Drug interactions
Apremilast + Carbamazepine
Severity: Major
Apremilast and Carbamazepine: major interaction.
Last updated Sources: UK SmPC
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Carbamazepine markedly reduces apremilast exposure, which may lead to loss of efficacy in psoriasis or psoriatic arthritis.
What this interaction means in plain words
Apremilast and Carbamazepine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Apremilast belongs to Miscellaneous; Carbamazepine belongs to Central Nervous System.
Why it happens
Carbamazepine induces CYP3A4, increasing apremilast clearance.
What to do
Avoid concurrent use; choose a non-inducing anticonvulsant or another psoriasis therapy.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
- Apremilast 10 mg, 20 mg, 30 mg Film-coated Tablets ( Treatment initiation pack) - SmPC sections 4.3/4.5 (names the partner; "premilast, which may result in a loss of efficacy of apremilast. Therefore, the use of strong CYP3A4 enzyme inducers (e.g. rifampicin, phenobarbital, carbamazep") — electronic medicines compendium (UK SmPC)
Other interactions of Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Other interactions of Apremilast
- Apalutamide + Apremilast Major
- Apremilast + Efavirenz Major
- Apremilast + Enzalutamide Major
- Apremilast + Phenytoin Major
- Apremilast + Rifampicin Major
- Apremilast + Secobarbital Major
Frequently asked questions
Can I take Apremilast with Carbamazepine?
MediHelp rates the interaction as major. Apremilast and Carbamazepine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Carbamazepine markedly reduces apremilast exposure, which may lead to loss of efficacy in psoriasis or psoriatic arthritis.
How serious is the interaction between Apremilast and Carbamazepine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use; choose a non-inducing anticonvulsant or another psoriasis therapy.
What other medicines interact with Carbamazepine?
MediHelp also lists interactions of Carbamazepine with, for example, Artemether / lumefantrine, Cabotegravir, Delamanid. The full list is on the Carbamazepine page.
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