Drug interactions
Carbamazepine + Ivosidenib
Severity: Major
Carbamazepine and Ivosidenib: major interaction.
Last updated Sources: EMA SmPC
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 a strong CYP3A4 inducer and can substantially lower ivosidenib exposure, risking loss of antileukemic efficacy. Ivosidenib may also induce CYP3A4 and lower carbamazepine concentrations, potentially reducing seizure control.
What this interaction means in plain words
Carbamazepine and Ivosidenib 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 belongs to Central Nervous System; Ivosidenib belongs to Oncology.
Why it happens
Mutual CYP3A4 induction increases the metabolism of ivosidenib, and ivosidenib may in turn lower carbamazepine levels.
What to do
Avoid the combination and choose a non-inducing antiseizure drug where possible. If it cannot be avoided, monitor clinical response to ivosidenib and carbamazepine serum levels.
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
Other interactions of Ivosidenib
- Alfuzosin + Ivosidenib Major
- Amiodarone + Ivosidenib Major
- Amisulpride + Ivosidenib Major
- Amitriptyline + Ivosidenib Major
- Amobarbital + Ivosidenib Major
- Anagrelide + Ivosidenib Major
Frequently asked questions
Can I take Carbamazepine with Ivosidenib?
MediHelp rates the interaction as major. Carbamazepine and Ivosidenib 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 is a strong CYP3A4 inducer and can substantially lower ivosidenib exposure, risking loss of antileukemic efficacy. Ivosidenib may also induce CYP3A4 and lower carbamazepine concentrations, potentially reducing seizure control.
How serious is the interaction between Carbamazepine and Ivosidenib?
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-inducing antiseizure drug where possible. If it cannot be avoided, monitor clinical response to ivosidenib and carbamazepine serum levels.
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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