Drug interactions
Carbamazepine + Oxycodone
Severity: Major
Carbamazepine and Oxycodone: 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 lowers oxycodone exposure, which can lead to reduced analgesia and possible opioid withdrawal symptoms. If carbamazepine is stopped, oxycodone levels can rise and cause excess sedation or respiratory depression.
What this interaction means in plain words
Carbamazepine and Oxycodone 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; Oxycodone belongs to Musculoskeletal.
Why it happens
Induction of CYP3A4 (and possibly other enzymes) by carbamazepine increases oxycodone metabolism to noroxycodone.
What to do
Monitor pain control and withdrawal signs and titrate oxycodone upward if needed, or consider an alternative analgesic. When carbamazepine is discontinued or its dose reduced, reduce the oxycodone dose and watch for sedation and respiratory depression.
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 Oxycodone, 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 Oxycodone
- Alvimopan + Oxycodone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Oxycodone Contraindicated
- Isocarboxazid + Oxycodone Contraindicated
- Olanzapine / samidorphan + Oxycodone Contraindicated
- Oxycodone + Phenelzine Contraindicated
- Oxycodone + Sodium oxybate 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 Oxycodone?
MediHelp rates the interaction as major. Carbamazepine and Oxycodone 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 lowers oxycodone exposure, which can lead to reduced analgesia and possible opioid withdrawal symptoms. If carbamazepine is stopped, oxycodone levels can rise and cause excess sedation or respiratory depression.
How serious is the interaction between Carbamazepine and Oxycodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor pain control and withdrawal signs and titrate oxycodone upward if needed, or consider an alternative analgesic. When carbamazepine is discontinued or its dose reduced, reduce the oxycodone dose and watch for sedation and respiratory depression.
What other medicines interact with Oxycodone?
MediHelp also lists interactions of Oxycodone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Isocarboxazid. The full list is on the Oxycodone 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.
