Drug interactions
Carbamazepine + Nimodipine
Severity: Major
Carbamazepine and Nimodipine: major 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 strongly induces CYP3A4 and markedly lowers nimodipine concentrations, which may cause loss of efficacy, including reduced protection against vasospasm after subarachnoid hemorrhage.
What this interaction means in plain words
Carbamazepine and Nimodipine 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; Nimodipine belongs to Cardiovascular.
Why it happens
Carbamazepine induces CYP3A4, increasing nimodipine first-pass and systemic metabolism.
What to do
Avoid the combination where possible and choose a non-inducing anticonvulsant. If it must be used, monitor clinical response and blood pressure closely.
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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Other interactions of Nimodipine
- Apalutamide + Nimodipine Major
- Ceritinib + Nimodipine Major
- Clarithromycin + Nimodipine Major
- Cobicistat + Nimodipine Major
- Darunavir + Nimodipine Major
- Duvelisib + Nimodipine 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 Nimodipine?
MediHelp rates the interaction as major. Carbamazepine and Nimodipine 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 strongly induces CYP3A4 and markedly lowers nimodipine concentrations, which may cause loss of efficacy, including reduced protection against vasospasm after subarachnoid hemorrhage.
How serious is the interaction between Carbamazepine and Nimodipine?
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 and choose a non-inducing anticonvulsant. If it must be used, monitor clinical response and blood pressure closely.
What other medicines interact with Nimodipine?
MediHelp also lists interactions of Nimodipine with, for example, Apalutamide, Ceritinib, Clarithromycin. The full list is on the Nimodipine page.
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