Drug interactions
Carbamazepine + Cyclosporin
Severity: Major
Carbamazepine and Cyclosporin: 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 markedly lowers cyclosporine concentrations, which can lead to graft rejection or loss of immunosuppressive control. Cyclosporine may also raise carbamazepine levels in some patients, causing neurotoxicity.
What this interaction means in plain words
Carbamazepine and Cyclosporin 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 belongs to Central Nervous System; Cyclosporin belongs to Miscellaneous.
Why it happens
Carbamazepine induces CYP3A4 and P-glycoprotein, increasing cyclosporine clearance; cyclosporine may inhibit carbamazepine metabolism.
What to do
Avoid the combination where possible; if used, monitor cyclosporine trough levels frequently and increase the dose as needed, and monitor carbamazepine levels and neurotoxicity.
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 Cyclosporin
- Adenovirus types 4 and 7 live + Cyclosporin Contraindicated
- Aliskiren + Cyclosporin Contraindicated
- Bcg vaccine live + Cyclosporin Contraindicated
- Bosentan + Cyclosporin Contraindicated
- Cidofovir + Cyclosporin Contraindicated
- Cyclosporin + Dengue vaccine Contraindicated
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 Carbamazepine with Cyclosporin?
MediHelp rates the interaction as major. Carbamazepine and Cyclosporin 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 lowers cyclosporine concentrations, which can lead to graft rejection or loss of immunosuppressive control. Cyclosporine may also raise carbamazepine levels in some patients, causing neurotoxicity.
How serious is the interaction between Carbamazepine and Cyclosporin?
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 where possible; if used, monitor cyclosporine trough levels frequently and increase the dose as needed, and monitor carbamazepine levels and neurotoxicity.
What other medicines interact with Cyclosporin?
MediHelp also lists interactions of Cyclosporin with, for example, Adenovirus types 4 and 7 live, Aliskiren, Bcg vaccine live. The full list is on the Cyclosporin page.
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