Drug interactions
Bictegravir + Carbamazepine
Severity: Major
Bictegravir and Carbamazepine: major interaction.
Last updated Sources: US FDA label
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 can substantially lower bictegravir concentrations, risking virologic failure and resistance. Bictegravir-containing regimens should not be used with strong inducers.
What this interaction means in plain words
Bictegravir 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.
Why it happens
Carbamazepine induces CYP3A4 and UGT1A1, increasing bictegravir clearance.
What to do
Avoid the combination; use a non-inducing anticonvulsant or a different antiretroviral regimen, and monitor HIV RNA if exposure occurs.
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
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
Frequently asked questions
Can I take Bictegravir with Carbamazepine?
MediHelp rates the interaction as major. Bictegravir 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 can substantially lower bictegravir concentrations, risking virologic failure and resistance. Bictegravir-containing regimens should not be used with strong inducers.
How serious is the interaction between Bictegravir 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 the combination; use a non-inducing anticonvulsant or a different antiretroviral regimen, and monitor HIV RNA if exposure occurs.
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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