Drug interactions
Carbamazepine + Felbamate
Severity: Moderate
Carbamazepine and Felbamate: 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 reduces felbamate concentrations, while felbamate tends to lower carbamazepine and raise its epoxide metabolite. This can cause toxicity even when carbamazepine levels look low and may reduce seizure control.
What this interaction means in plain words
Carbamazepine and Felbamate 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; Felbamate belongs to Central Nervous System.
Why it happens
Carbamazepine induces CYP3A4 metabolism of felbamate, and felbamate alters carbamazepine metabolism and epoxide clearance.
What to do
Monitor levels of both drugs and signs of toxicity such as dizziness, diplopia and ataxia. Adjust doses and be mindful of felbamate's hematologic and hepatic risks.
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 Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Other interactions of Felbamate
- Felbamate + Ulipristal Major
- Amisulpride + Felbamate Moderate
- Amitriptyline + Felbamate Moderate
- Apalutamide + Felbamate Moderate
- Asenapine + Felbamate Moderate
- Bosentan + Felbamate Moderate
Frequently asked questions
Can I take Carbamazepine with Felbamate?
MediHelp rates the interaction as moderate. Carbamazepine and Felbamate 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 reduces felbamate concentrations, while felbamate tends to lower carbamazepine and raise its epoxide metabolite. This can cause toxicity even when carbamazepine levels look low and may reduce seizure control.
How serious is the interaction between Carbamazepine and Felbamate?
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 levels of both drugs and signs of toxicity such as dizziness, diplopia and ataxia. Adjust doses and be mindful of felbamate's hematologic and hepatic risks.
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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