Drug interactions
Carbamazepine + Cyclosporine
Severity: Major
Carbamazepine and Cyclosporine: 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 strongly induces CYP3A4 and can markedly reduce cyclosporine concentrations, risking graft rejection. Cyclosporine may modestly raise carbamazepine levels.
What this interaction means in plain words
Carbamazepine and Cyclosporine 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 P-glycoprotein, increasing cyclosporine clearance; cyclosporine may inhibit carbamazepine metabolism.
What to do
Monitor cyclosporine trough levels frequently and increase the dose as needed. Monitor carbamazepine levels, and readjust doses if either drug is started or stopped.
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 Carbamazepine with Cyclosporine?
MediHelp rates the interaction as major. Carbamazepine and Cyclosporine 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 strongly induces CYP3A4 and can markedly reduce cyclosporine concentrations, risking graft rejection. Cyclosporine may modestly raise carbamazepine levels.
How serious is the interaction between Carbamazepine and Cyclosporine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor cyclosporine trough levels frequently and increase the dose as needed. Monitor carbamazepine levels, and readjust doses if either drug is started or stopped.
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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