYP3A4.
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Inferred from pharmacokinetic dataMaterialised by the inference engine; provenance shown per row
Carbamazepine induces CYP3A4 (inducer_strong, intensity 90); Midazolam is a substrate_major of CYP3A4 (intensity 80). Derived: Midazolam exposure lowered.
Inferred via Enzyme:CYP3A4 (exposure lowered)
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Confidence in this inference: is the inferred magnitude sound?overstatedsound
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Carbamazepine induces CYP3A4 (inducer_strong, intensity 90); Triazolam is a substrate_major of CYP3A4 (intensity 80). Derived: Triazolam exposure lowered.
Inferred via Enzyme:CYP3A4 (exposure lowered)
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Clinical relevance: does this interaction matter in practice?trivialcritical
Confidence in this inference: is the inferred magnitude sound?overstatedsound
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Summary
Classes
Mood Stabilizer, Anticonvulsant
Common uses
Pharmacy
Pharmacology
Purported mechanism
Sodium channel blocker