Drug interactions
Carbamazepine + Lopinavir
Severity: Major
Carbamazepine and Lopinavir: 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
Carbamazepine can lower lopinavir concentrations and risk virologic failure, while lopinavir/ritonavir can raise carbamazepine levels and cause toxicity.
What this interaction means in plain words
Carbamazepine and Lopinavir 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; Lopinavir belongs to Anti Virals.
Why it happens
Carbamazepine induces CYP3A4 while ritonavir-boosted lopinavir inhibits CYP3A4, altering both drugs' clearance.
What to do
Avoid if possible and choose another antiseizure drug. If used together, monitor carbamazepine levels, reduce its dose as needed, and monitor HIV viral load.
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 Lopinavir
- Alfuzosin + Lopinavir Contraindicated
- Avanafil + Lopinavir Contraindicated
- Cisapride + Lopinavir Contraindicated
- Dronedarone + Lopinavir Contraindicated
- Eletriptan + Lopinavir Contraindicated
- Eplerenone + Lopinavir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Lopinavir?
MediHelp rates the interaction as major. Carbamazepine and Lopinavir 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 can lower lopinavir concentrations and risk virologic failure, while lopinavir/ritonavir can raise carbamazepine levels and cause toxicity.
How serious is the interaction between Carbamazepine and Lopinavir?
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 if possible and choose another antiseizure drug. If used together, monitor carbamazepine levels, reduce its dose as needed, and monitor HIV viral load.
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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