Drug interactions
Carbamazepine + Donepezil
Severity: Moderate
Carbamazepine and Donepezil: moderate interaction.
Last updated
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 is an enzyme inducer and can lower donepezil plasma concentrations, since donepezil is partly metabolized by CYP3A4 and CYP2D6. This may reduce cognitive benefit.
What this interaction means in plain words
Carbamazepine and Donepezil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Carbamazepine belongs to Central Nervous System; Donepezil belongs to Central Nervous System.
Why it happens
Induction of CYP3A4 by carbamazepine increases donepezil clearance.
What to do
Monitor clinical response to donepezil and titrate the dose upward within the labeled range if benefit is lost. Reassess if carbamazepine is stopped.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
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 Donepezil?
MediHelp rates the interaction as moderate. Carbamazepine and Donepezil can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Carbamazepine is an enzyme inducer and can lower donepezil plasma concentrations, since donepezil is partly metabolized by CYP3A4 and CYP2D6. This may reduce cognitive benefit.
How serious is the interaction between Carbamazepine and Donepezil?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor clinical response to donepezil and titrate the dose upward within the labeled range if benefit is lost. Reassess if carbamazepine is stopped.
What other medicines interact with Donepezil?
MediHelp also lists interactions of Donepezil with, for example, Dronedarone, Pimozide, Thioridazine. The full list is on the Donepezil page.
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