Drug interactions
Carbamazepine + Hydrocortisone
Severity: Moderate
Carbamazepine and Hydrocortisone: 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 induces CYP3A4 and can lower hydrocortisone exposure, reducing its glucocorticoid effect. This matters in adrenal insufficiency, where underdosing can precipitate adrenal crisis.
What this interaction means in plain words
Carbamazepine and Hydrocortisone 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; Hydrocortisone belongs to Endocrine.
Why it happens
Carbamazepine induces CYP3A4, increasing hydrocortisone metabolism.
What to do
Watch for loss of corticosteroid effect and increase the hydrocortisone dose as needed, especially in adrenal insufficiency. Reassess the dose 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 Hydrocortisone
- Hydrocortisone + Mifepristone Contraindicated
- Hydrocortisone + Poliovirus vaccine live oral trivalent Contraindicated
- Hydrocortisone + Smallpox vaccine live Contraindicated
- Adenovirus types 4 and 7 live + Hydrocortisone Major
- Aldesleukin + Hydrocortisone Major
- Aspirin + Hydrocortisone 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 Hydrocortisone?
MediHelp rates the interaction as moderate. Carbamazepine and Hydrocortisone 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 induces CYP3A4 and can lower hydrocortisone exposure, reducing its glucocorticoid effect. This matters in adrenal insufficiency, where underdosing can precipitate adrenal crisis.
How serious is the interaction between Carbamazepine and Hydrocortisone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Watch for loss of corticosteroid effect and increase the hydrocortisone dose as needed, especially in adrenal insufficiency. Reassess the dose if carbamazepine is stopped.
What other medicines interact with Hydrocortisone?
MediHelp also lists interactions of Hydrocortisone with, for example, Mifepristone, Poliovirus vaccine live oral trivalent, Smallpox vaccine live. The full list is on the Hydrocortisone page.
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