Drug interactions
Carbamazepine + Perampanel
Severity: Moderate
Carbamazepine and Perampanel: moderate 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 substantially lowers perampanel levels, potentially weakening seizure control. Perampanel dosing and response should be reassessed when carbamazepine is started or stopped.
What this interaction means in plain words
Carbamazepine and Perampanel can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Carbamazepine belongs to Central Nervous System; Perampanel belongs to Central Nervous System.
Why it happens
Carbamazepine induces CYP3A4, increasing perampanel clearance.
What to do
Titrate perampanel according to clinical response, as enzyme-inducer dosing is typically required, and reassess if carbamazepine is withdrawn. Monitor for seizure breakthrough and for toxicity after any inducer discontinuation.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Perampanel
- Apalutamide + Perampanel Major
- Enzalutamide + Perampanel Major
- Alprazolam + Perampanel Moderate
- Amisulpride + Perampanel Moderate
- Amobarbital + Perampanel Moderate
- Asenapine + Perampanel Moderate
Frequently asked questions
Can I take Carbamazepine with Perampanel?
MediHelp rates the interaction as moderate. Carbamazepine and Perampanel can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Carbamazepine substantially lowers perampanel levels, potentially weakening seizure control. Perampanel dosing and response should be reassessed when carbamazepine is started or stopped.
How serious is the interaction between Carbamazepine and Perampanel?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate perampanel according to clinical response, as enzyme-inducer dosing is typically required, and reassess if carbamazepine is withdrawn. Monitor for seizure breakthrough and for toxicity after any inducer discontinuation.
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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