Drug interactions
Carbamazepine + Mefloquine
Severity: Major
Carbamazepine and Mefloquine: 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 is a strong CYP3A4 inducer and can lower mefloquine concentrations, risking loss of antimalarial protection. Mefloquine may also lower anticonvulsant control by lowering the seizure threshold, which is relevant in patients with epilepsy.
What this interaction means in plain words
Carbamazepine and Mefloquine 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; Mefloquine belongs to Anti Parasitic.
Why it happens
Carbamazepine induces CYP3A4, increasing mefloquine clearance; mefloquine may also lower the seizure threshold.
What to do
Avoid mefloquine in patients with epilepsy and choose an alternative antimalarial. If it cannot be avoided, monitor for seizures and malaria breakthrough and check anticonvulsant 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 Mefloquine
- Arsenic trioxide + Mefloquine Contraindicated
- Dronedarone + Mefloquine Contraindicated
- Ibutilide + Mefloquine Contraindicated
- Levoketoconazole + Mefloquine Contraindicated
- Mefloquine + Nilotinib Contraindicated
- Mefloquine + Pimozide Contraindicated
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 Mefloquine?
MediHelp rates the interaction as major. Carbamazepine and Mefloquine 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 lower mefloquine concentrations, risking loss of antimalarial protection. Mefloquine may also lower anticonvulsant control by lowering the seizure threshold, which is relevant in patients with epilepsy.
How serious is the interaction between Carbamazepine and Mefloquine?
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 mefloquine in patients with epilepsy and choose an alternative antimalarial. If it cannot be avoided, monitor for seizures and malaria breakthrough and check anticonvulsant levels.
What other medicines interact with Mefloquine?
MediHelp also lists interactions of Mefloquine with, for example, Arsenic trioxide, Dronedarone, Ibutilide. The full list is on the Mefloquine page.
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