Drug interactions
Carbamazepine + Mifepristone
Severity: Major
Carbamazepine and Mifepristone: 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 induces CYP3A4 and can lower mifepristone exposure, which may reduce its efficacy. Mifepristone, in turn, inhibits CYP3A4 and may raise carbamazepine concentrations, although induction is the more clinically important effect.
What this interaction means in plain words
Carbamazepine and Mifepristone 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; Mifepristone belongs to Endocrine.
Why it happens
Carbamazepine induces CYP3A4 metabolism of mifepristone, while mifepristone inhibits CYP3A4 and can reduce carbamazepine clearance.
What to do
Avoid the combination where possible, particularly when mifepristone is used for Cushing syndrome. If unavoidable, monitor clinical response and carbamazepine levels and adjust doses accordingly.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Carbamazepine and Mifepristone, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Mifepristone
- Apixaban + Mifepristone Contraindicated
- Argatroban + Mifepristone Contraindicated
- Cisapride + Mifepristone Contraindicated
- Cortisone + Mifepristone Contraindicated
- Cyclosporin + Mifepristone Contraindicated
- Dabigatran etexilate + Mifepristone Contraindicated
Frequently asked questions
Can I take Carbamazepine with Mifepristone?
MediHelp rates the interaction as major. Carbamazepine and Mifepristone 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 induces CYP3A4 and can lower mifepristone exposure, which may reduce its efficacy. Mifepristone, in turn, inhibits CYP3A4 and may raise carbamazepine concentrations, although induction is the more clinically important effect.
How serious is the interaction between Carbamazepine and Mifepristone?
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 where possible, particularly when mifepristone is used for Cushing syndrome. If unavoidable, monitor clinical response and carbamazepine levels and adjust doses accordingly.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
