Drug interactions
Carbamazepine + Erythromycin base
Severity: Major
Carbamazepine and Erythromycin base: 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
Erythromycin can markedly raise carbamazepine concentrations and cause toxicity such as dizziness, ataxia, diplopia, and nausea. Carbamazepine may also lower erythromycin levels, reducing antibacterial effect.
What this interaction means in plain words
Carbamazepine and Erythromycin base 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
Erythromycin inhibits CYP3A4 metabolism of carbamazepine, while carbamazepine induces CYP3A4 metabolism of erythromycin.
What to do
Avoid the combination and choose a non-macrolide such as azithromycin if suitable. If used, monitor carbamazepine levels and reduce the dose as needed.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Carbamazepine and Erythromycin base, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Erythromycin base?
MediHelp rates the interaction as major. Carbamazepine and Erythromycin base 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. Erythromycin can markedly raise carbamazepine concentrations and cause toxicity such as dizziness, ataxia, diplopia, and nausea. Carbamazepine may also lower erythromycin levels, reducing antibacterial effect.
How serious is the interaction between Carbamazepine and Erythromycin base?
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 and choose a non-macrolide such as azithromycin if suitable. If used, monitor carbamazepine levels and reduce the dose as needed.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
